What is the first documented eating disorder?

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It looks like some of the first recorded disorder of "Anorexia" were in the 1st Century based on references below, but I disagree with this theory. Still some people claim you can find evidence of these behaviors from the ancient Egyptians and Romans but I would argue that this does not fit the bill for an eating disorder as the expectation was put on them only during certain events or rituals. Knowing that these diseases are more an issue with the mind and chemical imbalances, ritualized vomiting and fasting don't count in this case. I turned to more recent times that reflect a more scientific study of these diseases and offer better proof. These papers talk about the diseases that are caused by "unknown" reason, or "unclear ... cause".

1873, British doctor William Gull presented a paper to the Royal College of Physicians on a disorder he called “Anorexia Hysterica.” It described a loss of appetite without a clear gastric cause. The same year, French doctor Ernest Charles Lasègue published a similar article.

French doctor Pierre Janet first described patients with bulimic behaviors in 1903. But it was not until 1979 that Gerald Russell published the first formal paper on bulimia nervosa. He described it as a distinct variant of anorexia. In 1987, the DSM-III-R listed bulimia as a separate disorder for the first time.

Historical understanding of Eating Disorders

A History of Eating Disorders

A Brief History of Eating Disorders

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Food disorders are probably as old as humans. Purging after meals was recorded in Ancient Egypt as a health ritual, as well as in early China, Persia and Rome (1). Purging wasn't particularly common among the Romans (the word vomitorium doesn't mean what you think it means) but did occur:

"Entries compatible with bulimia could be seen in the Latin writings of Aulus Gellius and Sextus Pompeius Festus, grammarians of the 2nd and 4th centuries AD respectively, and with the description of "canine hunger" in the works of Theodorus Priscianus, a physician in the 5th century (Smith, 1866; Lewis & Short, 1900). Romans were known to tickle their throats with feathers after each meal to induce vomiting thus allowing them to return to gluttonous feasting (Fischer, 1976). The Romans did so to enhance the enjoyment of a wider selection of palatable foods. (In contrast Bulimis patients have a narrow sterotyped food selection usually carbohydrates with the repetitive eating of the same item). Galen, a 2nd century greek physician noted that an abnormal acid humor in the stomach was the cause of "bulimis". Bulimis gave an exaggerated but false signal of hunger (Siegel, 1973; Stein & Laakso, 1988). Powdermaker (1973) noted gluttony was an acceptable behavior for primitive cultures. After months of hunger, hunting for food and finally preparing the feast, one Trobriand Islander declared: "We shall be glad, we shall eat until we vomit." (Boskind-White and White, 1986). In the Talmud (400-500 A.D.) the term "boolmut" was used to describe an overwhelming hunger which impaired a person's judgment about food and on external event (Kaplan & Garfinkel, 1984; van der Eycken, 1985; Blinde & Cadenhead, 1986)." (2)

It's also been hypothesised that the Roman emperors Claudius and Vitellius were bulimic (3).

The modern study of bulimia began in 1903, when Pierre Janet published the first detailed descriptions of patients with bulimia in "Obsessions et la Psychasthenie". The first clinical documentation of bulimia nervosa was published only in 1979, arguing that "overeating and self-induced vomiting may have been common practices among otherwise normal female students attending North Americans universities".

A number of female saints, most famously Catherine of Siena, fasted to the point of death as a sign of holiness or humility: so-called anorexia mirabilis (4). There is disagreeement as to whether there is a continuity between this and the modern anorexia nervosa. The earliest medical descriptions of anorexic illnesses are attributed to English physician Richard Morton in 1689, while the term anorexia nervosa was coined in 1873 by Sir William Gull in a paper containing detailed case descriptions (5). Public awareness of anorexia nervosa took off following the publication of Hilde Bruch's 1973 book "Eating Disorders: Obesity, Anorexia Nervosa, And The Person Within?" and 1978 book "The Golden Cage: the Enigma of Anorexia Nervosa".

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