Anorexia, 138 Years Ago

On the final day of Women’s History Month, let’ s take a moment to remember Miss A, the first woman medically diagnosed with anorexia, and the pioneering doctor who used her case to challenge the era’s prevailing presumption that eating disorders were simply a mark of an hysterical woman.

On October 24, 1873, esteemed English physician–and Queen Victoria’s personal doctor–Sir William Withey Gull stood before the Clinical Society of London and described his patient, the 17-year-old Miss A, in a paper entitled “Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).

Gull wrote that Miss A was 5 feet 5 inches tall and weighed 82 pounds. Other doctors had given Miss A concoctions containing mercury, iodine and other skeptical substances. Yet she remained gaunt and withdrawn. Gull noted that her gaze was often downcast and her eyes skewed.

Unlike many of his colleagues, Gull did not think that Miss A’s condition was a mark of insanity. He believed she had an independent disease that could be treated outside of the mental asylum. He believed this disease, though more prominent in women, could also afflict men.

Gull provided Miss A at-home care for two years. He kept Miss A on a strict re-feeding regimen—a course of therapy that involved an abundance of foods (eggs, fish, oils, chicken, cream soups) administered at regular intervals by a nurse. Eventually, Miss A reached 128 pounds.

The case study of Miss A helped create the medical diagnosis still named “anorexia nervosa.” How would Miss A be medically treated today? Nearly 140 years later, surprisingly, in many ways the same. Gull’s treatment model has resurfaced with the Maudsley Method—a family-based treatment where food is, again, treated as medicine. This time, however, Miss A’s parents and not a nurse would administer her cream soups and eggs. Clinical trials show that the Maudsley Method, so far, is the most effective way to treat people suffering from anorexia, particularly young patients, with recovery rates more than double individual therapy.

But much else would have changed for Miss A. Today, women researchers are exploring a host of issues that male researchers have historically overlooked. For instance, they’re studying anorexia during pregnancy and finding that the disease can have lasting, sometimes lethal, effects for both mother and child. They’re turning their attention to women of color, a group in which eating disorders remain under-diagnosed, because doctors still subconsciously believe anorexia and bulimia to be “upper-middle-class white girls’” diseases. Women researchers are figuring out ways to stop anorexia in its tracks and prevent it from becoming a lifelong illness. Stay tuned to the Ms. Blog for a series of posts in which I’ll share recent research and developments in the scientific study of eating disorders—research now led by women.

Photo of Miss A. from Wikimedia Commons.


Ann Heppermann is a Brooklyn-based independent radio/multimedia documentary producer, transmission sound artist and educator. Her stories have aired nationally and internationally on shows including: This American Life, Radio Lab, Marketplace, Morning Edition, Studio360 and many others. Ann is a Peabody award-winning producer who also has received awards from Associated Press, Edward R. Murrow, and the Third Coast International Audio Festival. She is a transmission artist with free103point9 and her work has been exhibited at UnionDocs, Chicago Center for the Arts, among other venues.