Eating disorders have existed for centuries, long before Instagram, diet culture and the modern beauty industry. But how did we come to understand anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders as the complex mental health conditions we recognise today?
The history of eating disorders is more complicated than a growing obsession with thinness. It reflects centuries of changing beliefs about food, fasting, body image, morality, health and mental illness. From historical accounts of extreme fasting to the development of modern psychological treatments, our understanding of eating disorders has evolved considerably.
Historical research, including studies exploring the history of anorexia nervosa before 1970, highlights how earlier descriptions of restrictive eating shaped the development of modern clinical understanding. Research examining the evolution of eating disorder understanding and treatment over the past 50 years also demonstrates how approaches to diagnosis, treatment and recovery have changed over time.
Today, eating disorders are recognised as complex mental health conditions influenced by a range of biological, psychological and social factors. They can affect people of all genders, ages, cultural backgrounds and body sizes. They are not simply a choice, a phase or a desire to lose weight.
For Australians seeking reliable information, the National Eating Disorders Collaboration (NEDC), InsideOut Institute and Butterfly Foundation offer evidence-informed resources about eating disorders, their impact and pathways to support.
In this blog, we explore the history of eating disorders, from ancient fasting practices and the first medical descriptions of anorexia nervosa to the recognition of bulimia nervosa and binge eating disorder. We also examine how diet culture, changing beauty standards, and advances in psychological research have influenced the way eating disorders are understood and treated today, and what this history can teach us about compassionate, evidence-informed recovery.
The History of Eating Disorders
Eating disorders have existed for centuries, long before Instagram, diet culture and the modern beauty industry. But how did we come to understand anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders as the complex mental health conditions we recognise today?
The history of eating disorders is not a simple story about changing beauty standards or a sudden obsession with being thin. It is a story about how societies have understood food, the body, morality, gender, health and mental illness, and how those beliefs have shaped the way people experience and receive treatment for eating disorders.
From historical accounts of extreme fasting to the development of modern psychological treatments, our understanding of eating disorders has changed considerably. Yet many misconceptions remain, including the idea that eating disorders are a modern phenomenon, that they only affect young women, or that they are always motivated by a desire to lose weight.
So, where did eating disorders begin, and how did our understanding evolve?
What is the history of eating disorders?
Eating disorders are complex mental health conditions characterised by disturbances in eating behaviours, thoughts about food, and relationships with weight, shape or the body. They can affect physical health, emotional wellbeing, relationships and everyday functioning.
Although the term eating disorder is relatively modern, behaviours resembling some eating disorder symptoms have been documented throughout history. Historical accounts describe prolonged food restriction, episodes of excessive eating and other unusual eating behaviours in a range of cultural and social contexts.
However, it is important to distinguish between historical behaviours that resemble eating disorder symptoms and a modern clinical diagnosis. People who fasted for religious reasons, for example, did not necessarily have anorexia nervosa. We cannot retrospectively diagnose historical figures with certainty.
Research suggests that eating disorders are not new illnesses. Rather, the ways they are understood, described, recognised and treated have evolved alongside medical knowledge and social attitudes.
1. Ancient history: When fasting had a different meaning
Long before eating disorders were formally recognised by medicine, fasting was practised in many societies for religious, spiritual, philosophical and cultural reasons.
In some historical contexts, abstaining from food was associated with purification, self-discipline, devotion or transcendence. Some religious traditions viewed detachment from physical needs as a way to demonstrate spiritual commitment.
Historical accounts from early Christianity and the Middle Ages describe individuals who engaged in extreme fasting. Some women, later described in historical literature as fasting saints, were celebrated for their apparent ability to survive with little food. One frequently discussed example is Catherine of Siena, a 14th-century Italian religious figure whose severe fasting was interpreted within the spiritual beliefs of her time.
But these accounts require careful interpretation. Extreme fasting can occur for many reasons, and the motivations, medical circumstances and experiences of historical individuals are not always clear. Religious fasting is not inherently an eating disorder, and it would be inaccurate to assume that every historical case of food restriction represented a psychiatric illness.
