The evolution of our understanding and treatment of eating disorders over the past 50 years.

Although historical descriptions date back to the Hellenistic era, and Gull's naming of anorexia nervosa as a medical disorder to the late 19th century, it is only in the past 50 years that eating disorders have become widely recognized as the prevalent, potentially fatal, complex, and confounding biopsychosocial illnesses we confront today. This paper reviews the considerable advancements in our knowledge of eating disorders during three time periods: the "early years" of the 1960s and 1970s; the "middle years" of the 1980s and 1990s; and the 21st century to date. The recent Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes six major feeding and eating disorders. This historical focus addresses the interaction of multiple factors contributing to the incidence, primarily of anorexia nervosa and bulimia nervosa, in vulnerable individuals, and efforts to develop effective treatment strategies and programs in a variety of settings. Future challenges are also addressed.