History of Eating Disorders

Table of ContentsView AllTable of ContentsFirst Eating DisorderHistory of AnorexiaHistory of BulimiaHistory of Binge EatingDiagnosis History

Table of ContentsView All

View All

Table of Contents

First Eating Disorder

History of Anorexia

History of Bulimia

History of Binge Eating

Diagnosis History

Given the modern-day sociocultural fixation with thinness, you might conclude thateating disordersare relatively recent phenomena. However, historical evidence shows these disorders have been around for quite some time—albeit in somewhat different forms.

Learn about the history of eating disorders, including when they first appeared and how they were diagnosed. We also discuss when and how three common eating disorders—anorexia nervosa, bulimia nervosa, and binge eating disorder—were first recognized to give you a better historical perspective of eating disorders over time.

When Eating Disorders First Appeared

The earliest historical descriptions of people experiencing symptoms consistent with modern-day eating disorders date back to Hellenistic (323 BC-31 BC) and medieval times (5th-15thcentury AD).Around this time, purification through the denial ofphysical needsand the material world emerged as a religious theme.

St. Catherine of Siena died at the age of 33 after reportedly practicing extreme food abstinence as a form of religious fasting, making it difficult for her to eat or even drink water. Yet, she was always able to receive the Eucharist.

The motivation for this form of fasting seems to be different than the drive for thinness that dominates modern-day discussions of eating disorders. Despite this, many believe it to be the same disorder merely assuming different meanings based on the sociocultural climate.

The Different Causes of Eating Disorders

History of Anorexia Nervosa

In 1689, English physician Richard Morton described what are considered the earliest modern cases of the illness we now know asanorexia nervosa, one in a male and one in a female.He indicated the lack of a physical explanation for the loss of appetite and wasting and, hence, determined “this Consumption to be Nervous.”

The next cases reported 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 physician, Ernest Charles Lasegue published descriptions of individuals with “anorexie hysterique.”

In 1982, the American doctor Hilde Bruch greatly influenced the understanding of modern anorexia nervosa with a foundation lecture.It was at this time that anorexia became more widely known.

More recent research has advanced our knowledge and some of Dr. Bruch’s ideas—such as those that implicateearly family dynamicsas causing the disorder—are now considered outdated. Earlier psychoanalytic explanations of the illness have been replaced as our understanding of genetic and biological processes has increased.

In 2003, researchers Keel and Klump proposed that the differing motivations for food refusal across historical periods may represent culturally meaningful ways to understand a disorder that leaves people—disproportionately, females—feeling unable and unwilling to eat.

History of Bulimia Nervosa

Russell reported that some early Roman emperors were observed to eat to excess and then vomit, sharing that purging was a practice in ancient Egypt, Greece, Rome, and Arabia—cultures in which it was used to prevent diseases believed to come from food.Physicians also prescribed it.

Russell believed bulimia nervosa was a culture-bound condition and not relevant to our modern understanding of the disorder. Some disagree and propose that this behavior was an early historical variant of bulimia nervosa, lacking—as in the case of the early accounts of anorexia nervosa—the modern drive for thinness.

In 1960, U.S. psychiatrists Bliss and Branch published case histories that included a number of cases of bingeing and vomiting. The German psychiatrist Ziolko published papers in the 1970s describing patients who engaged in compulsive food intake and vomiting and experienced increased weight concerns.

In 1979, Gerald Russell published his case series of 30 patients who reported self-induced vomiting as an attempt to mitigate the effects of episodes of overeating.It was determined that these represented a syndrome that was distinct from anorexia nervosa but shared the same fear of fatness. This famous paper was titled “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 barely heard of before the latter half of the 20thcentury. Since then, it has become more common.

History of Binge Eating Disorder

Binge eating disorder was first studied in weight loss populations.

History of Eating Disorder Diagnosis

These three major disorders—anorexia, bulimia, and binge eating—entered theDiagnostic and Statistical Manualin the same order.

