Eating Disorders

The History of Bulimia Nervosa

Descriptions of eating disorders such as bulimia nervosa can be found written in various historical texts. However, it seems the classic traits of this illness, such as binging and purging, were more likely linked to a show of wealth and plenty rather than preoccupation with a thin appearance.

In the past, the causes of this habit seemed to be far different from the modern eating disorder we have come to know as bulimia. It wasn’t until 1977 that the term bulimia nervosa entered the English language. The condition is characterised by a rapid consumption of food with a subsequent, concentrated period devoted to self-induced vomiting to remove all the food previously consumed. Often bulimics exercise excessively and use laxatives to assist in the purging of food.

Cases of bulimia nervosa increased rapidly during the late 1970s and 1980s. The condition we know as bulimia is a relatively modern disorder. However, the two areas characterising the condition – binging and purging – can be found in old texts from around A.D. 400 – 500. On religious feasting days, it states in the Hebrew Talmud that those “seized with bulimy” on the day, should be treated by feeding them “unclean” things, which would supposedly cure the binge by putting them off their food. Additionally, the word bulimia can be found in many different texts from the fourteenth century to modern times.

As a side note, it is a popular misconception that a vomitorium is a place visited by the ancient Romans to purge themselves of a meal to make room for more feasting. It actually means an entrance or exit from an amphitheater.

In medieval times, there are certainly accounts of people consuming vast amounts of food in times of plenty. Indeed, the more consumed, the richer you appeared, so the act of binging and purging was related to showing off wealth.

During the Nineteenth century, doctors reported overeating in patients suffering various diseases of the brain such as epilepsy or head trauma. However, this overeating is more likely to be connected with these illnesses rather than a desire for a thin body.

All in all, any historical accounts of overeating and binging and purging do not seem to be connected with desires for thinness or to be manifestations of the modern disease we know as bulimia nervosa. The emergence of bulimia nervosa as we know it happened in the 1900s, especially during the 1970s and 1980s when it rose in epidemic proportions throughout Europe and the US. The first, now famous, case in the early Nineteenth century was that of Ellen West, patient of Swiss doctor Ludwig Binswanger. Her aim was thinness and she abused laxatives and binged and purged to achieve her goal.

During the 1930s, it was thought bulimia was a disease of immigrants which arose from emotional deprivation and difficulties integrating into a new society. However, the first proper account of bulimia came in 1976 by Marlene Boskind-White. She has written a book and organises education programs and support groups for sufferers of bulimia and their families.

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