What these accounts tell us: Eating-related behaviours have always existed within a wider cultural context. The meaning attached to food restriction has changed over time, from spiritual devotion in some settings to a behaviour increasingly examined through medical and psychological frameworks.
2. 1689: One of the earliest medical descriptions of anorexia nervosa
A major milestone came in 1689, when English physician Richard Morton published descriptions of patients experiencing severe weight loss without an obvious physical explanation.
Morton described what he called nervous consumption, including cases involving a young woman and a young man. His observations are often cited as among the earliest medical descriptions of a condition resembling what we now call anorexia nervosa.
This was significant because it began to shift the discussion away from purely spiritual or supernatural explanations and towards the possibility that psychological distress could be involved in severe food restriction.
However, Morton was not diagnosing anorexia nervosa according to modern criteria. The diagnosis did not yet exist, and the psychological, social and medical factors involved were understood very differently.
His work nevertheless represents an important step in the history of eating disorder research: the recognition that unexplained weight loss and food refusal could require medical investigation.
3. The 1800s: Anorexia nervosa becomes a recognised medical condition
The 19th century marked a turning point in the medical understanding of restrictive eating disorders.
In 1873, French physician Charles Lasègue published a clinical account of what he called anorexie hystérique. Around the same period, British physician Sir William Gull described a similar condition.
In 1874, Gull used the term anorexia nervosa, helping establish the name that remains in use today.
The term can be misleading. Anorexia generally refers to a loss of appetite, but people with anorexia nervosa do not necessarily lose their appetite. Many experience intense hunger while feeling compelled to restrict their food intake. The word nervosa reflected historical medical thinking about the nervous system and psychological factors.
Early descriptions were important, but they were also shaped by the assumptions of Victorian medicine. The condition was often associated with young women, and clinicians interpreted patients' behaviour through the gendered expectations of the time.
These early accounts also illustrate a continuing challenge: distinguishing the observable behaviour of not eating from the underlying reasons for it.
Eating disorders can involve fear, anxiety, rigidity, sensory sensitivities, emotional distress, compulsive behaviours and a range of other experiences. There is rarely a single explanation that captures every person's experience.
4. The late 1800s and early 1900s: Searching for an explanation
After anorexia nervosa was described as a medical condition, clinicians continued to debate what caused it.
Some explanations focused on physical illness and the nervous system. Others emphasised psychological conflict, family relationships or the social circumstances of the individual.
As psychiatry and psychology developed, eating disorders became part of wider debates about the relationship between the mind and body.
At different times, clinicians placed considerable emphasis on individual personality, unconscious conflict and family dynamics. Some of these historical approaches contributed to further investigation, but others encouraged blame and oversimplified the causes of eating disorders.
For example, families were sometimes treated as the cause of a person's illness rather than as potential sources of support. Contemporary eating disorder care recognises that families and close relationships can play an important role in recovery, without assuming that family members caused the disorder.
Today, eating disorders are understood through a biopsychosocial framework. Biological vulnerability, genetics, psychological processes, relationships, lived experiences and wider social influences can interact in complex ways.
There is no single personality type, family background or life event that explains every eating disorder.
5. The 20th century: Thinness, diet culture and body image
It is tempting to explain the history of eating disorders as a direct consequence of society becoming increasingly obsessed with thinness. Cultural ideals do matter, but the relationship is more complicated.
Ideas about the ideal body have changed considerably throughout history. In some Western settings, larger bodies were historically associated with wealth or prosperity, while later cultural movements increasingly celebrated slenderness, particularly for women.
By the 20th century, commercial advertising, fashion, film, popular magazines and the expanding diet industry helped circulate increasingly standardised ideals about appearance.
Weight-loss practices became more visible in everyday life, and messages linking thinness with attractiveness, discipline, success and social acceptance became influential in many settings.
These cultural messages can contribute to body dissatisfaction, restrictive eating and pressure to change one's appearance. However, they do not explain every eating disorder, and exposure to thin ideals does not mean someone will develop an eating disorder.
