Though it has been proposed that food issues such as extreme dieting, anorexia and bulimia are on the rise and influenced by media pressures, analysis of texts about and by many of history's key figures suggests that these problems have been around for centuries.
Problematic food concerns are far from a modern phenomenon
Saint Catherine of Siena may have been the world’s first documented case of anorexia. Catherine was a fourteenth century nun from Tuscany, who wrote extensively about her own experiences with fasting, starting from when she was a child. She eventually died, aged 33, of starvation after long periods of eating very little bar herbs and communion wafers.
Catherine’s writings reveal she regarded her eating problems half as a testament of her self-denial, and half as an illness over which she had little control — just as today’s insights into eating disorders recognise that the compulsion to avoid eating, or to binge eat with or without later vomiting (bulimia), can be overwhelmingly powerful and long-lasting.
Later religious writings document cases of extreme fasting in a number of religious and cultural traditions, sometimes justified as a means of battling worldly desires in order to achieve spiritual enlightenment. Later, ‘wasting disease’ was documented in medical texts from the middle ages up to Victorian times and beyond, predominantly affecting women. It is likely that some of these cases were what we would now call anorexia.
Elizabeth Barrett Browning ‘stubbornly’ ate toast
In fact, a number of commentators have ‘diagnosed’ anorexia retrospectively in many prominent women, especially writers and poets — notably Elizabeth Barrett Browning, who ‘stubbornly’ ate toast and not much else and weighed just six stone at the time of her marriage, and Emily Bronte, whose journals and work have been analysed from this perspective, and whose death was caused by consumption probably aggravated by anorexia.
For the past 100 years or so, eating disorders have become accepted as resulting from emotional, psychological, cultural and social factors. More recent dimensions have been added to the discussion from gender studies in particular: while men do acquire food issues, of all types, their numbers are much smaller. It is estimated that 90% of all people with eating disorders of all types are female.
The rise in eating disorders
The rise in eating disorders since the 1970s and 1980s may be linked with greater recognition and diagnosis, but this isn’t going to be the whole story. There’s ample evidence that the fashionable ideal of slimness, even thinness, is part of the cultural context for eating disorders, and the way the ideal has spread around the world along with a rise in incidence is a big clue to this. But there are other personal factors, too, in individual situations.
Food issues can be long-lasting — and very painful to endure — but they can be resolved successfully with the right kind of therapy. Research suggests that Cognitive Behavioural Therapy (CBT) and interpersonal psychotherapy (IPT) are effective at reducing symptoms of anorexia and bulimia. Antidepressant medications are also useful, but are less likely to result in long-term remission of symptoms than CBT.
Acceptance-based therapies for food issues are receiving increased attention, and several interventions that incorporate mindfulness based training and acceptance-based procedures are becoming more and more popular. For example, Acceptance and Commitment Therapy (ACT) is based on an experiential avoidance model, which suggests that many forms of our behaviour (which can often give rise to distress manifested as anxiety, depression or food issues) are related to attempts to avoid or escape aversive internal experiences. ACT emphases non-judgemental acceptance of these thoughts and feelings, while working to change our behaviours towards valued goals and life directions.
Roman myth
There’s a well-known idea that the ancient Roman word ‘vomitorium’ is the part of a public building intended for purging after over-eating, in order to make room in the stomach for more feasting — as if the Romans suffered from some sort of culturally-approved bulimia Zurich Prime.
This is a persistent myth. The vomitorium is well-documented as no more than the exit passage for audiences to use as a means of leaving the theatre — nothing to do with eating or vomiting at all. At other times and in other cultures, deliberate vomiting has been thought to bring health benefits and to ward off disease, but this is not bulimia or an eating disorder in the way we understand it today.
The House Partnership, 2nd June 2014
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In the current economic climate - when job security is at an all time low - many people are finding that their best course of action when ill is going to work anyway... but what are the costs not only to the economy, but more importantly to our wellbeing?
A man's problems with his wife keep him awake during a whole night. An animation about insomnia, by Marie-Margaux Tsakiri-Scanatovits, promoting the short story 'Night Thoughts' by Helen Simpson, for Granta magazine's issue on feminism.
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This powerful film by documentary filmmaker Martin Hampton introduces us to the lives of four people struggling with compulsive hoarding; each vignette more uncomfortable that the last.
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A short video from animator Kelly Bailey on what it's like to live with panic and agoraphobia, containing recorded testimony of real people who have struggled with and overcome these fears.
The focus of mindfulness-based therapy is upon recognising and accepting each moment in the present instead of jumping to hasty and often damaging reactions. This is proving to be greatly beneficial to improving our relationships with others.
Professor Paul Salkovskis, a clinical psychologist and director of the Centre for Anxiety Disorders and Trauma, discusses Cognitive Behavioural Therapy for Obsessive Compulsive Disorder. And Karen reveals how this form of therapy helped her overcome OCD.
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Cutural and religious rituals and many of the behaviours of Obsessive Compulsive Disorder (OCD) show striking similarities: washing, checking, repetition... is OCD a manifestation of a deep human need that has spun out of control?
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Iain and Susan are struggling to work out why their sex life has ground to a halt. A short promotional film for the BBC animated documentary: Wonderland: The Trouble With Love and Sex.
Levni Yilmazis is an independent film-maker, artist and publisher. This is his ironic take on the less-than-helpful advice some people give when you're experiencing depression.
A clip from the BBC's Weird Nature series showing how Vervet Monkeys in the Caribbean have taken to stealing cocktails from people on the beach. Studies show that they have the same percentage of teetotal and alcoholic individuals as the human population.
