Long, but good. Courtesy of Ryan Andrews: I remember the following statement from a lecture in 2006: “Use new information about eating disorders very carefully.” Becoming aware of new information isn’t always a good thing in the world of eating disorders. Some people learn new things about disordered eating and instead of using it to heal themselves, they add it to their destructive eating arsenal. If you struggle with disordered eating and you think reading this article offers more risk than benefit, and/or you think this article may trigger problematic behaviour, proceed with caution. What is disordered eating and when did it start? Anorexia “Anorexia” comes from the ancient Greek orexis, or appetite. The prefix “an” denotes “without”; thus “anorexia” is literally “without appetite”. Now we use the term to describe purposeful non-eating or avoidance of food. Historical examples We can track human anorexia back over 11,000 years. Nomadic foragers migrated from location to location and the biological capacity to suppress hunger may have offered an adaptive advantage. Modern yogic ascetic, demonstrating imperviousness to cold and hunger in the Himalayas Fasting days have often been part of religious rituals and processes across cultures. Many traditional indigenous societies include occasional prolonged fasts in order to strengthen their self-discipline and/or achieve spiritual insight. However, some groups and individuals tried to go without food longer and more frequently. For them, extreme food restriction was part of a daily routine that also included other forms of self-punishment. The premise was that the body’s needs were somehow immoral and sinful, and thus forcing the body to endure pain, extreme deprivation, and humiliation was a good thing. For instance, during the medieval period (approx. 5th century CE to late 1500s), early Christian saints often practiced extreme asceticism, refraining from as many fleshly indulgences as possible, and engaging in fasts lasting several days or more. This extreme food abstinence was linked to other forms of self-punishment in the name of religious devotion. As one source notes regarding medieval asceticism: Ascetics would deliberately inflict pain or damage (e.g. looking at the sun until they went blind); live in crude, unpleasant conditions (such as in caves); and generally endure extensive psychological and physical torment. This torment, notes the source: Binge eating & purging Binge eating has been known for thousands of years. Historically it was related to cycles of scarcity and abundance. Food insecurity can lead to overconsumption in times of plenty. Like fasting days, many world religions also had feasting days. Among populations accustomed to frequent famines or food shortages, feasting days or times of abundance were undoubtedly a license to over-eat. The modern-day equivalent, now that food is as close as the supermarket, is a cycle of extreme dieting followed by eating to excess. While not all eaters include the extreme dieting — some simply over-eat — a cycle of deprivation followed by over-eating is common. Humans have also known for millennia about forms of purging — methods of forcing the body to expel what it has consumed. This includes using emetics (substances or methods of inducing vomiting), diuretics (which flush out body water), laxatives, and/or enemas. Historically, some regarded purging as a “health promoting” practice. This was depicted in the novel and film The Road to Wellville, which satirized the 19th-century purging-oriented practices of Dr. John Harvey Kellogg (inventor of Kellogg’s Corn Flakes). Because of the reluctance to associate obesity with disordered eating, it wasn’t until the early 1990s that binge eating was understood to be separate from bulimia. Modern understandings and diagnoses The actual “diagnosing” of disordered eating began in the 1870s. There are two recognized eating disorder diagnoses: anorexia nervosa (AN), which is self starvation, and bulimia nervosa (BN), which is binging and purging. These diagnoses are incomplete. They reflect only two types of disordered eating, and focus mostly on extreme cases. They do not encompass the countless individuals who struggle with other disordered eating patterns. Health professionals can utilize a catchall diagnosis, “Eating Disorder Not Otherwise Specified (EDNOS).” Currently, binge eating disorder (BED) is simply a provisional diagnostic status under EDNOS. When the fifth revision of the Diagnostic and Statistic Manual of Mental Disorders (DSM) is released in 2011 (or 2012), BED will have its own separate category. The characteristics of disordered eating are listed below.