Holy Anorexia

by Rudolph M. Bell

Is there a resemblance between the contemporary anorexic teenager counting every calorie in her single-minded pursuit of thinness, and an ascetic medieval saint examining her every desire? Rudolph M. Bell suggests that the answer is yes.

"Everyone interested in anorexia nervosa . . . should skim this book or study it. It will make you realize how dependent upon culture the definition of disease is. I will never look at an anorexic patient in the same way again."—Howard Spiro, M.D., Gastroenterology

"[This] book is a first-class social history and is well-documented both in its historical and scientific portions."—Vern L. Bullough, American Historical Review

"A significant contribution to revisionist history, which re-examines events in light of feminist thought. . . . Bell is particularly skillful in describing behavior within its time and culture, which would be bizarre by today's norms, without reducing it to the pathological."—Mary Lassance Parthun, Toronto Globe and Mail

"Bell is both enlightened and convincing. His book is impressively researched, easy to read, and utterly fascinating."—Sheila MacLeod, New Statesman

Genres: Nonfiction, History, Medieval, Religion, Psychology, Christianity, Philosophy

255 pages, Paperback

First published November 1, 1985

Reviews

[Petra · Rating 1 out of 5]

Two times reading this, I have come to the conclusion which I admit that Rudolph M. Bell has done his research and is a good writer but I can't just appreciate this as academical nonfiction. The case basically is that Bell applies the diagnosis of anorexia nervosa to medieval women saints' who starved themselves to be more connected to their religion and feel more pure. Convenient, yes, but in no way it is a good thing to use a modern diagnosis to the time where anything like that existed. The medieval culture didn't have the same obsession to body image and thin bodies and while it is almost impossible to find a short answer why asceticism and self-starving happened, I don't think that it was in any case near what anorexia nervosa is nowadays. Long story short, good in writing sense but I ca't get past of the anachronistic tendencies.

[Suzanne · Rating 2 out of 5]

This was okay--a bit reductionist and anachronistic in its conclusions. You should go read Caroline Bynum's Holy Feast, Holy Fast for a richer, more complex view of medieval female religiosity and relationship with body control.

[Valentina · Rating 4 out of 5]

a really interesting and thorough study of the plausible convergence between what we currently diagnose as anorexia nervosa and the plethora of historical accounts of female saints and devotees engaging in rituals of extreme fasting which the author refers to as "holy anorexia", i.e., the specific and historical phenomenon of female anorexia in religious contexts. the author's main thesis is that the female subjects' strict and repressing upbringing, where they were largely stripped from any type of personal agency under an unforgiving misogynistic society, was the driving force behind their engagement in extreme fasting rituals later in life, as a sort of coping mechanism that sought to regain part of the bodily autonomy that had been continuously denied to them.

overall, the accounts of the many "holy anorexics" provided by the author were very illuminating and revealing of his argument, and i was shocked more than once at the lengths to which these women were willing to take their bodies to in order to achieve their mission (that being their own deaths in some cases). however, i can't help but to doubt the extent of truth behind some of these accounts, since we know they were written with the intervention of the women's own biographers, confessors, or close acquintances (all male, for context), which likely altered some of the events recorded in order to appeal to a preexisting model of a "female saint" which had been popularized at the time many of these holy anorexics lived. this is of course a factor we should always take into consideration when engaging with historical documents of any kind (and especially with this genre of religious "vitas"), but i would've liked if the author had emphasized this more. at times, it felt like he was backing up his arguments with fiction rather than fact, and placing too much trust on the veracity of these accounts.

still, i really enjoyed this book and it introduced me to the lives and experiences of many female saints i hadn't heard of previously, as well as proving to be an exciting example of the kind of research that can be done today that merges contemporary science with medieval female history, which shows that our past still has so much to say to us.

[Paola · Rating 4 out of 5]

Psicostoria...