Anorexia Diagnosis History

Anorexia nervosa was accepted as a psychological disorder in the late 1800s after the early reports recounted above. In 1952, it earned a place in the first edition of theDiagnostic and Statistical Manual of Mental Disorder (DSM-I), the first eating disorder to do so.

However, it was officially categorized as a psychophysiologic gastrointestinal reaction, a broad category that included gastrointestinal disorders such as peptic ulcers, chronic gastritis, and ulcerative colitis. The common factor was that emotional factors were believed to play a causal role.

The DSM’s second edition (DSM-II) was published in 1968. In it, anorexia was categorized under special symptoms. This category included other “special symptoms feeding disturbances” such as pica and rumination.

Bulimia Diagnosis History

In the DSM-III,which was published in 1980, eating disorders debuted as a diagnostic category under the rubric of disorders of infancy, childhood, or adolescence. Bulimia—not yet called bulimia nervosa—made its first appearance in this edition.

Other eating disorders included in DSM-III were anorexia nervosa, thedisorder known as pica, rumination disorder, and atypical eating disorder.

With thepublication of the DSM-IVin 1994, bulimia nervosa appeared in its current form. This diagnostic criteria introduced the required feature of shape and weight concerns.

Binge Eating Diagnosis History

It was also in the DSM-IV that binge eating disorder (BED) was mentioned for the first time.At this point, BED was still not known as an independent disorder but was included in an appendix as a proposed diagnosis for future study.

In this edition, anorexia nervosa and bulimia nervosa were moved out of disorders of infancy, childhood, or adolescence and became their own category. Other eating disorders (pica, rumination disorder, and feeding disorder of infancy or early childhood) were not moved and remained infancy, childhood, and adolescent disorders.

Binge eating disorder finally made an appearance as an independent diagnosis in theDSM-5 in 2013. In this version of the DSM, the categories of “Eating Disorders” and “Feeding and Eating Disorders of Infancy or Early Childhood” were reunited in the new umbrella category ofFeeding and Eating Disorders.

TheDSM-5also includedavoidant restrictive food intake disorder (ARFID) for the first time.

Summary

Binge eating relies on large stores of readily edible food so it is limited to places and periods with abundant food. Purging appears limited to a context in which prevention of weight gain is culturally meaningful.

