While the intent of Thanksgiving is a day to give thanks, it is really a day of celebrating gluttony for most Americans. It’s estimated that the average American eats more than 4,500 calories on Thanksgiving Day. Considering an average diet should consist of around 2,000 calories (less than that for most women), this is more than twice the daily calorie allowance for the average person.

Eating this much means that feeling full is bound to happen – maybe even feeling like your stomach is going to burst. A stomach fills up on about one to one-and-a-half liters of food and liquids at any one time. To put it in perspective, there are only four cups in a liter. Your Thanksgiving dinner plate probably holds more than four cups of food, and you haven’t even eaten dessert yet. This is the point when you will feel uncomfortably full.

The stomach can hold about a gallon of food before your gag reflex kicks in and you’ll vomit because the stomach just can’t hold any more food. However, some people don’t have this reaction, typically as a result of a history of disordered eating causing a stretched-out stomach and their brain having learned to ignore the gag reflex signal.

So this begs the obvious question: could a stomach actually burst from overeating?

If we look at reports, there have been cases of patients whose stomachs ruptured and killed them. In 2003, a Japanese case reported that a 49-year-old man was found dead in a public bathroom, and the autopsy showed rupture wounds in the stomach despite no other trauma to the area. He also had an ulcer, which meant the stomach couldn’t expand as much in that area. The cause of death was suspected to be excessive over-eating that caused the stomach to expand so much it ruptured.

When the stomach ruptures, a hole is formed. This open hole lets out the stomach contents into the abdominal cavity where it results in infection and requires surgical intervention. The medical term for this is gastrointestinal perforation, and it’s almost always not caused simply by overeating. Instead, it’s a result of other illnesses like appendicitis, diverticulitis, stomach ulcer, gallstones, IBS, cancer, or trauma such as a gunshot wound or abdominal surgery. Symptoms of gastrointestinal perforation include abdominal pain, vomiting, and running a fever.

The good news is the cause of gastrointestinal perforation has never been reported as eating too much on Thanksgiving. So you can go ahead and enjoy all the delicious food, but listen to your body’s cues and if you get to the point of throwing up, it’s definitely time to stop eating.