Mettere in parallelo storia e analisi psicologica.
Le testimonianze delle vitae delle sante (agiografiche certo ma non solo) e quel disturbo dell’alimentazione che si chiama anoressia. Bell ne analizza 261 di queste vitae, di sante italiane su un arco di tempo che va dal XIII al XVIII secolo, di alcune di esse per ogni periodo storico ci propone un'analisi dettagliata. (Caterina da Siena, Angela da Foligno, Chiara d'Assisi...)
Diciamo subito che é uno studio un po’ datato (1992) per quello che riguarda la psicologia. Ai tempi si, si parlava spesso di relazione primaria con la madre “problematica”, come una delle cause che poteva portare a tale disturbo, e Bell qui ne porta, laddove ne trova testimonianza, alcuni esempi, oggi invece tale interpretazione in generale é stata abbandonata ora l'approccio é di tipo “biologico” e la neurofisiologia e il suo dis-funzionamento sta giocando un ruolo importante.
(con parole grosse e grezze: si ipotizza che un’anoressica abbia difficoltà a comporre un’immagine “reale” del proprio corpo, vedendolo sempre “deformato”, grasso).
Anche per le “visioni” delle sante, e alcune di esse ci sono giunte perché le hanno dipinte, (Ildegarda di Bingen ad esempio) si parla di auree date da crisi di emicrania (cfr O. Sachs e il suo "Emicrania")
Però risulta interessante il metodo, l’approccio, seppure son presentate sempre più ipotesi che certezze.
E comunque le sante anoressiche erano donne forti decise a autodeterminare la propria vita al di fuori delle sole e uniche due possibilità che le venivano offerte, matrimonio o convento, e il campo di battaglia dove tale lotta veniva esperita era il loro corpo. D'altronde non avevano altro.

[Alexandra · Rating 2 out of 5]

I found this challenging to rate despite enjoying the tales of the dedication of female saints, discovering their quirks and character, and being fascinated by the decision to link female saints and modern anorexics. However, Bell's scholarly practice is questionable, and the book lacks an overarching analytic framework or substantial argument. I thought the body of this book was too divorced from its original intention. The link between anorexia, gender identity and holiness was often stated without further analysis. And what analysis was present was surface-level psychoanalytic notions that detracted rather than added to the portrait created by Bell. Ironically, the conclusion (written by a different author) was far more concise and thought-provoking in tying modern-day anorexia and the 'Holy Anorexia' of Saints together. Too often, this felt like reading narratives of Saints rather than analysis or genuine historiographical research.

[Kelli Peters · Rating 3 out of 5]

Rudolph Bell’s work Holy Anorexia examines women’s quest for liberation and autonomy through the process of self-starvation and flagellation. Bell argues that women resisted patriarchal domination at home and in the church by forging a place for themselves as holy heroines. Rudolph Bell’s immense undertaking in Holy Anorexia demonstrates a successful psychohistorical approach to individual and group trends amongst religious women in the thirteenth century on the Italian Peninsula. Bell includes a wide variety of sources throughout his work, and, as Green and Troup highlight, he is able to support the speculative claims made throughout the work with “considerable primary evidence”. Bell draws from hagiographies, confessions, and a variety of other sources to make determinations about the psyche of female saints. Bell argues that through this evidence, he is able to reflect the ideas pertinent during the time and analyze the larger group trend of anorexia. Bell’s focus on these types of sources and his analysis of the women’s relationships with their parents is indicative of the psychohistorical approach.

[Amber · Rating 3 out of 5]

Other than Bell’s weird preoccupation with Freud, which I ascribe to his scholarship being dated at this point (nearly 40 years old now), this is a good exploration of what he terms “holy anorexia” among medieval saints. I have read some of the very low star reviews and I feel like many are missing the point. He’s not trying to say that holy women wanted to be thin. They wanted to seek a spiritual enlightenment, holiness as an analogy to the modern desire for thinness that leads to anorexia nervosa. I think he’s quite clear about not conflating the two, and the epilogue, written by a colleague, states it again very well. This isn’t a book for someone trying to read about modern anorexia in the past. It’s a book grappling with real issues about why so many women sought holiness by starving themselves to death. This is but one of four books I’ll be reading on the topic, and I suspect I’ll like this one the least of the four, but in no way does it mean I think this book is bad or useless.

[Sarah Chait · Rating 5 out of 5]

I had to make a 30-day free subscription on a weird German website in order to read this, as all physical copies are hidden away in private institution's libraries or 40+ dollars in physical form.

What a book! Well written and easy to read as someone who only has a tenuous grasp on Medieval life and religiosity.

All EDs are a reaction to or a reclamation of control in an uncontrollable environment. However, the lens of cultural relativity in Medieval Italy warps this into not an issue of control but of agency. To destroy the flesh/worldly/unsacred/oneself is to purify/save/redeem others, or to forge one's own path in a world where you are not allowed to do so.

