Some claim that the history of anorexia begins with descriptions of religious fasting dating from the Hellenistic era and continuing into the medieval period.Bell, Rudolph. 1985. Holy Anorexia. U Chicago P A number of well known historical figures, including Catherine of Siena and Mary, Queen of Scots are believed to have suffered from the condition.Hepworth, Julie. 1999. The Social Construction of Anorexia Nervosa. Thousand Oaks, CA: Sage Publications, Ltd Others link the emergence of anorexia to the distinctive presence of an extreme fear of being overweight despite being underweight which emerged in the second half of the 19th century and was first observed by Jean Martin Charcot and other French psychiatrists at the Salpêtrière.
Still others credit the English physician Richard Morton, in 1689 for publishing an early account of a case of anorexia nervosa. However it was not until the late 19th century that anorexia nervosa was to be widely accepted by the medical profession as a recognized condition. In 1873, Sir William Gull, one of Queen Victoria's personal physicians, published a seminal paper which established the term anorexia nervosa and provided a number of detailed case descriptions and treatments. In the same year, French physician Ernest-Charles Lasègue similarly published details of a number of cases in a paper entitled De l’Anorexie Hystérique.
Awareness of the condition was largely limited to the medical profession until the latter part of the 20th century, when German-American psychoanalyst Hilde Bruch published her popular work The Golden Cage: the Enigma of Anorexia Nervosa in 1978. This book created a wider awareness of anorexia nervosa among lay readers. A further important event was the death of the popular singer Karen Carpenter in 1983, which prompted widespread ongoing media coverage of eating disorders.
Etymology The term anorexia nervosa was established in 1873 by Queen Victoria’s personal physician, Sir William Gull. The term anorexia is of Greek origin: an- (ἀν-, prefix denoting negation) and orexis (ὄρεξις, "appetite"), thus translating to "nervous absence of appetite".
In an earlier address, in 1868, Gull referred to the condition as Apepsia hysterica, but subsequently amended this to Anorexia hysterica and then to Anorexia nervosa. In a paper published in 1873, French physician Ernest-Charles Lasègue published a paper entitled De l’Anorexie Hystérique. The use, and subsequent abandonment, of the term hysterica is of interest, since in the Victorian era the term was interpreted as applying to female behaviour. In 1873, Gull wrote:Medical Papers, Sir William Withey Gull, edited by T D Acland (1894) p311
Early descriptions
Hellenistic–Early Christian Asceticism
During the Hellenistic period (323–30 BC) and late antiquity, Asceticism became a prominent spiritual practice in various philosophical and religious traditions. Influenced by Platonic dualism and earlier schools such as Pythagoreanism, certain sects believed that bodily pleasures and needs—including food—distracted the soul from its divine purpose.
Groups like the Encratites, Manichaeans, and other Gnostic communities emphasized bodily denial as a path to salvation. Members of these sects often practiced abstention from meat, wine, sexual activity, and in more extreme cases, food. These beliefs were rooted in a worldview that associated the material body with corruption or evil.
A prominent example of early ascetic practice is the Therapeutae, a Jewish monastic group described by Philo of Alexandria in the 1st century AD. They lived in isolation near Lake Mareotis in Egypt, practiced celibacy, and fasted six days a week as part of their contemplative religious life.
In early Christian theology, writers such as Tertullian promoted extreme fasting as a form of penance and spiritual warfare. His treatise De Iejuniis (On Fasting) outlines practices like “xerophagy”—a dry and minimal diet—as evidence of moral superiority and bodily discipline.
Roman Christian Ascetics In 4th-century Rome, Christian asceticism flourished among women of the aristocracy. Under the guidance of Saint Jerome, many affluent Roman women adopted lives of chastity, prayer, and radical fasting. Jerome encouraged asceticism as a spiritual ideal, framing food denial as a way to resist temptation and mortify the flesh.
One of the most well-documented cases is that of Blaesilla, the daughter of Saint Paula. After being widowed at a young age, Blaesilla came under Jerome's mentorship and began practicing extreme asceticism, including prolonged fasting. Within months, she fell seriously ill and died in 384 AD, likely due to self-starvation. Her death caused a public scandal in Rome, with critics accusing Jerome of promoting excessive and dangerous forms of devotion. As a result, Jerome was forced to leave the city and later settled in Bethlehem.
Other Roman women in Jerome’s circle, including Eustochium and Melania the Younger, similarly adopted lives of intense fasting and ascetic withdrawal. Their practices were venerated as examples of Christian virtue, reinforcing cultural ideals that spiritual greatness—especially for women—could be achieved through the suppression of physical needs.
