History of Eating Disorders

Eating Disorders Throughout History

• Eating disorders have been documented throughout history, although their manifestations may have varied due to cultural and societal influences.

Ancient Times

• In the Hellenistic and medieval periods, purification through fasting and self-denial was a common cultural theme.
• Ascetic practices, including extreme fasting, were sometimes pursued to dangerous extremes, leading to cases of anorexia nervosa.
• These practices were primarily observed among women, earning the term "holy anorexia" by some contemporary authors.

Renaissance and Early Modern Eras

• In the 17th century, English physician Richard Morton presented two cases resembling modern-day anorexia nervosa, noting the absence of a physical explanation for their weight loss.
• By the mid-19th century, physicians such as Sir William Gull and Ernest Charles Lasegue coined the terms "anorexia nervosa" and "anorexie hysterique," although motivations for food refusal may have differed across time periods.

20th Century

• Anorexia nervosa gained more recognition in the early 20th century, with influential contributions from Hilde Bruch and others advancing its understanding.
• In the late 20th century, bulimia nervosa emerged as a distinct disorder, characterized by binge eating followed by purging behaviors.
• Binge eating disorder was first described in the 1950s, with its diagnostic criteria refined in subsequent decades.

Diagnostic Classification

• Eating disorders were gradually incorporated into diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM).
• Initially classified as a psychophysiologic gastrointestinal reaction, anorexia nervosa was later assigned its own category.
• Bulimia nervosa was incorporated into the DSM in the 1980s, and binge eating disorder was recognized as an independent diagnosis in 2013.

Contemporary Understanding

• Eating disorders are now recognized as complex illnesses influenced by genetic, psychological, and environmental factors.
• They affect individuals of diverse backgrounds, ages, and body types.
• Treatment typically involves a combination of psychotherapy, medication, and nutritional counseling.

Conclusion

• The history of eating disorders reveals their enduring presence across cultures and time periods.
• Our evolving understanding of these illnesses has led to more comprehensive diagnostic criteria and effective treatment approaches.
• Ongoing research continues to shed light on the causes and pathways to recovery from eating disorders.