Empress Elisabeth of Austria (1837-1898), known for her beauty as well as for her opposition to the ceremonial court of the Austrian ruling family, suffered from a disease that has been termed typical for modern-day industrial nations. The biography of the Empress discloses information revealing symptoms of anorexia nervosa. Over a period of decades she developed strategies for weight reduction such as fasting rituals, gymnastics, hour-long horse-riding and forced marching. Numerous documents repeatedly describe her considerable fear of weight gain and the psychopathological changes specific for anorexia nervosa. Up to her death she succeeded in restricting to a minimum not only her body weight but also her social obligations. The documents on the life of Empress Elisabeth suggest that cultural, historical and psychodynamic factors play an important role in the genesis of this disorder.