In the past several decades, awareness of the signs and symptoms of anorexia has increased. Although it might seem like anorexia is a relatively new phenomenon or a modern-day condition, this eating disorder has a long history. The history of anorexia nervosa has led to how the condition is understood, identified and treated today.
The history and timeline of anorexia nervosa dates back hundreds of years. Anorexia, as it is known today, has been shaped by culture and time, and it has evolved from a demonstration of religion and spirituality to a pathological eating disorder based on perfection and control. What was once considered a demonstration of faith is now considered a severe psychiatric condition, influenced by environmental, psychological and individual factors.
Origins of Anorexia Nervosa
The idea or the recording of self-starvation has not been in existence since antiquity, but does have a timeline dating back hundreds of years. In ancient Greece, the mind and body were believed to be closely linked, and based on this belief of “sound body, sound mind,” there are few reports of anorexia-like symptoms in ancient societies.
Anorexia has origins in religious practice, and is believed to have developed out of early European fasting practices. Fasting was a common practice in ancient Christianity, and was typically just a few days in duration and was associated with purity.
Over time, European religion was exposed to Eastern ideas, which promoted the holiness of gods and spirits and the selfishness and impurity of the body. These ideas contributed to longer and more extreme periods of fasting, and self-starvation was linked to ideas of spirituality and faithfulness.
Reports of anorexia or self-starvation have come in and out of history books over time, seemingly disappearing in periods of famine or war, and re-appearing in more prosperous times. The historic background of anorexia as a practice of purity has contributed to how the disorder is understood today.
Etymology of the Term “Anorexia”
The term anorexia has been used for over 140 years. The word originates from the Greek language, and means “without appetite.” Initial publications on this eating disorder in 1873 were titled “anorexia hysterica,” but the condition was referred to as “anorexia nervosa” in a significant medical presentation the following year.
The term was initially coined by Sir William Gull, who called the condition “anorexia nervosa” and classified the condition as separate from medical hysteria. The term anorexia is now well recognized, but the etymology of anorexia has received some criticism as those with the condition do still experience hunger and have an appetite.
The understanding and classification of anorexia have changed dramatically over time. This anorexia timeline demonstrates how the disorder evolved from religious practice to a complicated psychological condition.
- 12th and 13th centuries: Self-starvation was considered an exercise in spiritual purity, and could be explained by a person’s holiness. The daughter of a Hungarian king died of self-starvation during this time. Following this event, there was an increase in cases of “holy” fasting, often resulting in death. Many of the women who engaged in this behavior, like St. Catherine of Siena, were praised and idealized for their strength.
- Victorian era: The beliefs about fasting began to move from spiritual to medical during this era. Fasting or self-starvation were considered symptoms of hysteria, a disorder diagnosed in women experiencing symptoms like nervousness or overexpression of emotions or sexuality.
- 1873: In 1873, both Ernest-Charles Lasègue and Sir William Withey Gull completed medical descriptions of anorexia nervosa. At that time, anorexia nervosa was described as a condition emerging from emotional or mental stressors, and included many of the same symptoms of modern anorexia, including severe weight loss and absence of any other medical explanation for food avoidance.
- Late 1800s to the early 1900s: Anorexia was accepted as a disorder during this time. However, it appeared to become less prevalent during World War I.
- 1919: Anorexia was noted to share symptoms with poor pituitary function, and was considered a hormonal issue and treated with medication during this year.
- The 1940s: Scientists proposed that anorexia may be a psychological issue, and gave several psychoanalytic interpretations of the disorder, such as fears of sexuality and adulthood.
- The 1950s: Anorexia was the first eating disorder included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and was considered a neurotic illness.
- The 1960s: In the second edition of the DSM, anorexia was characterized by a drive for thinness and focus on weight.
- The 1980s: Eating disorders were moved to their own independent section in the DSM, which included anorexia.
- 2013: The fifth edition of the DSM, or DSM-5, includes anorexia in a chapter titled Feeding and Eating Disorders, alongside eight other eating disorders. Understanding of sub-threshold and atypical anorexia continued to grow during this year.
The most recent diagnostic criteria in the DSM-5 classify anorexia nervosa as a severe eating disorder characterized by an extreme fear of weight gain. Although the understanding of anorexia has come a long way from its links to religion and spirituality, anorexia is still linked to ideas of perfection and control.
Research has improved the understanding of anorexia nervosa as a complex psychiatric condition. The eating disorder is most commonly seen in “Westernized” countries, although rates are increasing worldwide, and it’s understood that cultural beliefs about bodies and appearance can influence rates of anorexia significantly.
Health professionals now acknowledge the role of genetic, environmental, psychological, social and individual factors in the development and experience of anorexia. The current classification and criteria of eating disorders allow for proper diagnosis and appropriate treatment.
Research on anorexia nervosa has also helped to identify effective treatments for the disorder, often involving a combination of re-nourishment and psychotherapy. Current research on anorexia is also investigating some of the biological or psychological markers that can improve early detection, prevention and treatment strategies for the condition.
The underlying reasons that may drive people to disordered eating may also cause them to abuse substances. If you or someone you love has a substance use disorder and co-occurring eating disorder, please contact The Recovery Village to see how we can help you get back to a healthy life.
Fairburn, Christopher G., Brownell, Kelly D. “Eating Disorders and Obesity: A comprehensive handbook, Second Edition.” The Guilford Press, 2002. Accessed June 13, 2019. Bemporad, Jules R. “Cultural and historical aspects of eating disorders.” Theor Med, 1997. Accessed June 13, 2019. Habermas, Tilmann. “History of Anorexia Nervosa.” The Wiley Handbook of Eating Disorders, 2015. Accessed June 13, 2019. Dell’Osso, Liliana et al. “Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.” Neuropsychiatric disease and treatment, July 7, 2016. Accessed June 13, 2019. Zipfel, S., et al. “Anorexia nervosa: aetiology, assessment, and treatment.” Lancet Psychiatry, October 27, 2015. Accessed June 13, 2019.
Fairburn, Christopher G., Brownell, Kelly D. “Eating Disorders and Obesity: A comprehensive handbook, Second Edition.” The Guilford Press, 2002. Accessed June 13, 2019.
Bemporad, Jules R. “Cultural and historical aspects of eating disorders.” Theor Med, 1997. Accessed June 13, 2019.
Habermas, Tilmann. “History of Anorexia Nervosa.” The Wiley Handbook of Eating Disorders, 2015. Accessed June 13, 2019.
Dell’Osso, Liliana et al. “Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum.” Neuropsychiatric disease and treatment, July 7, 2016. Accessed June 13, 2019.
Zipfel, S., et al. “Anorexia nervosa: aetiology, assessment, and treatment.” Lancet Psychiatry, October 27, 2015. Accessed June 13, 2019.