When did eating disorders first appear? (2023)

Given the current sociocultural fixation on thinness, one might reasonably conclude that eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are relatively new phenomena. However, historical evidence shows that eating disorders have been around for quite some time — albeit perhaps in slightly different forms.

The historical record

The earliest historical descriptions of people with symptoms consistent with modern eating disorders come from the Hellenistic (323 BCE-31 BCE) and Medieval (5th–5th century BCE) periods^th-fifteen^thcentury AD).

There is an account of a twenty year old upper class Roman girl starving herself to death in search of holiness. There are other reports from the Middle Ages of extreme self-induced fasting, often resulting in premature starvation - Catherine of Siena is an example.

The motivation for this fast appears to be different from the urge to be thin that has dominated contemporary discussions of eating disorders. Despite this, many believe that it is the same disorder that takes on different cultural meanings simply because of the sociocultural climate.

history of anorexia

In 1689, the English doctor Richard Morton described two cases of "nervous consumption" - one in a boy and one in a girl. These are believed to be the earliest modern cases of the disease that we know of todayanorexia. He described the lack of a physical explanation for the loss of appetite and wasting, and therefore classified "this consumption as jittery".

The next reported cases were about 200 years later. In 1873, Sir William Gull, another English physician, coined the term "anorexia nervosa" in published case reports. Also, in 1873, a French doctor, Ernest Charles Lasegue, published descriptions of people with "anorexia hysterique".

Recent research has expanded our knowledge, and some of Dr. Bruch's ideas - such as those implying early family dynamics as the cause of the disorder - are now considered obsolete. Previous psychoanalytic explanations of the disease were superseded as our understanding of genetic and biological processes increased.

Researchers Keel and Klump (2003) suggest that the differing motivations for food refusal across historical time periods may represent culturally significant ways to understand a disorder that leaves people - disproportionately women - feeling unable and unable to eat to be ready.

History of Bulimia Nervosa

Unlike anorexia nervosa - which seems to have been identified throughout history -Bulimiaseems to be a more modern development. Bulimia nervosa was first described in 1979 by British psychiatrist Gerald Russell as a variant of anorexia.

Russell himself believed that bulimia nervosa was a culture-bound condition and did not believe that extrapolation to historical cases of overeating and vomiting was relevant to our modern understanding of the disorder. Nonetheless, cleaning was a practice in ancient Egypt, Greece, Rome, and Arabia, cultures where it was used to prevent diseases thought to originate from food. Doctors have also prescribed it. Some early Roman emperors were observed to overeat and then vomit. Some authors disagree with Russell and suggest that this behavior was an early historical variant of bulimia nervosa which—as in the case of the early reports of anorexia nervosa—lacked the modern urge to be thin.

Searches for descriptions of bulimia nervosa in the early medical literature were less successful than searches for anorexia nervosa.

Another early description, the case of patient D, was given by Mosche Wulffin in 1932. This patient had periods of fasting alternating with periods of overeating and vomiting.

In 1960, US psychiatrists Bliss and Branch published case histories containing a number of cases of binge eating and vomiting. The German psychiatrist Ziolko published articles in the 1970s describing patients suffering from compulsive eating and vomiting and increasing weight problems.

The 1970s produced case reports of patients with what more closely resembles modern bulimia nervosa. Gerald Russell published his case series of 30 patients between 1972 and 1978 reporting self-induced vomiting in an attempt to mitigate the effects of binge eating. These were found to present a syndrome distinct from anorexia nervosa but shared the same fear of obesity.

His famous article, published in 1979, called bulimia nervosa "an ominous variant of anorexia nervosa." In 1976, Christopher Fairburn also saw an early case of bulimia nervosa and began studying it and developing a treatment for it. The disorder was little known before the second half of the 20th century^thCentury; since then it has become relatively common.

History of Binge Eating Disorder

binge eating disorderwas later on the scene. Binge eating disorder was first described in 1959 by psychiatrist Albert Stunkard, who coined the term "Night-Eating-Syndrom“. He later specified that binge eating could occur without the nocturnal component of this disorder. Binge eating disorder was first studied in populations experiencing weight loss.

In 1993, a manual of cognitive-behavioral therapy for binge eating and bulimia nervosa was published by Fairburn, Marcus, and Wilson. This guide has described howcognitive behavioral therapycould effectively treat bulimia nervosa and binge eating disorder. It has become the most-studied manual on treating eating disorders

diagnostic history

The three main disturbances occurredDiagnostic and Statistics Guidein the same order.

Anorexia nervosa was recognized as a mental disorder in the late 1700s, following the early reports mentioned above. In 1952 it received a place in the first edition of theDiagnostic and Statistical Manual of Mental Disorders (DSM-I), the first eating disorder to do so. However, it was officially categorized: "006-580 Psychophysiological Gastrointestinal Reaction" in a broad category that included gastrointestinal disorders such as peptic ulcer disease, chronic gastritis, and ulcerative colitis. What they had in common was that emotional factors were assigned a causal role.

ThatDSMsecond edition (DSM-II) was released in 1968. Anorexia has been categorized under Particular Symptoms (306). “This category is intended for occasional patients whose psychopathology is manifested by discrete, specific symptoms. An example could be anorexia nervosa under feeding disorder as listed below. However, it does not apply if the symptom is the result of an organic disease or defect or another mental disorder. For example, anorexia nervosa due to schizophrenia would not be included here.”

Other diagnoses in this category in the DSM-II were:

306.0 speech disorder

306.1 Specific learning disorder

306.2 Tick

306.3 Other psychomotor disorder

306.4 Sleep disorders

306.5 Feeding disorder

306.6 Enuresis

306.7 Encopresis

306.8 Headache

306.9 Other special symptom

ImDSM-III(1980) debuted eating disorders as a diagnostic category under the rubric of disorders of infancy, childhood, or adolescence. Bulimia - not yet called bulimia nervosa - appeared for the first time in this issue. The other eating disorders that are included inDSM-IIIWaren Anorexia nervosa, pica,rumination disorder, and atypical eating disorder.

With the publication ofDSM-IVIn 1994, bulimia nervosa appeared in its current form, with the required shape and weight characteristics. Binge Eating Disorder (BED) was also mentioned for the first time. At this point, BED was not yet recognized as a distinct disorder, but was included in an appendix as a proposed diagnosis for future studies.

In this edition, anorexia nervosa and bulimia nervosa were lifted out of the disorders of infancy, childhood, or adolescence and became their own—eating disorders—while the other disorders (pica, rumination disorder, and eating disorder of infancy or early childhood) remained in the Category feeding and eating disorders in infancy or early childhood.

The binge eating disorder eventually emerged as an independent diagnosis in theDSM-5 in 2013. The categories "Eating Disorders" and "Nutrition and Eating Disorders in Infants and Toddlers" were reunited in the new umbrella category,Nutrition and Eating Disorders. ThatDSM-5also includedAvoidant restrictive feeding disorder (ARFID), for the first time. It replaced the feeding disorder in infancy or early childhood.

In Summe

While anorexia nervosa appears to have existed for centuries, gaining importance depending on sociocultural context, bulimia nervosa is thought to be a more modern disorder influenced by sociocultural factors, particularly the intensified idealization of thinness and increased availability of high-density foods . Binge eating relies on large supplies of easily edible foods and is therefore confined to places and times when food is plentiful. Purging appears to be limited to a context where preventing weight gain is culturally significant.

Our understanding of these diseases is expanding and evolving. We now know that these are complex diseases that are caused by a combination of genetic and environmental factors. We recognize that this affects people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations and socioeconomic status.