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Dieting Eating Disorders History

It’s Not Just Us! A Brief History of Restrictive Eating

Eating disorders are now a widespread problem. Between 1.25 and 3.4 million people in the UK are affected: around 10% of these suffer from anorexia nervosa.1

The current Diagnostic and Statistical Manual of Mental Disorders (DSMV) defines anorexia as:

  • restriction of energy intake relative to requirements leading to a significantly low body weight
  • intense fear of gaining weight
  • persistent behaviour that interferes with weight gain.2

Restrictive eating practices are not new, however. Self-starvation has a long history, dating right back to the fifth century.

The first evidence of self-starvation comes from the Middle Ages. During this time, food restriction was commonly practiced a form of religious observance. This occurred particularly during Lent, where the control and reduction of food intake was culturally institutionalised. This provided women with the means of experiencing bodily suffering through spiritual fasting.

In her book Holy Feast and Holy Fast, Caroline Walker Bynum explores the role of women role in divine practices that involved abstaining from bodily desire. This included renouncing their appetite for food.3

These women would fast in order to prepare themselves for Christ’s body and blood. They derived nourishment from prayer and the Eucharist, rather than from real food items.

In England this practice lasted until 1534. With the advent of the Protestant Reformation, worship of saints was abolished and ‘[t]he renunciation of food, once experienced and explained as a form of female holiness, was increasingly cast as demonical, heretical, and even insane.’4

A century later, however, the development of scientific and medical understanding shed new light on restrictive eating behaviours.

Rejection of food was thought to result from a lack of appetite caused by other illnesses

The first medical account of self-starvation is credited to the seventeenth century physician Richard Morton. He observed that rejection of food that resulted from a lack of appetite was the symptom of other illnesses, including tuberculosis and chlorosis (anaemia). Morton named chlorosis the ‘Green-Sickness’ and in 1694 described the case of an eighteen year old girl, ‘who resembled ‘“a skeleton only clad with skin.”’5

He writes that she: ‘fell into a total Suppression of her Monthly causes … her Appetite began to abate, and her Digestion to be bad; her flesh also began to be flaccid and loose, and her looks pale.’6

Further evidence of this green sickness came 150 years later in 1838. A medical adviser in The Penny Satirist described a common disease ‘to which the tender sex is subjected, particularly in the large towns of over-refined countries’, which was identified as ‘chlorosis or green sickness.’7

The medical establishment responded by perceiving this susceptibility as a female trait and as further evidence that women were the ‘tender sex’. The advisor continues to observe that: ‘in the streets of large towns there are young ladies with a pale yellow complexion, mixed with a peculiar greenish tinge, a bluish circle around the eyes, an air of languor and debility.’8

They had cravings for strange substances such as chalk, dirt, ashes, or vinegar

These symptoms were thought to result from the patient’s ‘capricious’ appetite. Sometimes they exhibited symptoms of pica, cravings for ‘strange substances such as chalk, dirt, ashes, or vinegar’. At other times they lost their appetite altogether, sometimes refusing to eat.9

Chlorosis was diagnosed in psychosomatic terms. It was thought to arise from ‘bad physical and moral education’, which was the result of ‘[w]ant of proper exercise, improper dress, tight lacing, too much sitting, improper development of the imagination at the expense of the reasoning faculties, boarding-school education, play-going, and novel-reading’ (!)10

At this time, other ‘morbid mortifications of the appetite’ began to be diagnosed alongside chlorosis. In 1840 physician Thomas Laycock added ‘“[b]ulimia and pica’ to the list and claimed that these conditions were all characteristic of the pregnant, chlorotic, and hysterical female.”’11

Even though Morton and Laycock established a specific pathology of self-starvation, however, anorexia would not be formally named for almost two hundred years.

In 1873, anorexia nervosa was simultaneously diagnosed in England and France

By the nineteenth century, the physicians’ social status and power increased as medical authorities grew secure in the scientific validity of their own assumptions. This coincided with the official medicalisation of appetite in 1873. This was when anorexia nervosa was simultaneously diagnosed in England and France by Sir William Gull and Ernest Lasèque.

Sir William Withey Gull

While Lasèque named the condition anorexie hystérique, the term anorexia nervosa was coined by Gull, whose description of the malady first appeared in Transactions of the Clinical Society of London (1874). In an 1888 issue of the Lancet, Gull credited his patients’ refusal to eat to a psychological, rather than a physical affliction. He stated:

That mental states may destroy appetite is notorious, and it will be admitted that young women at of sixteen to twenty-three are specially obnoxious to mental perversity.12

Yet, while Gull noted the psychological cause of anorexia, he chose not to engage with his patients’ subjective mental states. By concentrating upon the physical effects of the condition, rather than psychological causes, Gull thereby dismissed the emotional states of his female patients.

In 1883, anorexia was divided into two sub-conditions: anorexie gastrique and anorexie mentale. Anorexie gastrique applied to patients with digestive complaints. ‘Hysteria was believed to cause a physiological disturbance leading to impaired gastrointestinal absorption.’ Anorexie mental, on the other hand, occurred in patients with ‘“pure” psychiatric conditions and involved mental rather than digestive problems.’13

Despite a more detailed definition of anorexia, however, this did not significantly alter methods of treatment, or the way in which female mental health was regarded. Patients diagnosed with anorexie mentale were still treated by controlled or forced feeding in order to overcome the physiological effects, rather than by engaging with the underlying causes.

In conclusion, from this brief history of restrictive eating it evident that it’s not just us. Self-starvation and other similar eating practices have occurred throughout history in various guises.

For more information on how theories of anorexia continued to develop into the 20th century, please click here. {link to why women theories of anorexia when its published!}


  1. https://www.beateatingdisorders.org.uk/how-many-people-eating-disorder-uk
  2. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  3. Walker Bynum, Caroline, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley, 1986)
  4. ibid
  5. R. Morton Phthisiologica: Or a Treatise of Consumptions 2nd edition (London, 1720), pp.8-9, in R. M. Bell, Holy Anorexia (London: University of Chicago Press, 1985)
  6. ibid
  7. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  8. ibid
  9. Victorian Literature and the Anorexic Body, p.2, Noted by Samuel Ashwell, in A Practical Treatise on the Diseases Peculiar to Women (Philadelphia, PA: Lea and Blanchard, 1845)
  10. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  11. T. Laycock, A Treatise on the Nervous Diseases of Women (London: Longman, Orme, Brown, Green and Longmans 1840), p.73, in A. Krugovoy Silver, Victorian Literature and the Anorexic Body (Cambridge: Cambridge University Press, 2002)
  12. W. Gull, ‘Anorexia Nervosa’ (apepsia hysterica, anorexia hysterica), Transactions of the Clinical Society of the London 7 (1874)
  13. E.L. Bliss and C.H. Hardin Branch, Anorexia Nervosa: Its History, Psychology, and Biology (New York: Paul B. Hoeber, 1960)