Background: Women today more commonly suffer the morbidity and mortality of eating disorders. Looking through the dual prisms of historical accounts and modern theory the authors examined the meaning of eating disturbance in two cases from the late Middle Ages. The historic role of women and food is explored. Method: Widely reviewing historical sources and the current academic literature, we gathered data and considered two women, Margery Kempe and Catherine of Siena. They were empowered by their roles as religious mystics, and drew strength from suffering, distress and fasting. We briefly examined them in the context of modern diagnostic and aetiological explanations of eating disorders (particularly Anorexia nervosa). Results: We present an account of these women's lives. The relevance these cases have for our understanding of patients, eating disorders, and expressions of suffering today is discussed. Conclusions: Historic accounts provide a rich counterpoint to understanding our present clinical culture of theory and diagnosis. Both our subjects had disturbed eating: one probably died as a consequence of it. Subjective distress was a central component of the life that was desired by each of these women, and they were empowered by their eating disturbance. Food has immense meaning historically, and personally it had meaning for each of our subjects. This is reflected in current clinical experience. The authors suggest we may be aided by adding our cultural, historical and gender based experience of food to our modern biological understanding of eating disorders, to further illuminate the complexities of today's eating disordered patient.