This is the second piece of a three-part series acknowledging the serious nature of eating disorders and how little was known about how to help people with eating disorders in the past.
Today’s blog shares history. Since the 1980s, major advances have been made in the field. Now, people recover from eating disorders every day. As we reflect on the history of eating disorder diagnosis and treatment, it’s important to remember just how far the field of eating disorders has come.
12th and 13th centuries –
Hundreds of years ago, a number of women practiced self-starvation as a religious practice. Saint Catherine of Siena (1347-1380) was one of the most well-known of these women who would starve themselves for weeks or eat very little for months at a time. They believed that yielding to food was a sin; fasting was a way to show their devotion to God.
English physician Richard Morton described symptoms of anorexia
in a condition he termed, “wasting disease.”
Sir William Gull established the term “anorexia” — pointing out that it occurs in males and in females. At this time, anorexia started to move from the traditions of folklore and theology (women starving themselves as a devotion to God) to the fields of medicine and psychiatry. It has been said that there was a transition from a pursuit of spiritual perfection to a pursuit of bodily perfection in sufferers with anorexia nervosa
Doctors noted conditions similar to what we now know as eating disorders in both male and female patients.
Early 1900s -
“Parentectomy” was considered an appropriate treatment for anorexia nervosa well into the 20th
century. Essentially, a person with an eating disorder would be separated from their parents as a “cure.”
Dr. Pierre Janet noted bulimic behaviors
in his patients. Other doctors reported patients displaying various signs of what we now know as bulimia — including binging, purging and abusing laxatives to maintain a low weight. Eating disorders were often treated as endocrine disorders at this time.
Psychoanalysis influenced how professionals thought about eating disorders. These professionals considered anorexia nervosa as being linked to possibly sexual origins. Psychiatrists started taking on more patients showing signs of eating disorders.
Dr. Albert Stunkard first described binge eating disorder (BED)
. Interestingly, he noted that BED seemed to be linked to night eating.
Psychoanalyst Dr. Hilde Bruch released a highly influential book: Eating Disorders: Obesity, Anorexia Nervosa and the Person Within.
This book coincided with an increase in both anorexia and bulimia.
Bulimia (binging and purging by exercise, vomiting or using laxatives) cases rapidly rose during the 1970s and 1980s in the U.S., England, France and Germany.
Gerard Russell published an influential article “Bulimia Nervosa: An Ominous Variant of Anorexia Nervosa,” noting the differences in symptoms and health risks between patients who have anorexia and patients who have bulimia.
– The Diagnostic and Statistical Manual of Mental Disorders (DSM-III) added an eating disorders section including anorexia.
College counseling centers expanded counseling services for eating disorders. Celebrities started speaking out about their own eating disorders (Diana, Princess of Wales). Some treatment practices that are still used today (refeeding, talk therapy) were used with patients.
1983 - Karen Carpenter died of heart failure
— likely linked to anorexia — increasing awareness of eating disorders in the public eye.
The DSM-III-R listed bulimia as a separate eating disorder for the first time.
The American Psychiatric Association mentioned binge eating in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was listed as a feature of bulimia.
The American Psychiatric Association again mentioned binge eating in the DSM-4. It was listed as a feature of “eating disorder not otherwise specified” (EDNOS).
Binge eating disorder is recognized as its own disorder in the DSM-5. For the first time, people are able to get treatment for this disorder and have it covered by insurance.
2000s and beyond –
Eating disorder treatment now encompasses a holistic model that addresses multiple approaches — medical, psychological, nutritional, and more. Eating Recovery Center (ERC) converts their treatment model in Adult Programs to Acceptance and Commitment Therapy (ACT) in addition to established principles of medical stabilization and nutritional rehabilitation. Using skills from Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) therapeutically, ACT provides the theoretical framework to understand what processes help people get well. ERC also focuses on caregivers and support system as the agents of change and healing through their commitment to a variety of family treatment methods (including Family Systems, Family Based Treatment, and Emotion Focused Family Therapy).
Learn More About the History of Eating Disorder Treatment
Blog 1: Anorexia: The Deadliest Mental Illness
Blog 2: A Brief History of Eating Disorders
Blog 3: A Search for Effective Eating Disorder Treatment: How Far We’ve Come with Eating Recovery Center’s Dr. Emmett Bishop
People recover from eating disorders every day — but we still have so much more work to do. One day, we hope that all individuals are able to get the help and the treatment that they deserve and need.
When individuals seek specialized treatment for eating disorders, a full and complete recovery is possible. Please call us at 877-711-1878 to learn more about treatment options at ERC or to schedule a free confidential consultation with an Eating Recovery Center Masters-level clinician.