Why Intervention Is Necessary to Prevent Eating Disorder Deaths

19 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marks A.The evolution of our understanding and treatment of eating disorders over the past 50 years.J Clin Psychol. 2019;75(8):1380-2019.doi:10.1002/jclp.22782Witztum E, Latzer Y, Stein D.Anorexia nervosa and bulimia nervosa as idioms of distress: From the historical background to current formulations.Int J Child Adolesc Health. 2008;1(4):283-294.Hoskin RA, Homberg D, Jenson K, Blair KL.Holy anorexia: Views of femininity as a potential mediator in the association between religiosity and disordered eating.Women Stud Int For. 2020;79:102345. doi:10.1016/j.swif.2020.102345Sukkar I, Gagan M, Kealy-Bateman W.The 14th century religious women Margery Kempe and Catherine of Siena can still teach us lessons about eating disorders today.J Eat Disord. 2017;5:23. doi:10.1186/s40337-017-0151-5Wilkinson G.Richard Morton: treatment of anorexia nervosa in a male - psychiatry in history.Brit J Psychiatry. 2018;214(1):10. doi:10.1192/bjp.2018.182Valente S.The hysterical anorexia epidemic in the French nineteenth-century.Dial Phil Ment Neuro Sci. 2016;9(1):22-23.Treasure J, Cardi V.Anorexia nervosa, theory and treatment: Where are we 35 years on from Hilde Bruch’s foundation lecture.Eur Eat Dis Rev. 2017;25(3):139-147. doi:10.1002/erv.2511Keel PK, Klump KL.Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.Psycholog Bull. 2003;129(5):747–769. doi:10.1037/0033-2909.129.5.747Castillo M, Weiselberg E.Bulimia nervosa/purging disorder.Curr Prob Ped Adoles Health Care. 2017;47(4):85-94. doi:10.1016/j.cppeds.2017.02.004Russell G.The history of bulimia nervosa. In:Handbook of Treatment for Eating Disorders(Second Edition).Cuzzolaro M.Body schema and body image: history and controversies.Body Image Eat Weight. 2018. doi:10.1007/978-3-319-90817-5_1Ely AV, Cusack A.The binge and the brain.Cerebrum. 2015;2015;cer-12-15.Gordon RA.The history of bulimia nervosa. In:The Wiley Handbook of Eating Disorders.2015:25–38. doi: 10.1002/9781118574089.ch3Russell G.Bulimia nervosa: an ominous variant of anorexia nervosa.Psychol Med. 1979;9(3):429-48. doi:10.01017/s0033291700031974Mohajan D.Binge-eating: a life-threatening eating disorder.Innov Sci Tech. 2023;2(4):62-67.Fairburn CG, Marcus MD, Terence WG.Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In:Binge Eating: Nature, Assessment, and Treatment.Murnen SK, Smolak L.The Cash effect: Shaping the research conversation on body image and eating disorders.Body Image. 2019;31:288-293. doi:10.1016/j.bodyim.2019.01.001Dell’Osso L, Abelli M, Carpita B, et al.Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.Neuropsychiatric Dis Treat. 2016;12:1651-1660.Substance Abuse and Mental Health Services Administration.DSM-5 changes: Implications for child serious emotional disturbance [Internet].Additional ReadingStunkard AJ.Eating patterns and obesity.Psych Quar.1959;33:284–295. doi:10.1007/BF01575455

19 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marks A.The evolution of our understanding and treatment of eating disorders over the past 50 years.J Clin Psychol. 2019;75(8):1380-2019.doi:10.1002/jclp.22782Witztum E, Latzer Y, Stein D.Anorexia nervosa and bulimia nervosa as idioms of distress: From the historical background to current formulations.Int J Child Adolesc Health. 2008;1(4):283-294.Hoskin RA, Homberg D, Jenson K, Blair KL.Holy anorexia: Views of femininity as a potential mediator in the association between religiosity and disordered eating.Women Stud Int For. 2020;79:102345. doi:10.1016/j.swif.2020.102345Sukkar I, Gagan M, Kealy-Bateman W.The 14th century religious women Margery Kempe and Catherine of Siena can still teach us lessons about eating disorders today.J Eat Disord. 2017;5:23. doi:10.1186/s40337-017-0151-5Wilkinson G.Richard Morton: treatment of anorexia nervosa in a male - psychiatry in history.Brit J Psychiatry. 2018;214(1):10. doi:10.1192/bjp.2018.182Valente S.The hysterical anorexia epidemic in the French nineteenth-century.Dial Phil Ment Neuro Sci. 2016;9(1):22-23.Treasure J, Cardi V.Anorexia nervosa, theory and treatment: Where are we 35 years on from Hilde Bruch’s foundation lecture.Eur Eat Dis Rev. 2017;25(3):139-147. doi:10.1002/erv.2511Keel PK, Klump KL.Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.Psycholog Bull. 2003;129(5):747–769. doi:10.1037/0033-2909.129.5.747Castillo M, Weiselberg E.Bulimia nervosa/purging disorder.Curr Prob Ped Adoles Health Care. 2017;47(4):85-94. doi:10.1016/j.cppeds.2017.02.004Russell G.The history of bulimia nervosa. In:Handbook of Treatment for Eating Disorders(Second Edition).Cuzzolaro M.Body schema and body image: history and controversies.Body Image Eat Weight. 2018. doi:10.1007/978-3-319-90817-5_1Ely AV, Cusack A.The binge and the brain.Cerebrum. 2015;2015;cer-12-15.Gordon RA.The history of bulimia nervosa. In:The Wiley Handbook of Eating Disorders.2015:25–38. doi: 10.1002/9781118574089.ch3Russell G.Bulimia nervosa: an ominous variant of anorexia nervosa.Psychol Med. 1979;9(3):429-48. doi:10.01017/s0033291700031974Mohajan D.Binge-eating: a life-threatening eating disorder.Innov Sci Tech. 2023;2(4):62-67.Fairburn CG, Marcus MD, Terence WG.Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In:Binge Eating: Nature, Assessment, and Treatment.Murnen SK, Smolak L.The Cash effect: Shaping the research conversation on body image and eating disorders.Body Image. 2019;31:288-293. doi:10.1016/j.bodyim.2019.01.001Dell’Osso L, Abelli M, Carpita B, et al.Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.Neuropsychiatric Dis Treat. 2016;12:1651-1660.Substance Abuse and Mental Health Services Administration.DSM-5 changes: Implications for child serious emotional disturbance [Internet].Additional ReadingStunkard AJ.Eating patterns and obesity.Psych Quar.1959;33:284–295. doi:10.1007/BF01575455

