It’s a pretty violent action. Your esophagus and stomach are mostly designed as a one way street. It takes a lot of muscle contraction to push everything up and out. It’s also something that’s usually unfamiliar for most people. An average person might puke once a year or once every few years even? A person who throws up more frequently can probably more consistently do it quietly. I believe there are people with bulimia who are so adept at throwing up that essentially no one can tell.
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