Research also cautions against treating anorexia nervosa as a purely modern illness caused by beauty standards. Historical descriptions predate modern mass media, and eating disorders can develop in a wide range of cultural contexts.
The important distinction is this: Diet culture did not invent eating disorders, but weight stigma, appearance-based judgement and restrictive ideas about health can contribute to the environments in which eating disorders develop and persist.
How does diet culture influence eating disorders today?
Diet culture often presents food choices and body size as measures of personal discipline, morality or worth. It can encourage people to divide food into categories such as "good" and "bad", praise restriction as an achievement, or assume that weight loss is always a sign of improved health.
For someone vulnerable to an eating disorder, these messages can reinforce rigid food rules, compulsive exercise, guilt after eating and fear of weight gain.
Even seemingly positive comments about weight loss can have unintended consequences. They may reinforce the idea that a smaller body is automatically healthier or more deserving of approval, regardless of the person's physical or psychological wellbeing.
A compassionate approach to eating disorder recovery challenges these assumptions. Food is not a moral test, body size does not reveal someone's mental health, and health cannot be accurately assessed from appearance alone.
6. The mid-20th century: Psychology and psychiatry evolve
During the mid-20th century, researchers began developing more detailed accounts of the psychological features associated with anorexia nervosa.
Clinicians and researchers explored the roles of body image, fear of weight gain, control, anxiety and other psychological processes. However, there was no single agreed explanation, and the field continued to debate the relative contributions of biological, psychological and social factors.
As research progressed, eating disorders became increasingly recognised as serious conditions that could affect both physical and mental health.
This period also helped establish the importance of examining eating behaviour alongside the individual's emotional experiences, beliefs and social environment.
Over time, treatment approaches moved towards more structured psychological interventions and multidisciplinary care. The importance of medical monitoring became clearer, particularly because severe restriction, bingeing, purging and other eating disorder behaviours can have significant medical consequences.
7. The 1970s and 1980s: Bulimia nervosa receives greater recognition
Although binge eating and compensatory behaviours had been described before the late 20th century, bulimia nervosa became more clearly recognised as a distinct clinical condition during this period.
In 1979, British psychiatrist Gerald Russell published an influential description of bulimia nervosa, helping establish it as a distinct area of clinical research.
Bulimia nervosa involves recurrent episodes of binge eating alongside behaviours intended to compensate for eating, such as self-induced vomiting or other harmful attempts to prevent weight gain. People can experience significant distress and medical complications even when their body weight appears to fall within a socially expected range.
Its recognition challenged the assumption that eating disorders could be identified simply by looking at someone's body.
This was a crucial development. People experiencing binge eating, purging or intense distress about food had often been overlooked when they did not fit the stereotypical image of anorexia nervosa.
During the 1980s, research and public awareness of eating disorders expanded, and psychological treatment approaches continued to develop.
8. The 1990s and 2000s: Binge eating disorder and a broader understanding
As eating disorder research progressed, clinicians increasingly recognised that not all eating disorders involve restrictive eating or compensatory behaviours.
Binge eating disorder (BED) involves recurrent episodes of binge eating accompanied by a sense of loss of control and significant distress. Unlike bulimia nervosa, binge eating disorder does not involve regular compensatory behaviours as part of the diagnostic criteria.
Although binge eating had been described in earlier clinical literature, it took time for the condition to gain formal diagnostic recognition.
Binge eating disorder was included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, as a distinct eating disorder diagnosis.
The diagnostic landscape also expanded to better describe presentations that did not fit older, narrower categories.
These developments helped challenge the misconception that eating disorders are only about wanting to be thin. Eating disorders can involve fear of eating, sensory distress, loss of control, compulsive rules, emotional regulation, avoidance, shame or a complicated combination of experiences.
They can also occur at any body size.
9. Today: Eating disorders are understood as complex, multifactorial conditions
Modern eating disorder research recognises that these conditions are not simply choices, lifestyle habits or attempts to achieve a particular appearance.
They are complex illnesses involving interacting biological, psychological and social factors. Genetic vulnerability, temperament, anxiety, perfectionism, trauma, dieting, weight stigma, environmental stressors and other influences may be relevant, although their roles differ between individuals.