To be a woman in a world that hates you! Not unfamiliar territory!

[Jay · Rating 4 out of 5]

I feel like he sometimes stretches his argument, and he definitely overlooks a few things, but overall this is a lot of fun and hot damn Catholics are really just like that

[enyaaaa · Rating 4 out of 5]

:0

[akoz · Rating 1 out of 5]

this dude has never been a teenage girl with an eating disorder and it shows

so bad i couldn’t finish it

[Francesca Penchant · Rating 5 out of 5]

I loved this book; it has a fascinating premise and empathizes with the iron-willed saints it examines. I’m grateful there are authors like Bell, who take on such controversial and daring research.

“Anorexics struggle against feeling enslaved, exploited, and not permitted to lead a life of their own. They would rather starve than continue a life of accommodation. In this blind search for a sense of identity and selfhood they will not accept anything that their parents, or the world around them, has to offer.... [In] genuine or primary anorexia nervosa, the main theme is a struggle for control, for a sense of identity, competence, and effectiveness.”
—Hilde Bruch
Quoted in Holy Anorexia by Rudolph M. Bell

“The only path [for a medieval girl] was from parental domination to submission before a husband. Western culture reproves any deviation from this pattern in ways distinctly unfavorable and psychologically guilt-ridden for women. Spinster-not-bachelor, whore-not-philanderer, prostitute-not-john. Such gender-split words convey images of a deep historical reality, which tolerates or only smirkingly disapproves the same self-expression in men that it condemns in women, especially sexual expression in the refusal to be bound by marital vows.”
—Rudolph M. Bell in Holy Anorexia

[Kathleene · Rating 5 out of 5]

I own this book and use it as a reference book for a series of poems I'm writing. I haven't read it cover to cover; it's one of those books I dip into from time to time. I call this a "Keep on hand" book. I've been interested in anorexia as a social construct for a long time. It's always seemed more complex to me than issues of control, and certainly more complex than weight issues. This book uses examples from saints, who are supposed to be revered, prayed to, entities who are asked by individuals to intercede for them with god. (It doesn't glamorize anorexia as a path to sainthood.) For me, t helps to show that "women's issues" is a phrase that doesn't mean B-level importance.

[Claire]

The young girl becomes the arbiter of a direct and personal relationship with God that offers not only salvation in the next world but liberation in this, liberation from family, siblings, even confessors—anyone or anything that would tell her against her will what to do, how to do it, or what its value. Such self-assurance, however, does not come easily or without the sacrifice of conquering all bodily desire.

The young girl here is Catherine of Siena and Veronica Giulani, but it is also Umiliana de' Cerchi, Margaret of Cortona, Clare of Assisi, Angela of Foligno, and a number of other Italian holy women* both cloistered and in the public eye, virgins and housewives and mothers and ex-prostitutes, recovered or having died of their austerities. Many inadvertent vegans.

Bell situates anorexia nervosa somewhere between cultural and psychological and as different from holy anorexia which, like its contemporary incarnation, persists despite societal opposition toward the sufferer but begins removed from society—particularly its modern equation of thinness with status—as a whole**. To that end, it is a pretty sympathetic book—therapy over etiology, a look at Eustochia of Messina's notably women-written vita—despite the references to Freudian stages of development which, as with everything Freudian, you may find either detrimental to Bell's analysis or just kind of silly. There's more related to Italian Catholic history and convention, too, like the difference between models of piety in the Franciscan and Dominican mendicant orders and the misogynist doctrines that dominated the church before the rise of mendicancy and after the Reformation.

*Bell's focus is the Italian Middle Ages because he hopes to reduce cultural/historical confounding variables, but states in later chapters that they still exist because he covers South Italian women in addition to ones from the northern provinces, for example.

**Make no mistake: It is a shaky distinction from the start, reliant despite Bell's acknowledgement of these women's failure to be taken seriously by the public on their most performative, public-facing writings. I agree with another commenter's assertion that William N. Davis's epilogue draws the intersection of lust and appetite (as well as the key role which the rejection of both plays in the medieval holy woman's quest for self-actualization) toward which Bell had been aiming clearer and more succinctly than he could. From here, I could go the Fasting Girls: The History of Anorexia Nervosa route, or something like Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Volume 1) since I'm already on the subject of women's food restriction/religious ascetism but would like to continue with fewer anachronistic trappings.

