History of Eating Disorders
Anorexia nervosa was the first eating disorders placed in the Diagnostic and Statistical Manual of Mental Disorders DSM-I (DSM-I), in 1952, as a psycho physiological reaction. A psycho physiological reaction was considered a neurotic illness. The second publication of the DSM-II, in 1968, placed anorexia under special symptoms-feeding disturbances which included pica and rumination.
Throughout history, a form of anorexia has been prevalent in regards to religious beliefs. Ritual fasting lasted for a couple days, to prepare the individual to receive some sacred message from God. Many religions today still practice fasting for a certain amount of time to show their devotion to the lord. The Pythagoreans practiced a form of abstinence by not eating any form of meat; even though this was for religious beliefs. The Pythagoreans believed the human soul could reside in the animal. This was quite the opposite in Eastern religion practices which fasting was prolonged and most often lead to death. This teaching was looked as the ultimate withdraw from all worldly materials which were considered “evil” (Bemporad, 1996). In Western Christianity, women who starved themselves were thought to be closer to God and highly esteemed. One such person was Catherine of Siena (1347-1380), who was considered a saint (Heywood, 1996). Fasting was Catherine’s was the ultimate control over her body, and in a deception to God. This continued until the 16th century; when the Catholic Church looked down upon this. The Catholic Church thought anorexics were witches and burned them at the stake (Brumberg, 2000).
The first case of anorexia was studied in 1689, by an English physician named Richard Morton, who described two cases in his book Phtisiologia: A Treatise on Consumption. In these two cases, a man and woman were wasting away (Gordon, 2000). Other clinical cases of wasting disease was described by other physicians; such as Baglivi in the early 1700s, Robert Whytt in 1764, Louis-Victor Marce in 1860, and Charles Laseque. Only when Sir William Gull (1816-1890), prominent physician to Queen Victoria; published Anorexia Hysterica, did anorexia nervosa become the focus of medical attention (Hepworth, 1999). Gull coined the term anorexia nervosa to distinguish the disorder from the umbrella term “hysteria,” by doing this made anorexia be considered a psychological disorder (Hepworth, 1999).
The discovery of endocrine disease had dropped the study of anorexia because the symptoms were similar of anorexia. A pathologist from Hamburg, named Morris Simmonds, described a case of cachexia (physical wasting), which he attributed to a lesion in the anterior lobe of the pituitary gland in 1914. This was known as Simmond’s Disease in which the pituitary gland was extracted (Hepworth, 1999). Later in the 1930s, physicians and psychologist were able to define the difference of endocrine disease and anorexia nervosa. There were still confusion on the interpretation of anorexia nervosa; psychoanalytical interpretation argued that the origin was sexual (Hepworth, 1999). The traditional psychoanalytical views which focused on the sexual factors proved to be little value to anorexia patients; which helped anorexia return to psychological discussion (Brumberg, 2000). Hilda Bruch published Eating Disorders in 1973, which showed an increasing rise of anorexia and bulimia. Bruch thought both disorders shared a common thread of emotional pathologies which was their perception of body image and body concept, ability to recognize nutritional needs, and an almost paralyzing sense of ineffectiveness which pervades all thinking and activities (Vogler, 1993). Anorexia continued rapidly into the next decade and was known as the “rich white girls” disorder. With the death of Karen Carpenter, public awareness of anorexia nervosa had increased.
Binge eating was first acknowledge in the DSM-III, in 1980 and was designated bulimia. Bulimia included bingeing, purging and preoccupation with body shape and weight. The symptoms of bulimia were closely related to those of anorexia except for the use of laxatives, diuretics, bingeing of food, and vomiting. The revised version of the DSM-III (DSM-III-R), published in 1987, adopted the term bulimia nervosa, which was coined by Gerald Russell in 1979 (Volger, 1993).
Bingeing and purging is prevalent in ancient history. Ancient Egyptian physicians recommended periodical purgation as a health practice. The Hebrew Talmud (A.D. 400-500), referred to a ravenous hunger that should be treated with sweet foods, called boolmot (Gordon, 2000). The Romans used the word “vomitorium” which was a special room where the wealthy Romans would go to purge themselves after a large meal (Gordon, 2000).
There were earlier cases of bulimia in the twentieth century. Ellen West, a patient of Ludwig Bins Wanger, who had exhibited some traits of bulimia, such as bingeing, purging, and abusing laxatives to remain thin. Another case was in 1903, a patient of Pierre Janet, who exhibited a bulimic form of anorexia. Bulimia was considered a disease among immigrants, because they had poor social skills and was deprived emotionally (Gordon, 2000). In the 1970s, bulimia increased in epidemic proportions, in the US, England, France, and Germany. Dr Marlene Boskind-White and her husband gave the first detail description of bulimia in 1976, to educate and increase public awareness of this disorder (Gordon, 2000).
The first formal paper of bulimia was written by psychiatrist Gerald Russell; it remains a definitive work in the study. The article “Bulimia Nervosa: An Ominous Variant of Anorexia Nervosa”, was written in 1979, which states anorexia and bulimia nervosa are developmental disorders that share the same characteristics; a fear of becoming fat and body image (Vogler, 1993). The difference of bulimia is that it’s developed later and they tend to loose less weight than anorexics.
Bemporad, J. R. (1996), Self-starvation through the ages: Reflections on the pre-history of anorexia nervosa. International Journal of Eating Disorders, 19: 217–237. doi: 10.1002/(SICI)1098-108X(199604)19:3<217::AID-EAT1>3.0.CO;2-P
Brumberg, J. J., (2000). Fasting Girls: The History of Anorexia Nervosa. New York, NY: Vintage Books.
Gordon, R. A., (2000). Eating Disorders: Anatomy of a Social Epidemic. 2nd ed. Malden, MA: Blackwell Publishers, Ltd.
Hepworth, J., (1999). The Social Construction of Anorexia Nervosa. Thousand Oaks, CA: Sage Publications, Ltd.
Heywood, L., (1996). Dedicated to Hunger: The Anorexic Aesthetic in Modern Culture. Berkeley, CA: University of California Press.
Vogler, R. J., (1993). The Medicalization of Eating: Social Control in an Eating Disorders Clinic. Greenwich, CT: Jai Press, Inc.