Rumination Disorder

Rumination disorder is a feeding and eating disorder defined in the DSM-5-TR by repeated regurgitation of food over a period of at least one month. Regurgitated food is food that is re-chewed, re-swallowed, or spat out. The behavior is not attributable to an associated gastrointestinal or other medical condition, and does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or ARFID. When rumination occurrs in the context of intellectual developmental disorder or another neurodevelopmental disorder, symptoms should be severe enough to warrant additional clinical attention (American Psychiatric Association, 2022). Rumination disorder reflects a learned disruption of post-meal digestive and interoceptive regulation not explained by a medical condition.

In nutritional psychology, rumination disorder is significant because repeatedly occurring after a meal results in weight loss, faltering growth, dental erosion, and electrolyte disturbance. It also establishes a conditioned association between eating and aversive post-ingestive experience that drives meal avoidance and withdrawal from shared eating. It is important to note that first-line management is behavioral rather than pharmacological, with diaphragmatic breathing the most widely used intervention, typically combined with other therapeutic strategies (Sartori et al., 2024).