Who, When, and Where?

Abstract

Answering “who, when, and where?” establishes the public health burden associated with purging disorder and gives us insight into why someone develops the illness. Right now, over 2 million girls and women in the United States have purging disorder, and they are joined by another half-million boys and men. Cases of hysterical vomiting from the late 1800s resemble purging disorder in some respects, but vomiting in purging disorder is intentional and directed toward influencing weight or shape, supporting the influence of modern idealization of thinness. Finally, we see the emergence of purging to control weight and purging disorder following the introduction of Western cultural ideals into non-Western contexts. Non-Western cultures further shape the clinical presentation of purging disorder with misuse of traditional herbal emetics to produce purging.