Asceticism and spirituality in anorexia nervosa: A historical psychosocial analysis

Background Asceticism is deeply related to spirituality and fasting practices that have been observed in Anorexia Nervosa (AN) throughout history. Objective To make a psychosocial analysis of spirituality and asceticism within the historical context of Anorexia Nervosa (AN), from the Middle Ages to the 21st century, comparing ‘holy anorexia’ and contemporary AN. Ad hoc illustrative cases are described. Method Medline/PubMed, databases, and specialized textbooks were used to look for evidence on asceticism and spirituality in AN and its historical development. Results From a historical point of view, asceticism of medieval saints (holy anorexia) and that of modern anorexics display common features; nevertheless, they are oriented towards different goals: spirituality versus worldly appearance, respectively. Contemporary Puritanism and AN share distinctive characteristics of protestant ethics, mainly self-discipline, self-control, self-sacrifice, rationality, efficiency, and goal achievement. Asceticism is significantly related to feelings of anger, immature features, and purging. Discussion and conclusion Many mystical medieval women shared similar characteristics to present-day AN; nevertheless, while asceticism in saints was oriented to achieving the divine encounter, the drive for thinness in contemporary young anorexics is instead related to sociocultural aesthetic ideals. The atemporal occurrence of the pathogenic essence of Anorexia suggests that factors like age, personality, and/or psychosocial environment model it pathoplastically.