First Documented Cases of Bulimia Nervosa in History

First Documented Cases of Bulimia Nervosa in History

Roman Caesars Claudius and Vitellius May Be the First Documented Cases of Bulimia Nervosa in History!

Bulimia nervosa is an eating disorder that includes binge eating episodes, self-induced vomiting, and compensatory behaviors such as misusing laxatives. Those with bulimia nervosa are of normal or above-normal weight. Due to the presence of compensatory behaviors, they differ from other patients with a diagnosis of binge eating disorder.

What is Bulimia Nervosa?

In 1979, British psychiatrist Gerald Russell described 30 patients treated for anorexia nervosa in his clinic as “people with a morbid fear of being fat”. These patients had behaviors of self-induced vomiting, use of laxatives, and prolonged fasting to keep their weight below a self-determined threshold. Russell could not classify bulimia nervosa patients who overeat and make themselves vomit as a separate eating disorder. Due to overeating and weight gain, she had categorized it as “the realization of the anorexia nervosa patient’s worst fears.” He stated that compared to anorexia patients, bulimia patients have a worse prognosis, are more resistant to treatment, have a higher risk of physical complications, and have an increased risk of suicide.

The third edition of the Diagnostic and Statistical Manual of Mental Disorders, published in 1980, was the first source for the diagnosis of bulimia. But back then, bulimia was defined simply as the presence of binge eating behaviors. In the revised edition published in 1987, the term bulimia nervosa was first used. In accordance with the psychiatric nature of the condition, the term nervosa was added.

In 2004, Russell, who has twenty-five years of experience on the nature and course of bulimia, retracted his earlier view, stating that people with bulimia have a more favorable and long-term prognosis than patients with anorexia. He also acknowledged, as the medical and psychiatric communities do, that bulimia is indeed an eating disorder different from anorexia.

Historically, bulimia nervosa was not scientifically researched and comprehensively described until Russell’s 1979 article. Although generally accepted as a modern phenomenon, cases that are pathological have been documented as far back as the 17th century. Bulimia is an ancient Greek word used by Aristotle, among others, meaning “the hunger needed to eat an ox, bull, or cow.”

Two Roman Caesars Thought to Have Bulimia Nervosa: Vitellius and Claudius

There is some documentation that binge eating and self-induced vomiting were practiced by the Romans in the early Roman Empire. Two cases of Roman emperors, who were thought to be bulimia nervosa in history, vomited the food they ate at feasts in special places called vomitorium in order to make space in their stomachs and eat more. These are Vitellius and Claudius.

Suetonius was a writer who spent a long time around the palace and studied the official and secret archives of the empire. In his work titled The Lives of the Caesars, he took the famous rulers of Rome as the subject and gave critical details by going into their private lives. However, what he wrote is an important historical document because it is not only his own thoughts, but also the criticism and gossip of the people about the government.

According to Suetonius’s writings, the Roman emperor Claudius often held feasts to strengthen his power. He invited nobles like himself to dinners where 600 people could attend. He was very eager to eat at any time or place, especially to drink wine. The emperor once ate until he swelled up and went to bed and lay down. Opening his mouth wide, he got a feather in his throat to vomit and relieve his stomach. According to Suetonius, this behavior is another variation of the conscious self-induced vomiting behavior. Rather than vomiting behavior, the book focuses on the greed of the government and draws attention to imperial extravagance.

Vitellius, one of the shortest in reign, devoted himself above all to luxury. He ate at least three meals a day, sometimes four. These usually consisted of breakfast, lunch, dinner, and then additional meals in which he consumed alcohol. Thanks to his habit of vomiting, he relieved himself and his stomach after meals, so he could eat more. Besides being very hungry, he did not pay attention to when he ate. He continued this behavior during his duty.

Vitellius Büstü

Claudius and Vitellius are the earliest well-documented historical figures known to have binge-eating and consciously vomiting. Although it seems unlikely that Vitellius and Claudius had a morbid fear of being fat, Vitellius was overweight in the book. We guess from his employees making fun of his physical flaws, as it has been mentioned. According to this evidence, Vitellius was sensitive about his physical appearance and may have been afraid of getting fat. More likely, however, he was making himself vomit out of greed so that he could eat more without gaining extra weight. Claudius was tall and handsome. He was not weak and had a thick neck. Its thick neck is confirmed by a golden aureus bearing a portrait of Claudius.

Claudius Portresi Taşıyan Bir Aureus

While emetic products were abused at these feasts, surprisingly some of the most famous physicians of antiquity, including Hippocrates and Celsus, recommended intermittent vomiting and the use of laxatives as a cleansing measure that might aid health.[10]Some cultures, such as ancient Egypt, also recommended In order to maintain health, they purified themselves for three consecutive days each month, using emetics to maintain health, under the mistaken notion that human diseases come from food. But these attitudes are, of course, different from current attitudes. There is insufficient evidence to suggest that these behaviors include the urge to be weak, which is a prominent feature of current bulimia patients.

As a result, although bulimia nervosa is seen as an eating disorder that emerged in the 20th century, its historical examples date back to earlier times. However, it is known that the vast majority of Romans generally have healthy eating habits. Claudius and Vitellius are memorable exceptions. Of course, what is meant by the Romans is the table of the rich, we do not know much about what the people working in the background ate and how they ate.



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