A review of the anorexia nervosa literature suggests that bulimia as a symptom has been known throughout the past century, but that bulimia as a syndrome is of recent origin, around 1940, when it occurred in connection with anorexia nervosa. Comments indicating concern over body shape are infrequent in case reports before the forties, but afterwards become the rule.
It is hypothesized that changes in the cultural and economic conditions, such as the rising prosperity after the Depression Years, promoted an increased concern over body weight and recruited not only more, but also women of a psychologically different composition from the traditional anorexia nervosa patient, into dieting. This situation exposed more females to the risk of developing anorexia nervosa and those with a particular vulnerability, for example a tendency for affective instability, to the risk of developing bulimia nervosa. Similar dynamics might have promoted the unfolding of the bulimia nervosa syndrome in the late fifties and sixties.