Contemporary diagnostic systems recognise several feeding and eating disorders, including:
Anorexia nervosa: Restriction of energy intake associated with significantly low body weight, alongside characteristic fears, behaviours or disturbances in the experience of weight and shape.
Bulimia nervosa: Recurrent binge eating and inappropriate compensatory behaviours, accompanied by concerns about eating, weight or shape.
Binge eating disorder: Recurrent binge eating associated with loss of control and distress, without regular compensatory behaviours.
Avoidant/restrictive food intake disorder (ARFID): Restriction or avoidance of food associated with factors such as sensory sensitivities, low interest in eating or fear of adverse consequences, resulting in clinically significant nutritional, growth or other impacts.
Other specified feeding or eating disorder (OSFED): Clinically significant eating disorder presentations that do not meet all the criteria for another specific diagnosis.
Pica and rumination disorder: Other recognised feeding and eating disorders involving persistent eating of non-food substances or repeated regurgitation of food, respectively.
Diagnostic criteria evolve as research develops. Not everyone with an eating disorder fits neatly into a single category, and a person's presentation can change over time.
Eating disorders are not limited to young, thin, affluent women
Historically, research and public narratives often focused on young women with anorexia nervosa. This contributed to a narrow stereotype that continues to affect recognition and access to care.
Eating disorders can affect people of all genders, ages, cultural backgrounds, sexualities and body sizes. Men, transgender and gender-diverse people, older adults and people from culturally diverse communities may experience eating disorders too.
People in larger bodies can experience severe restriction, binge eating, purging and other eating disorder symptoms. Their distress may be missed or minimised when healthcare professionals focus too heavily on weight.
Similarly, neurodivergent people may experience eating difficulties involving sensory sensitivities, interoception, routines, executive functioning or fear of particular foods. These experiences deserve careful assessment rather than assumptions about motivation.
A person does not need to look unwell to be unwell. Eating disorder severity cannot be determined by appearance alone.
10. Social media and the digital age: What has changed?
The internet and social media have transformed how people encounter information about food, exercise, weight and appearance.
Online spaces can offer community, recovery stories, education and connection. They can also expose people to harmful dieting advice, appearance comparisons, extreme exercise content and communities that normalise disordered eating.
Algorithms may repeatedly show people similar content based on their previous engagement, making certain messages difficult to escape. Filters, edited images and highly curated online identities can also create unrealistic expectations about bodies.
However, social media is not the sole cause of eating disorders. Its effects vary depending on the individual, the content encountered, their existing vulnerabilities and their wider environment.
The digital age has also created opportunities for telehealth, online psychological treatment, peer support and easier access to evidence-informed resources.
The challenge is to make accurate, compassionate information more accessible while recognising that recovery requires more than simply unfollowing a few accounts.
11. How has eating disorder treatment changed?
The history of eating disorder treatment reflects a gradual shift towards more evidence-informed, individualised and multidisciplinary care.
Historically, approaches varied widely and were sometimes based on assumptions that are no longer supported. Contemporary treatment increasingly recognises the need to address both medical safety and psychological recovery.
Depending on the person's age, diagnosis, needs and circumstances, treatment may involve:
Medical monitoring: Assessing physical health and managing complications associated with eating disorder behaviours.
Nutritional rehabilitation and dietetic support: Supporting adequate nourishment and a more flexible relationship with food.
Evidence-based psychological treatment: Approaches may include enhanced cognitive behavioural therapy (CBT-E), family-based treatment (FBT), specialist supportive clinical management (SSCM), MANTRA and other appropriate interventions.
Multidisciplinary collaboration: Coordinating care between psychologists, GPs, psychiatrists, dietitians and other professionals when needed.
Family and carer involvement: Supporting recovery and strengthening the person's support network where appropriate and with consideration of their circumstances.
There is no universal treatment plan. The most appropriate approach depends on the individual's presentation, preferences, risks and support needs.
