The Origins of Bulimia
Bulimia is a disorder where a person binges on food, then they try to purge themselves of these extra calories through vomiting, excessive exercise, or use of laxatives1. Although this behavior is not new, it is difficult to know when the true history of bulimia began. For example, ancient Greeks regularly purged themselves2, and the Romans would have three day long feasts where they would eat until full then vomit3. After this, they would continue eating, and the cycle would continue until the feast was over.
In ancient Egypt, people purged themselves for three days in a row every month in a belief that they were preserving their health. These purging behaviors were also thought to exist in Arabia.
During the Middle Ages physicians would even encourage purging. It is believed that Saint Catherine of Siena, a 14th Century philosopher, scholar and theologian (and one of Italy's Patron Saints) may have fallen victim to this advice. It has been reported that she used a twig to cause herself to vomit2 although the reasons for this are thought to be religious. However, others suggest that she may simply have been ill, and it's this that caused the vomiting.
Catherine died at the age of 33 from this illness or behavior. However, these episodes were different from what we recognize as bulimia because the underlying goal was not to remain thin.
In time, accounts of anorexia would surface, and that would be the diagnosis for most eating disorders until 1970s when new behaviors were noticed.
The Modern History of Bulimia
The modern history of bulimia begins in the 20th century2. Anorexia had been a recognized eating disorder for hundreds of years, but in the 1970s three cases were reported in the medical literature that were different from the others. They concerned women who experienced purging episodes. One of them vomited, and the other two took laxatives to rid their bodies of food.
However, bulimia wasn't diagnosed as a separate eating disorder until 1979 when Dr. Gerald Russell published a description of 30 college age women who overate and then induced vomiting.
With further study, bulimia became associated with underlying psychological traits such as addictive tendencies, a lack of impulse control, obsession with weight and general looks, and also personality disorders. It is also common for bulimia to be paired with other psychological disorders including depression, anxiety, or obsessive-compulsive disorder.
A prominent theory about how bulimia evolved proposes that it started as a new standard of beauty. As the full-figured woman came to be viewed as less attractive, thin women emerged as the ideal of beauty. This put pressure on them to look thin. Those with poor impulse control discovered ways to purge calories from their system, and so the eating disorder took hold and spread. As long as the thin ideal remains (so the theory goes) so will bulimia.
1. Mayo Clinic, https://www.mayoclinic.com/health/bulimia/DS00607/DSECTION=risk-factors