You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In attempting to study eating disorders in adolescence, our Group first set out to review the literature on anorexia nervosa.
Apart from occasional research into endocrinology, there has always been general consensus about the psychogenic origin of the condition.
According to Morgan (1977), as early as 1613 Pedro Mexio recorded the case of Jane Balan, ‘The French Fasting Girl of Confolens’ who ‘lived without receiving meat or drink for at least three years‘. Mexio dismissed supernatural influences by seeing her condition as a ‘drying up of all parts serving to nourishment due to hurtful humours’. Morgan gives a fascinating account of these first lucid reports, including some unexpected insights by Gull (who in 1874 first coined the term anorexia nervosa) and Lasègue. Gull noted the difficult relationship that these patients have with close relatives and Lasègue likened the patients’ attitudes to ‘the obstinacy of the insane’.
These were rare cases of miraculous fasters, viewed by some as freaks, and people journeyed for miles to see the spectacle, sometimes leaving monetary tokens. Today, however, there appears to be an epidemic of the condition and there is a great deal of literature by well-known authorities who have treated large numbers of patients: Bruch (America); Crisp (England); Thomä (Germany).
In 1973 Crisp had treated 250 cases and reported that, according to his research figures, one in a hundred secondary schoolgirls developed the condition in severe form. In a recent lecture he reported that his Unit still admitted two new cases a week of every ten referred. (Only one case in twenty is male.)
Morgan noted how anxious we are to feed those who take insufficient food and if frustrated our anxiety turns to hostility. Forced feeding is not uncommon in the treatment of anorexic patients, particularly among the severely emaciated patients. All those who use a psychotherapeutic approach to these patients are familiar with the resistance to treatment and recovery. I