Importantly, eating disorder recovery is not simply about reaching a particular weight or eating a prescribed meal plan. It can also involve reducing food-related fear, challenging rigid rules, improving emotional regulation, rebuilding trust in the body, reconnecting with relationships and developing a life that is no longer organised around the eating disorder.
12. What can the history of eating disorders teach us?
Looking back at the history of eating disorders reveals how much our understanding has changed — and how much work remains.
First, eating disorders did not begin with social media or modern diet culture. Historical accounts show that eating-related difficulties existed long before contemporary beauty standards.
Second, culture influences how eating disorders are understood and experienced. Religious beliefs, medical theories, gender expectations, weight stigma and social ideals have all shaped interpretations of eating behaviour across different periods.
Third, diagnosis and visibility are not the same as existence. A condition may have existed long before medicine developed a name or diagnostic framework for it. The historical record is also incomplete, meaning some experiences were overlooked, misunderstood or never documented.
Finally, our understanding of eating disorders must continue to evolve. Better research, broader representation and more compassionate healthcare can help people receive appropriate support regardless of their body size, gender, age or background.
The history of eating disorders is not just a history of illness. It is also a history of how society decides whose suffering is recognised, which bodies are valued and what kinds of help people are offered.
Frequently asked questions about the history of eating disorders
When were eating disorders first discovered?
Eating-related behaviours resembling modern eating disorder symptoms have been described throughout history. One of the earliest medical descriptions of a condition resembling anorexia nervosa was published by Richard Morton in 1689. However, modern diagnostic categories developed much later.
Did eating disorders exist before diet culture?
Yes. Historical accounts of severe food restriction and other eating-related behaviours predate modern diet culture. However, social and cultural environments can influence the development, expression and maintenance of eating disorders.
Are eating disorders caused by social media?
No single factor causes all eating disorders. Social media can contribute to body dissatisfaction and disordered eating for some people, but eating disorders develop through complex interactions between biological, psychological and social factors.
Can you have an eating disorder at any body size?
Yes. Eating disorders occur across the weight spectrum. Body size alone cannot determine whether someone has an eating disorder or how medically or psychologically unwell they may be.
Are eating disorders a choice?
No. Eating disorders are complex mental health conditions, not simply lifestyle choices or a lack of willpower. Although behaviours can become entrenched, recovery is possible with appropriate support and treatment.
Where to find support
If you are worried about your relationship with food, exercise or your body, you do not need to wait until things become severe to seek help.
A GP can assess your physical health, discuss concerns and help coordinate appropriate care. A psychologist with eating disorder experience can help you understand the patterns maintaining your difficulties and work towards recovery. Depending on your needs, a dietitian, psychiatrist or other health professional may also be involved.
In Australia, you can explore support and reliable information through:
Butterfly Foundation: butterfly.org.au — eating disorder and body image support, information and helpline services.
National Eating Disorders Collaboration (NEDC): nedc.com.au — evidence-informed information and resources about eating disorders and recovery.
InsideOut Institute: insideoutinstitute.org.au — Australian eating disorder research, education and support resources.
At recoverED Clinic, we believe eating disorder care should be compassionate, evidence-informed, inclusive and responsive to the person behind the symptoms. Recovery is possible, and support is available.
You deserve support based on what you are experiencing, not what your body looks like.
If you're looking for an eating disorder psychologist in Melbourne, or would prefer online eating disorder therapy across Australia, our psychologists can help you explore recovery without making weight loss the measure of whether treatment is working. Make an enquiry , and we will be in touch to explore whether we are the right fit for you.
Contact recoverED Clinic / Make an Enquiry
Disclaimer
This blog is for general educational purposes only and does not constitute medical, psychological, diagnostic, or therapeutic advice. It should not be relied upon as a substitute for personalised care from a qualified health professional.
Reading this blog does not create a psychologist–client relationship with recoverED Clinic or its clinicians. If you have concerns about your mental health, eating behaviours, physical health, or safety, please seek professional support. In an emergency, call 000 or attend your nearest emergency department. You can access a list of Australian crisis helplines here.
This blog was created with the support of AI tools for clarity and structure and has been reviewed and edited by our team.