[Rita · Rating 5 out of 5]

UN DISTURBO EMOTIVO

Un'opera di interesse straordinario, la mia preferita nell'ambito di quelle lette per la stesura della tesi triennale, ma di cui paradossalmente ho fatto un uso limitato. Risulta sempre scivoloso, infatti, rapportare i fenomeni mistici alla malattia mentale, ed io ho preferito restare sul sicuro, accennando a tale connessione soltanto in via ipotetica. Non vi nascondo, tuttavia, che leggere le teorie di Bell (e soprattutto di Davis, autore del saggio finale) mi ha totalmente scombussolata.
Queste, infatti, apparentano l'aspirazione alla santità a quella, tutta moderna, alla magrezza: "entrambe rappresentano due stati ideali negli ambienti culturali considerati". S'indaga quindi questa "santa anoressia" nei termini di affermazione della propria autonomia, di controllo e purificazione, di lotta contra il patriarcato. Si analizzano le vicende biografiche di mistiche quali Caterina da Siena, Veronica Giuliani, Maddalena de' Pazzi sottolineando l'influenza degli eventi dell'infanzia e del rapporto con i famigliari nel determinare il percorso mistico di ciascuna.
Potrei scrivere righe e righe su questo studio, illustrarne i contenuti, descriverne le impressionanti immagini che si trovano a metà libro... senza riuscire comunque a rendere quanto mi abbia colpito. Soprattutto nelle conclusioni raggiunte:

"[L']eccesso di metodi di cura significa una sola cosa: non si sa ancora gran che circa la cura dei malati di anoressia nervosa. Certamente vi sono anoressiche che guariscono e riescono a condurre una vita appagante e produttiva; ma ve ne sono ancora troppe che non ricevono cure sufficienti. Queste anoressiche cadono in uno stato cronico della malattia, in cui la vita diventa una disperata sopravvivenza, oppure muoiono. L'anoressia presenta il più alto tasso di mortalità di tutte le malattie psichiche. [...] L'anoressia nervosa è una malattia che mette a repentaglio la vita. Ancora oggi le anoressiche hanno la capacità di incutere un senso di timore reverenziale. Per curare l'anoressia, invece, non ci si deve impressionare né paralizzare. È necessario prendere iniziative, talvolta in maniera drastica, pur di salvare una vita."

E non parliamo di sante, né di secoli fa. Parliamo della necessità di considerare l'anoressia nervosa quale "disturbo emotivo", dove il rifiuto del cibo è sempre sintomo di un disagio più esteso.

[Fungus Head · Rating 3 out of 5]

Personally, it seemed as if there were many flaws present-- nonetheless, I still found this book worthwhile and interesting given the focus. Some portions are a bit much, but others are within reason for a quick read, or introduction to this subject/similar ties.

While not perfect, it is a good read when it comes to first examining the topic. It is not possible to falsify or verify many things. So, it does depend on how seriously you take it all, in the end.

---
Objectively, anorexia nervosa is a disorder with remarkably homogeneous features that have appeared for many centuries. The differences have generally been dependent on the culture of the times. This book covers the topic in an easily understood manner, maintaining both a decent historical and scientific approach throughout.

This truly is an exceptional book for its time. It examines the similarities between what we now consider to be anorexia nervosa, as it is clinically defined, and Italian saints of the Middle Ages who engaged in seemingly unparalleled fasting as an expression of religious conviction-- largely pious self-denial.

Rudolph Bell presents a compelling case for the resemblance between the instances of anorexia nervosa we see today, typically viewed as related in some way to the culturally defined ideals some of us grew up with/have been sold, and the notion that many of these Italian saints would now be viewed as having the same disorder.

The book dives into just how enduring beliefs that the maintenance of voluntary starvation is worthwhile or related to self-worth, and just how much alike psychological and behavioral features of anorexia nervosa are compared to what was seen centuries and centuries ago.

All that seems truly inconsistent would be the individual psychological/personal rationale for the behaviors. They appear dependent on culture, while the rest endures-- finding worth and success in religious purity or secular attractiveness, or at minimum, using this as support and definition for the abstract, yet almost compulsory need individuals with the disorder have to mortify their own flesh.