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Marks A.The evolution of our understanding and treatment of eating disorders over the past 50 years.J Clin Psychol. 2019;75(8):1380-2019.doi:10.1002/jclp.22782Witztum E, Latzer Y, Stein D.Anorexia nervosa and bulimia nervosa as idioms of distress: From the historical background to current formulations.Int J Child Adolesc Health. 2008;1(4):283-294.Hoskin RA, Homberg D, Jenson K, Blair KL.Holy anorexia: Views of femininity as a potential mediator in the association between religiosity and disordered eating.Women Stud Int For. 2020;79:102345. doi:10.1016/j.swif.2020.102345Sukkar I, Gagan M, Kealy-Bateman W.The 14th century religious women Margery Kempe and Catherine of Siena can still teach us lessons about eating disorders today.J Eat Disord. 2017;5:23. doi:10.1186/s40337-017-0151-5Wilkinson G.Richard Morton: treatment of anorexia nervosa in a male - psychiatry in history.Brit J Psychiatry. 2018;214(1):10. doi:10.1192/bjp.2018.182Valente S.The hysterical anorexia epidemic in the French nineteenth-century.Dial Phil Ment Neuro Sci. 2016;9(1):22-23.Treasure J, Cardi V.Anorexia nervosa, theory and treatment: Where are we 35 years on from Hilde Bruch’s foundation lecture.Eur Eat Dis Rev. 2017;25(3):139-147. doi:10.1002/erv.2511Keel PK, Klump KL.Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.Psycholog Bull. 2003;129(5):747–769. doi:10.1037/0033-2909.129.5.747Castillo M, Weiselberg E.Bulimia nervosa/purging disorder.Curr Prob Ped Adoles Health Care. 2017;47(4):85-94. doi:10.1016/j.cppeds.2017.02.004Russell G.The history of bulimia nervosa. In:Handbook of Treatment for Eating Disorders(Second Edition).Cuzzolaro M.Body schema and body image: history and controversies.Body Image Eat Weight. 2018. doi:10.1007/978-3-319-90817-5_1Ely AV, Cusack A.The binge and the brain.Cerebrum. 2015;2015;cer-12-15.Gordon RA.The history of bulimia nervosa. In:The Wiley Handbook of Eating Disorders.2015:25–38. doi: 10.1002/9781118574089.ch3Russell G.Bulimia nervosa: an ominous variant of anorexia nervosa.Psychol Med. 1979;9(3):429-48. doi:10.01017/s0033291700031974Mohajan D.Binge-eating: a life-threatening eating disorder.Innov Sci Tech. 2023;2(4):62-67.Fairburn CG, Marcus MD, Terence WG.Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In:Binge Eating: Nature, Assessment, and Treatment.Murnen SK, Smolak L.The Cash effect: Shaping the research conversation on body image and eating disorders.Body Image. 2019;31:288-293. doi:10.1016/j.bodyim.2019.01.001Dell’Osso L, Abelli M, Carpita B, et al.Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.Neuropsychiatric Dis Treat. 2016;12:1651-1660.Substance Abuse and Mental Health Services Administration.DSM-5 changes: Implications for child serious emotional disturbance [Internet].

