There are cases of people who’ve fatally ruptured their stomach from eating enormous amounts of food in a short period of time.

The “600 Pound Life” subjects apparently have not suffered this fate.

But this isn’t just about the subjects on TLC’s “My 600 Pound Life,” but it also applies to any super morbidly obese man or woman.

According to one reputable news outlet, 600-pound Donna Simpson from New Jersey ate 30,000 calories in two hours. No stomach rupture, despite eating in that span of time:

• Two 25-pound turkeys
• Two 15-pound hams
• 15 pounds of potatoes

And that wasn’t all, so how is it that her stomach didn’t rupture?

Same with Paul Mason, at one point 900 pounds, who claimed to eat 20,000 calories a day.

Is it only a myth that eating too much can fatally rupture one’s stomach?

This is not myth. It has happened—but not to the people you’d first imagine would suffer this fate.

So the question isn’t CAN overeating rupture the stomach and kill a person.

The question is: “Why don’t more super morbidly obese people, such as those on ‘My 600 Pound Life’ who eat staggering amounts of food, suffer a stomach rupture?”

Four Conditions that Cause Enormous Caloric Consumption at One Sitting

• Binge eating disorder

• Compulsive overeating disorder

• Bulimia nervosa

• Prader-Willi syndrome

As much as people like Simpson and Mason eat at one sitting, and as much as a bulimic will eat, they will stop when the fullness in their stomach becomes intolerable.

“According to the literature, it is very rare to rupture one’s stomach (gastric rupture). I do not know the exact statistics,” says Linda Centeno, PhD, clinical psychologist, and assistant director of the Koch Center in NJ that specializes in eating disorder treatment.

What is Prader-Willi syndrome?

• Genetic, incurable disorder characterized by a never-ending feeling of starvation no matter how much the patient eats.

• The continuous feeling of starvation drives patients to seek food in dumpsters, steal food, eat spoiled food or rotten meat, and even eat flour, cake mix from the box, vegetable oil, dog food and even cardboard.

• If left alone with unlimited food, the patient will eat until sickness from the massive overeating incapacitates them.

• To protect against overeating, patients must live in very controlled environments where food is locked up (padlocks on cupboards, pantry and refrigerator); motion detectors and other alarms are necessary to alert caretakers of attempts to leave the home in search of food.

There are multiple case reports of people with PWS suffering a fatal stomach rupture due to overeating.

• Male, 17, 138 pounds, BMI 22, binged during a holiday.
• Male, 24, 179 pounds, BMI 27.
• Male, 22, 117 pounds.
• Male, 49, 240 pounds, BMI 50.

A very striking feature with two of these cases is low body weight. PWS patients have very short stature, but even when this is considered, 138 pounds is a healthy weight with its BMI of 22. And 117 pounds on a short frame is still reasonable.

A BMI of 27 for the 179 pound patient is in the overweight range, and a BMI of 50 is obese.

An obese person’s chronically-stretched-out stomach, to put it simply, is trained to handle huge quantities of food over a short period of time.

A person who’s never been obese — such as a Prader-Willi patient who’s always lived in a strictly controlled environment — or a PWS patient who has lost a large amount of weight and is now trimmed down – is at higher risk for a stomach rupture from binge eating.

“…alteration in stomach muscle integrity from weight loss may have been a predisposing factor” in PWS patients who’d suffered gastric perforation, says a report in the Journal of Pediatric Gastroenterology and Nutrition. “…individuals with PWS with recent weight loss or with a more ideal body weight may be at greater risk for gastric dilatation and perforation.”

Their smaller stomach organ—which is used to normal food portions—just cannot handle the unexpected influx of food during a massive binge, and is hence more prone to acute damage.

People on “My 600 Pound Life,” however, have a “trained” stomach muscle. It’s had years of practice at handling increasing amounts of food over time.

People don’t start out in life weighing 600 pounds. Many of these patients were overweight in childhood, and as they grew up and into young adulthood, they continued to gain weight as they increased food intake—giving their stomachs plenty of time to adapt.

So a 30,000 calorie binge of Simpson’s is no shock to her stomach. Furthermore, in non-PWS patients like Simpson and Mason who binge eat, there’s a lower threshold for stomach pain and vomiting which results from excess food filling the stomach.

When these occur in the non-PWS binge eater, they stop eating, which is a point well below the conditions necessary for stomach rupture. Think of it as a built-in warning.

Prader-Willi patients have a higher threshold for stomach pain and vomiting, which is much closer to that point when a gastric perforation is imminent.

This is why it’s dangerous to leave them alone in a well-stocked kitchen with access to food — there truly is a risk of fatal stomach rupture.

Dr. Centeno works with adolescents and adults. In her private practice her specific clinical expertise also includes anxiety and panic disorder, depression, relationship issues and sexual abuse.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.