Many people, with or without the disorder, see the empty satisfaction people who have anorexia nervosa get out of it all, but do the majority truly understand how much deeper it might actually go?

[Eric · Rating 4 out of 5]

Last book of 2025 146 total lost my goodreads midway through the year but we’re back. This is a beautiful work tho that explores the corner where spirituality, bodily denial, and control meet with a seriousness that feels intentional rather than sensational. It frames anorexia not only clinically but symbolically portraying faith, purity, and transcendence. That lens gives it a depth that stays with you well after finishing. The prose is frequently striking and thoughtful, especially when examining how suffering can be reframed as virtue. There’s a sharp awareness of how religious language can sanctify harm, and the text does an effective job of exposing the thin line between devotion and self-erasure. At its best, Holy Anorexia feels like a philosophical meditation as much as a cultural critique, inviting the reader to interrogate why self-denial is so often admired. That being said thought the reason I knock it down a star. The book can occasionally feel dense or repetitive in its arguments often lingering longer than necessary on some ideas. People may also wish for a bit more grounding or variation in tone to balance the heaviness of the subject matter. While this intensity is part of the book’s identity, it can make sections feel exhausting rather than illuminating. Personally this book really stuck the landing for me a very good read. I thank the TikTok I saw for recommending me this.

[noor · Rating 4 out of 5]

very informative read tbf and the research is pretty well done and insightful

Bell definitely has something with Freud but i won't deny that seeing a freud-believer's perspective makes me understand subconscious and mental illness more

one thing i found lacking was the line between different saints. it starts chapter wise but by the end of it most saints just feel jumbled up together in order to just prove a point. maybe Bell is a Christian himself (not sure, most likely is though) since it reflects in his words and the way he perceives these women. felt like there was a loss of objectivity in between and that he was interpreting the womens' hagiographies for the reader

however really liked the commentary in the first chapter. very clear opening from that and also is very certain about specific disorder-ly debates that still plague their spheres

[Michelle Altstaetter · Rating 5 out of 5]

i dont write reviews bc who cares but i feel like im
missing something ??? all my life i heard terrible things abt this book and read fasting girls or other books instead, finally read this, its totally fine? never feels like hes overstepping or making any unreasonable claims?? i get the freud critics but ???? this book was pretty excellent imo????? i think the catherine chapter was superior to what followed so things dragged afterwards bc catherine was so good but 1. im biased and 2. afterwards was still good. i dont get the beef here fellas i liked this as much or possibly more than my tried and true assortment of rexie books...

[Liis · Rating 5 out of 5]

A truly unique research, both horrifying and inspiring. The connections between anorexia and a holy, religious and almost sacred experience is what is often missed when dealing with contemporary cases of anorexia, and this book is a great way to show that nothing that anorexics nowadays experience is new.

[Marilina · Rating 2 out of 5]

Buona l'idea, pessima l'esecuzione. Pagine e pagine di indagine sulle vite delle sante anoressiche senza mai arrivare ad una conclusione incisiva. I parallelismi con la moderna anoressia risultano accademici e superficiali. Si può sicuramente leggere di meglio sullo stesso tema. Peccato!

[isa · Rating 3 out of 5]

the historical recounts are super interesting but the analysis bits fall short in a lot of freudian understands of gender and only a wash of church criticisms, but we needed more conversations about the evolution of sainthood!!

[Owen Contri · Rating 4 out of 5]

Really fascinating read.

[Zoe · Rating 4 out of 5]

very interesting, but the focus on Fried was off-putting and not aligned with current understandings of eating disorders.

[amelia · Rating 4 out of 5]

Very cool book but I wonder where the author got this rumor that Lucrezia Borgia had beef with Blessed Columba of Rieti from.

[Jack · Rating 4 out of 5]

An interesting study of the motivations and lives, arguably with parallels to the driving passions of our time.

[Matilda Millar-Carton · Rating 3 out of 5]

I liked reading about medieval saints but not convinced by the thesis

[madeleine]

I’m so glad this book exists so I have something to argue against my whole life long

[Jordyne · Rating 2 out of 5]

The data he compiled is helpful and even interesting. His thesis and conclusions on the data are useless and often maddening.

[Caius Hallett · Rating 3 out of 5]

A more rationalist approach to Italian Mysticism, Bell successfully explores ideas of Holy fasting in the church as a consequence of Anorexia nervosa