History of Eating Disorders

Eating disorders are not a new phenomenon, but our understanding of these conditions has changed over the centuries.

It would be easy to assume that the origins of eating disorders stem from our modern obsession with body image. However, the history of eating disorders goes way back to the 12th century. Our understanding of these disorders has grown and shifted over the years, and we continue to learn more all the time.

Eating Disorders Development Timeline

As we look back at the history of eating disorders timeline, we can see how our understanding of the condition has evolved. Like any disorder, the root causes are examined based on the most recent knowledge available.

As a result, the understanding of eating disorders has shifted throughout history as our body of knowledge has grown. Even with our current level of knowledge, more information is being gathered about eating disorders, which helps inform future studies and treatment options.

12th and 13th Centuries: Self-starvation as a religious act

A prime example of cultural shifts is found in the earliest recordings of disordered eating: religious starvation. During the 12th and 13th centuries, self-starvation was considered an act of piety and great faith. Disregarding one’s basic need for sustenance was the ultimate statement of devout commitment to God.

The secondary consequence of this behavior was the glorification of the starvation process. This attracted people who searched for martyrdom or wanted to express their intense devotion to God.

1689: Richard Morton provides the first medical description of anorexia symptoms

As centuries passed and medicine began expanding as a science, the focus of eating disordered behaviors shifted over to a medical model. This shift significantly affected the way anorexia was viewed.

When considered a practice of religious devotees, the condition was relegated as an extreme choice of a select few. As a medical condition, anorexia started to receive recognition as an illness. This shift signifies a difference in the way people with this condition were seen and treated. Richard Morton was the first to label anorexia as a medical condition, and he noted it as a condition of “nervous consumption.”

Early 1900s: Eating disorders thought to be endocrine disorders

In the early 1900s, the medical profession began exploring eating disorders as a condition stemming from problems within the endocrine system. The focus of these conditions remained tied to a medical root cause, and physicians of the time often prescribed pituitary hormones to treat these disorders. The endocrine system is definitely impacted by eating disorders, but it is no longer viewed as the source of the condition.

20th Century: Parentectomy considered an appropriate treatment

In the 1900s, parentectomy (removal of a child from their parents) was considered a useful treatment option for minors with eating disorders. The logic behind this came from a belief that an adolescent’s eating disorder was caused by their parents. The parental blame for eating disorders in adolescents was damaging and inflicted unnecessary pain on children and parents alike.

1903: Dr. Pierre Janet noted bulimic behaviors in patients

When bulimia behaviors were observed in patients of Dr. Pierre Janet, the spectrum of eating disorders expanded. Eating disorders were starting to be observed in a new light. Rather than being strictly tied to a medical model, these newly observed behaviors shed light on other possible explanations.

1930s and 1940s: Eating disorders are understood as psychological conditions

The shift from the purely medical model over to a psychological focus began in the 1930s and 1940s. As eating disorders became recognized in the mental health arena, the focus of treatment shifted into a behavioral and psychological framework.

This was a better approach to the treatment of these conditions because it was targeting the correct source. There was still much to be learned, but this was a significant shift in thinking that changed the course of study and treatment for eating disorders.

1959: First mention of binge eating disorder

Before 1959, eating disorders were thought to be primarily related to behaviors such as anorexia (abstaining from food) and bulimia (vomiting or using laxatives to rid oneself of food). The concept of binge eating as a disorder came about in 1959. At the time, binge eating disorder was considered a symptom associated with bulimia. It still took decades before binge eating disorder was classified as its own condition in the Diagnostic and Statistical Manual of Mental Disorders.

1973: Hilde Bruch publishes book with case studies on eating disorders

After eating disorders were recognized as a condition with psychological roots, the study of patients with these varying conditions shed even more light on the challenges and treatment needs.

Hilde Bruch authored a book of case studies in 1973 that shared intimate details about how those with eating disorders struggled. Hidle Bruch’s book, “The Golden Cage,” became a notable example of the challenges people with eating disorders faced. Since the publication in 1973, Hilde Bruch’s work with anorexia patients has been a source for many professionals working in the field.

1980: The DSM adds an eating disorders section

Eating disorders became a diagnosable mental health condition in 1980 when it was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The addition of eating disorders in the DSM was a major transition in the history of eating disorders. This recognition legitimized eating disorders as a serious mental health challenge that warranted treatment and care.

1987: Bulimia is listed as a separate eating disorder in the DSM

In the progression of eating disorder diagnoses, the distinction of bulimia as an eating disorder didn’t occur until 1987. The addition of bulimia in the DSM was an important distinction due to the differences between bulimia and other types of eating disorders, such as anorexia.

The differences in these disorders necessitate a separate diagnosis as well as an individualized treatment approach. As eating disorders have become more individually recognized in the DSM, better options for the care and treatment of the conditions have emerged.

2013: Binge eating disorder recognized as its own disorder in DSM-5

The inclusion of binge eating disorder in DSM-5 truly broadened the category in a significant way. Binge eating is a far different type of condition than anorexia and bulimia. It is the most prevalent type of eating disorder, and it takes a significant toll on those who struggle with it.

The expansion of the eating disorder category to include binge eating shows the broad spectrum of this condition. Diagnostic criteria for other types of eating disorders include restriction or purging, but the inclusion of binge eating disorder in the DSM allows for more behaviors.

Eating Disorders Today

As more information is obtained about eating disorders today, better treatment options become available. Current eating disorder news is shared through the use of case studies as well as reports of varying treatment programs and long-term successes.

Eating disorders are currently treated using a combined psychotherapy, cognitive-behavioral, educational and physical health approaches. The union of mind, body and behavioral treatments is beneficial. In the past, focusing on only one of these elements for treatment of eating disorders left a gap that made treatment less effective.

The expansion of eating disorder criteria and diagnoses can offer greater cultural awareness of these conditions. As a result, it can decrease stigma and offer needed support to those who struggle with these conditions.

If you or a loved one is struggling with an eating disorder as well as a co-occurring addiction, The Recovery Village is here to help. Our professional staff can find a treatment plan that works well for your specific situation. Contact us today to learn more about the options available to you.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more