History of eating disorders

Eating disorders were not defined until the end of the 20th century. It was placed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders for the first time in 1987. However, there have been several historical instances that have been recorded throughout history.

During the time of Emperor Julius Caesar, the elite would overindulge at lavish banquets and then vomit so that they could return to the feast and continue eating. Both the Persian’s and the Chinese describe conditions that are quite similar to those that now require medical nutrition therapy. Additionally, tales out of Africa contain stories wherein adults fasted during times of extreme famine in order to save food for their children. They also continued to restrict their diet and were in danger of dying even after the famine was over.

 

Saint Catherine of Siena was known to withhold food from herself as part of a spiritual denial of self. There are several other clinical descriptions of “wasting disease” in the 17th-19th century. This includes Dr. Richard Morton of London who, in 1686, described his twenty-year-old patient as “a skeleton clad with skin”. He suggested that her sadness literally ate away at her and she reportedly died two years later.

 

In 1873, both Sir William Gull, a physician to England’s royal family, and French psychiatrist, Charles Lasegue, came out with diagnosis and treatment suggestions for anorexia. However, neither suggested an eating disorder clinic. Though Gull believed that it was a disease that came from a mental state, he did not believe that patients should be treated as mentally insane. Instead, he treated the young women who came to him by prescribing force feeding, moral teaching and a change of scene. It was at that time that he presented his ideas to his colleagues at the Clinical Society of London, and named the disorder anorexia nervosa, which means loss of appetite.

 

Lasegue, on the other hand, described anorexia from a social and psychological standpoint and emphasized the role of the family. He believed that it was a disease that could only develop in upper-class homes that had an abundance of food. Since children were expected to eat everything on their plates, meal times were stressful and that led some children to refuse to eat as a form of rebellion. Furthermore, women who found their lives suffocating and could not display emotional distress, protested by not eating.

 

1903 was the first time in modern history that bulimia was mentioned when French doctor Pierre Janet discussed a woman named Nadia who engaged in compulsive binges in secret. It was not until 1979 that the first formal paper on bulimia nervosa was published. Gerald Russell described it as a distinct variant of anorexia.

 

Both of these ailments were originally thought to be physical diseases due to several medical conditions including hormone imbalances and endocrine deficiencies. Physicians also thought at one time that anorexia was a form of tuberculosis. In the 1930s, the medical community began to understand that the causes of eating disorders are part psychological and emotional and not just physical.

 

Prior to 1959, there is little or no reference made to binge eating.

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