13th and 14th Centuries: Saint Catherine of Siena & Saint Hedwig of Andechs or Silesia Of interest in terms of anorexia nervosa is the medieval practice of self-starvation by women, including some young women, in the name of religious piety and purity continued from ancient traditions. This is sometimes referred to as anorexia mirabilis. By the thirteenth century, it was increasingly common for women to participate in religious life and to even be named as saints by the Catholic Church. Many women who ultimately became saints engaged in self-starvation, including Saint Hedwig of Andechs in the thirteenth century and Catherine of Siena in the fourteenth century. By the time of Catherine of Siena, however, the Church became concerned about extreme fasting as an indicator of spirituality and as a criterion for sainthood. Indeed, Catherine of Siena was told by Church authorities to pray that she would be able to eat again, but was unable to give up fasting.Hepworth, Julie. 1999. The Social Construction of Anorexia Nervosa. Thousand Oaks, CA: Sage Publications, Ltd.
1556: Mary, Queen of Scots
Mary Stuart, known as Mary, Queen of Scots, was brought up as a child in the court of Henry II of France. Her medical history is documented in some detail thanks to the accounts of various ambassadors who sent reports back to their respective sovereigns. It is known, for example, that she had measles when she was five, rubella when she was seven, dysentery and malaria when she was 14 and smallpox when she was 15.
She also had an unnamed illness as a teenager that some now believe to have been anorexia nervosa/chlorosis Her condition is described as involving weight loss, uneven appetite, vomiting and diarrhoea, pallor, fainting fits and breathing difficulties. She was, however, physically active throughout the illness; she continued to ride on horseback and dance in the evenings at the same time as these symptoms were observed.
1613: Jane Balan – the “French fasting girl of Confolens”
The case of Jane Balans, the “French Fasting Girl of Confolens,” was described in 1613 by Pedro Mexio. He noted that she “lived without receiving meat or drink for at least three years.” The condition began on 15 February 1599, when Jane Balans was around 10 years old. After suffering a fever and vomiting, she became withdrawn and weakened, refusing all food.
Contemporary superstition blamed the wicked power of an apple given to her by an old woman some months prior to the start of the condition; Mexio diagnosed the case as a “drying up of the liver and of all the parts serving to nourishment due to hurtful humours”
1689: Richard Morton’s case descriptions
Two early medical descriptions of a syndrome involving loss of appetite and extreme fasting without any evidence of known disease are provided by the English physician Richard Morton in 1689. He provided two case descriptions in his “Phthisiologia: Or, a Treatise of Consumptions,” a 1694 translation of his 1689 work “Phthisiologica, seu exercitationes de phthisi libris comprehensae. Totumque opus variis histories illustratum.” Morton described these cases as “Nervous Atrophy, or Consumption.” The first, in 1684, involved a “Mr Duke’s daughter in St Mary Axe” (a street in the City of London). He writes of her thus:
The girl consulted Dr Morton only after she had been ill for two years, and then only because she experienced frequent fainting fits. Morton described her as a “Skeleton only clad in skin.” He noted her “continual poring upon Books” despite her condition and that she was indifferent to the extreme cold of an unusually severe winter. She refused any treatment (which consisted of the likes of cloves bruised in wine, and stomach plasters). She died three months later.
The other patient was described as “The Son of the Reverend Minister Steele.” He began to fast at the age of 16. Morton attributed his “want of appetite” to “studying too hard” as well as the “passions of his mind.” Morton was more successful with this patient, who followed the doctor's advice to abandon his studies and move to the country, take up riding and drink plenty of milk, whereupon he “recovered his health in great measure.”
1770s: Timothy Dwight
In a biography of Noah Webster, a near-fatal case of anorexia was described of an instructor at Yale College:
1790: Robert Willan’s case description
Robert Willan was an English physician in London who is credited with founding dermatology as a medical speciality. He is one of the first to describe the symptoms of extreme weight loss in males, in his paper “A Remarkable Case of Abstinence,” published in Medical Communications in 1790. This describes the case of a young Englishman who died in 1786 after fasting for 78 days. He wrote:
19th Century descriptions
1859: Louis-Victor Marcé’s case descriptions
Louis-Victor Marcé (1828–1864), a French physician in Paris, published a number of case studies describing psychiatric disorders of women during and following pregnancy. His case descriptions included that of a patient displaying the symptoms of anorexia nervosa in 1859. In 1860, Marcé wrote:
1868: William Gull (address to the British Medical Association)
In 1868, William Gull was a leading British physician living in London. That year, he described his observations of an emaciated condition in young women in an address to the British Medical Association (BMA) in Oxford. He observed that the causes of the condition were unknown, but that the subjects affected were "mostly of the female sex, and chiefly between the ages of sixteen and twenty three" although he also qualified this statement by adding that he had occasionally seen it in males of the same age.
The Lancet (the BMA's in-house journal) published the following extract from Gull's address:
1873: Sir William Gull’s "Anorexia Nervosa" paper
By 1873, Sir William Gull had been made a Baronet and was one of four Physicians-in-Ordinary to Queen Victoria. In that year, he published his seminal work “Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica)", in which he describes the three cases of Miss A, Miss B, and a third unnamed case.Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica) (1873) William Withey Gull, published in the 'Clinical Society's Transactions, vol vii, 1874, p22 In 1887, he also recorded the case of Miss K, in what was to be the last of his medical papers to be published.Medical Papers, Sir William Withey Gull, edited by T D Acland (1894) p311-314