In 1873, under the title of "anorexia nervosa," Sir William Gull1 described a syndrome characterized by extreme emaciation and amenorrhea in the absence of any demonstrable structural disease. The illustration is a reproduction of the pictures of one of his early patients before and after treatment. About the same time Lasègue2 described the condition as "hysterical anorexia." Numerous articles on the subject since then have added little to the clear, concise accounts of these authors.
The disorder occurs chiefly in adolescent girls, less commonly in men. Following some prolonged emotional conflict, either avowed or concealed, the appetite fails and the intake of food becomes grossly insufficient, leading to loss of weight. Commonly there are mild symptoms, such as uneasiness after food, epigastric distress or constipation, which provide a further excuse for the anorexia. Emaciation increases and the patient's health becomes an object of great concern to her family.
FARQUHARSON RF, HYLAND HH. ANOREXIA NERVOSAA METABOLIC DISORDER OF PSYCHOLOGIC ORIGIN. JAMA. 1938;111(12):1085–1092. doi:10.1001/jama.1938.02790380027007