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Out With It
Eat so many Tricky Treats that you get an upset tummy.
Out With It is a 10-point Hallow's End achievement earned by eating enough 
Tricky Treats to make your character vomit.
Eat Tricky Treats Repeatedly
Continuously eat Tricky Treats, using one each time the global cooldown expires. The number required is random, but it typically takes fewer than 5 to trigger the upset tummy effect and complete the achievement.
Tips
Tricky Treats are also used to purchase items for other Hallow's End achievements such as A Mask for All Occasions, so avoid eating your entire stockpile if you are working on those as well.