A safer road to relief is to drink a few sips of something carbonated. Or to swallow some air. People who swallow air chronically—aerophagia is the clinical term—are known among gastroenter-ologists, or one of them anyway, as “belchers.” “You see a lot of belchers,” says Mike Jones. “They do this hard swallow, where they’re gulping air. It’s like this nervous tic. Probably two-thirds of them are totally unaware that they’re doing it. You watch them do it right in front of you, and they’re going, ‘Doc, I’m belching, and I can’t understand it.’”
In addition to the social side effects, chronic belching splashes the esophagus with an excess of gastric acid, which sloshes out of the stomach along with the gas. If this happens too much or too often, the acid burns the esophagus. Now you have another reason to visit Dr. Jones: heartburn. How much acid exposure is “too much”? More than about an hour a day, according to research by David Metz, the University of Pennsylvania gastroenterologist we met in the previous chapter. That’s the cumulative time each day that the normal esophagus is exposed to gastric acid. (People with gastric reflux spend far more time bathing their pipes in acid; in their case the sphincter may be leaky.)
One of the surgical treatments for chronic gastric reflux, called fundoplication, occasionally creates problems with belching. Now you really, really need to keep away from the bicarbonate of soda. “I know a case, this was fifteen years ago, where the man ate a huge meal and then took an inordinate amount of Alka-Seltzer.” Jones made an exploding sound into the telephone.[64] “It was like that Monty Python sketch, the Wafer-Thin Mint, where the guy is gorging himself and finally he goes, ‘I’ll just have this one wafer-thin mint….’”
IF A WOMAN’S abdomen is stretched so far that her belly button is inside out, it is usually safe to assume she is pregnant. The woman wheeled into the emergency room of the Royal Liverpool Hospital at 4 A.M. on an unspecified date in 1984 was an exception. She turned out to be carrying a meal. As dinners go, this was triplets: two pounds of kidneys, one and a third pounds of liver, a half pound of steak, two eggs, a pound of cheese, a half pound of mushrooms, two pounds of carrots, a head of cauliflower, two large slices of bread, ten peaches, four pears, two apples, four bananas, two pounds each of plums and grapes, and two glasses of milk. Nineteen pounds of food. Though her stomach eventually ruptured and she died of sepsis, the organ heroically held out for several hours. Likewise, recall the other bulimic—the model with the badly chewed hotdogs and broccoli. She died of asphyxia; the stomach never actually ruptured.
Clearly some stomachs hold more than a gallon.
The only human to have come close to the poundage record set by the Liverpudlian is Takeru Kobayashi, who consumed eighteen pounds of cow brains in an eating competition. Kobayashi had a fifteen-minute time limit. Presumably he’d have bested, or worsted, or wursted, nineteen pounds had the timer not gone off. Most food records are not measured in pounds, so it is hard to know how many others have come close. Ben Monson, for instance, consumed sixty-five Mexican flautas. Who knows what the freightage was on that. I never before noted the similarity between flautas and flatus, but I bet Ben Monson has.
Bulimic models and professional eaters are career bingers. They challenge the body’s limits on a regular basis. Here is my question: Is the ability to eat to extremes a matter of practice, or are some stomachs—and I’m not saying anything here about my husband Ed—naturally more compliant?
In 2006, medical science took a look. David Metz observed the stomachs of a competitive eater—Tim Janus, then ranked number 3 on the circuit, under the name Eater X—and a six-foot-two, 210-pound control subject, while the men spent twelve minutes eating as many hotdogs as they could. A side of high-density barium enabled Metz to follow the wieners’ progress via fluoroscope. Metz had a theory I hadn’t considered: that prodigious eaters were people with faster-than-normal gastric emptying times. In other words, their stomachs might be making more room by quickly dumping food out the back door into the small intestine. The opposite turned out to be true. After two hours, Eater X’s stomach had emptied only a fourth of what he’d eaten, whereas the control eater’s stomach, more in keeping with a typical stomach, had cleared out three-fourths.
Somewhere into the seventh dog, the control eater reported to Metz that he would be sick if he ate another bite. His stomach, on the fluoroscope, was barely distended beyond its starting size. Eater X, by contrast, effortlessly consumed thirty-six hotdogs, taking them down in pairs. His stomach, on the fluoroscope, became “a massively distended, food-filled sac occupying most of the upper abdomen.” He claimed to feel no pain or nausea. He didn’t even feel full.
But the question remains: Are prodigious eaters born with a naturally compliant stomach, or do they alter the organ over years of incremental stretching—the digestive version of the tribal lip plate? Is the lack of discomfort there from the start, or does it come from habitually overriding the brain’s signals? The implication, for the rest of us, being that the more you overeat, the more you overeat.
By happenstance, a friend of mine is acquainted with Erik Denmark—aka Erik the Red, ranked number 7 nationally—and offered to put us in touch. (The two had met on the set of dLifeTV, a show about living with diabetes. That a diabetic man holds the record for fry-bread consumption is yet one more mystery of professional eating.) I asked Denmark, Is the successful glutton born or built? Both, it seems. Denmark recalled visits to McDonald’s as a child, where he would finish, by himself, the twenty-piece family box of Chicken McNuggets. But Metz had the impression, based on conversations with Eater X, that nature trumped nurture. “It’s a structural thing,” he told me. “At rest their stomachs are not much bigger, but their ability to receptively relax is unbelievable. The stomach just expands and expands and expands.”
Though Denmark agrees with Metz that genes matter—as he puts it, “very few people could eat sixty hotdogs no matter how hard they worked at it”—he considers the inherently stretchy stomach merely the foundation, the starting point, for a career that requires daily practice and training. “I think,” he told me, “that it has more to do with how much you’re willing to push your body past the point that you would ever want to go.” Despite his natural assets, Erik the Red did not hit the ground running. At his first competition, he put away just under three pounds to the winner’s six pounds. (In relating the story, Denmark does not bother to mention what the food had been. It doesn’t seem to matter. Flavor fatigue sets in after three to five minutes; beyond that point everything is more or less equally revolting.)[65]
I asked Denmark why the body’s safety mechanisms, specifically regurgitation, don’t kick in. In fact, they do. “This is going to sound gross,” he said, “but you just, you know, like, swallow it down and keep eating.” Major-league eating judges define regurgitation as the point at which food comes out, not up. “It’s like a speed bump that you just go over. It’s mental.” Yes.
All competitive eaters follow a conditioning regimen. The cheapest and least fattening training material is water. Denmark can water-load about two gallons at a sitting. When he began his career, he could barely get through one. As a point of reference—and warning—recall that one gallon was the point at which Key-Åberg’s cadavers’ stomachs began to rupture. Part of this training is psychological. In addition to stretching the stomach, water-loading gets the competitor accustomed to the feeling of being grotesquely full.
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Though you do read case reports in which patients say they heard a bursting noise, the experience is more often described as a sensation, as in “a sensation of giving way.” The “sudden explosion” recalled by a seventy-two-year-old woman following a meal of cold meat, tea, and eight cups of water was more likely something she felt, not heard. (The old eight-cups-of-water-a-day advice should possibly be qualified with the clause, “but not all at once.”)
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With one exception. While the consumption record for many foods exceeds eight and even ten pounds, no one has ever been able to eat more than four pounds of fruit cake.