Marks A.The evolution of our understanding and treatment of eating disorders over the past 50 years.J Clin Psychol. 2019;75(8):1380-2019.doi:10.1002/jclp.22782

Witztum E, Latzer Y, Stein D.Anorexia nervosa and bulimia nervosa as idioms of distress: From the historical background to current formulations.Int J Child Adolesc Health. 2008;1(4):283-294.

Hoskin RA, Homberg D, Jenson K, Blair KL.Holy anorexia: Views of femininity as a potential mediator in the association between religiosity and disordered eating.Women Stud Int For. 2020;79:102345. doi:10.1016/j.swif.2020.102345

Sukkar I, Gagan M, Kealy-Bateman W.The 14th century religious women Margery Kempe and Catherine of Siena can still teach us lessons about eating disorders today.J Eat Disord. 2017;5:23. doi:10.1186/s40337-017-0151-5

Wilkinson G.Richard Morton: treatment of anorexia nervosa in a male - psychiatry in history.Brit J Psychiatry. 2018;214(1):10. doi:10.1192/bjp.2018.182

Valente S.The hysterical anorexia epidemic in the French nineteenth-century.Dial Phil Ment Neuro Sci. 2016;9(1):22-23.

Treasure J, Cardi V.Anorexia nervosa, theory and treatment: Where are we 35 years on from Hilde Bruch’s foundation lecture.Eur Eat Dis Rev. 2017;25(3):139-147. doi:10.1002/erv.2511

Keel PK, Klump KL.Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.Psycholog Bull. 2003;129(5):747–769. doi:10.1037/0033-2909.129.5.747

Castillo M, Weiselberg E.Bulimia nervosa/purging disorder.Curr Prob Ped Adoles Health Care. 2017;47(4):85-94. doi:10.1016/j.cppeds.2017.02.004

Russell G.The history of bulimia nervosa. In:Handbook of Treatment for Eating Disorders(Second Edition).

Cuzzolaro M.Body schema and body image: history and controversies.Body Image Eat Weight. 2018. doi:10.1007/978-3-319-90817-5_1

Ely AV, Cusack A.The binge and the brain.Cerebrum. 2015;2015;cer-12-15.

Gordon RA.The history of bulimia nervosa. In:The Wiley Handbook of Eating Disorders.2015:25–38. doi: 10.1002/9781118574089.ch3

Russell G.Bulimia nervosa: an ominous variant of anorexia nervosa.Psychol Med. 1979;9(3):429-48. doi:10.01017/s0033291700031974

Mohajan D.Binge-eating: a life-threatening eating disorder.Innov Sci Tech. 2023;2(4):62-67.

Fairburn CG, Marcus MD, Terence WG.Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In:Binge Eating: Nature, Assessment, and Treatment.

Murnen SK, Smolak L.The Cash effect: Shaping the research conversation on body image and eating disorders.Body Image. 2019;31:288-293. doi:10.1016/j.bodyim.2019.01.001

Dell’Osso L, Abelli M, Carpita B, et al.Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.Neuropsychiatric Dis Treat. 2016;12:1651-1660.

Substance Abuse and Mental Health Services Administration.DSM-5 changes: Implications for child serious emotional disturbance [Internet].

Stunkard AJ.Eating patterns and obesity.Psych Quar.1959;33:284–295. doi:10.1007/BF01575455

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