History of Anorexia nervosa

The notion of eating disorders has been a prevalent issue globally and culturally spanning across all genders. It is characterized by “persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs health or psychosocial functioning” (Dell’Osso et al., 2016). One such example is anorexia nervosa, which is defined as “an eating disorder manifested when a person refuses to eat an adequate amount of food or is unable to maintain the minimal weight for a person’s body mass index” (Grinspoon & Herzog, 2019). 

Anorexia nervosa has been widespread since the middle ages, yet the idea of what it is and how it should be treated in the present time has changed drastically throughout that time. Starting in the middle ages, this disease was considered to be derived from the “element of spirituality along with reclusion, self-flagellation, humble dressing, and other practices” (Dell’Osso et al., 2016). The main idea during this time was not to approach ideal thinness but to, in actuality, achieve spiritual purity and holiness of the act. Women specifically were believed to take on a fasting habitual routine in order to obtain this “holy anorexia” complex as female sainthood was often correlated with these self-sacrifice practices. 

Continuing into the Renaissance period there was a slight turn in the reasonings behind this practice, and instead of solely spiritual it became reliant on material beliefs. “In 1700, Morton published the seminal monography ‘Phthisiologia or a Treatise of Consumptions’, which described ‘nervous atrophy’, a condition of self-imposed reduction of food intake” (Dell’Osso et al., 2016). He stated that fasting seen during this era was caused by the ill and morbid state of the spirits. He supposed this was due to a psychological etiology. 

As time has unrelentingly progressed, the idea of this disease as a religiously holy practice has been more or less debunked and has transitioned to be a disease caused by deeply rooted interconnectedness between individual and body self-representation. As ideologies of stature and beauty transitioned from round and plump to slender and sleek, individuals have felt immense pressure to adhere to the social norms present in society. 

The current definition of symptoms for individuals with anorexia, according to the DSM-5, “is one’s refusal to maintain a normal weight for one’s age and height, an intense severe fear of gaining weight or becoming fat despite being an ideal or even below weight category, and a disturbance in the self-evaluation in which one’s body weight or shape os experienced.” All of these are derived from self perceiving of their own body and how they feel it should or shouldn’t look. 

To combat this disease, the treatment plan for it is composed of 3 important goals in mind: “restoring weight lost due to severe dieting and purging, treating psychological disturbances associated with body image issues, and achieving either long-term remission and rehabilitation or full recovery” (Grinspoon & Herzog, 2019). One way to achieve these goals is through psychotherapy, which can help to uncover various factors contributing to fear about eating and weight gain in order to help work through them. Cognitive Behavioral therapy has also been seen as effective in helping these individuals. “It is time-limited and focused in nature, helping an individual to see the links between their thoughts, beliefs, and behaviors” (Grinspoon & Herzog, 2019). Family therapy has been seen to help in many cases as well. 

In addition to therapy, medication is another effective way to diminish this disease, despite being limited. On occasion, an eating disorder such as this one can lead to depression or anxiety, which leads the doctor to potentially have to prescribe antidepressants or other various types of psychiatric medications. 

I hope this brief summary of the history to the current understanding of anorexia nervosa has left you more informed on that matter than before. Thank you for reading. 

Anorexia Sources

Dell’Osso, L., Abelli, M., Carpita, B., Pini, S., Castellini, G., Carmassi, C., & Ricca, V. (2016, July 7). Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum. Retrieved March 08, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939998/

Grinspoon, B. A., & Herzog, K. A. (2019). Anorexia nervosa. Retrieved March 08, 2021, from https://www.psychologytoday.com/us/conditions/anorexia-nervosa

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