“I’m about to start on a 30 hour fast, who’s with me? We can do it!” reads one post on a pro-anorexia website. Another girl posts a picture of her hipbone on her Twitter account, eliciting approving comments about how far it juts out.
The Internet can be a dangerous place for young people, from online predators to identity theft. Now, adding to the list of potential online hazards, are a slew of websites that actually encourage eating disorders by asserting that anorexia and bulimia are lifestyle choices rather than life-threatening mental illnesses.
On pro-ana and pro-mia (anorexia and bulimia) sites, users share tips on how to avoid eating without anyone noticing. Questions are posed—do vitamins have calories? Interactive features, like calorie counters and BMI calculators, are widespread.
Many users visit the sites for “thinspiration,” images of paper-thin models who are held up as examples of perfection and female beauty. On several of the sites, “Ana” and “Mia” are portrayed as powerful deities to be worshiped. Being anorexic or bulimic is described as having a gift, an affirmative and special label.
According to Sara Forman, MD, director of Children’s Eating Disorder program, this feeds into the destructive elements of eating disorders. “When we treat people with eating disorders, we try really hard to separate the eating disorder from the person. We try to help them stop defining themselves by their illness,” she says. During therapy for an eating disorder, patients are encouraged to build up a strong and healthy sense of self, separate from the eating disorder.
Pro-ana and pro-mia websites are not a new phenomenon. But they are proliferating along with this generation of tech-savvy youth, who have grown up at ease sharing every detail of their personal lives online. As more youth take to the Internet to connect with like-minded people, researchers and experts are growing increasingly worried about the influence of sites that encourage others to continue (or initiate) an eating disorder. “Unfortunately, youth use the Internet as ‘crowd sourcing’ in their quest to find information or seek out others they can relate to,” says Michael Rich, MD, MPH, director of Children’s Center on Media and Child Health. “Anyone can post anything. There is no system for validating the truth or ensuring the health and safety of information.”
Now, a new study is shedding some light on pro-eating disorder sites and the risks they pose. In the largest study of its kind to date, researchers looked at 180 pro-ana and pro-mia websites and evaluated them on their potential for harm. Unsurprisingly, they found that 83 percent offered specific techniques for maintaining an eating disorder, including purging, using laxatives and concealing the eating disorder from peers and family members.
According to Forman, pro-eating disorder sites validate eating disorders as a lifestyle and encourage youth to take on dangerous behaviors. “If they truly want to engage in their eating disorder, these sites make it a lot more acceptable and easy to do so,” she says. While she’s pleased research is being conducted, Forman also worries that the resulting media coverage may prompt more youth to search these websites out. However, she acknowledges that increased public knowledge of pro-eating disorder websites is needed. “Many kids already know about this stuff; it’s the adults that really need to learn about it,” she says.
Pro-eating disorder sites are particularly dangerous because they encourage unhealthy thoughts and perceptions, says Forman. “You have these websites where the anorexic voice is being fed and strengthened,” she says. “They are saying, ‘you can do this, you look better, this is a healthy choice and it’s your choice to make’. It gives these potentially life-threatening decisions more validity.”
Forman says that 24-hour availability of pro-eating disorder sites can encourage the addictive tendencies in people suffering from a disorder. “Eating disorders are often looked at through an addiction model,” she says. “If you’re constantly finding out what your BMI is and how many calories you’ve burned that day, it can feed into the obsessive nature of the illness.”
There’s no way to avoid the Internet, and Forman doesn’t suggest parents ban their kids from using it if they are suffering from an eating disorder. But what she does advocate is parents paying attention to what websites children are looking at and engaging in conversations about using media wisely.
Parents can empower their kids by modeling healthy and balanced eating and exercise habits, and dispelling myths about thinness and weight. “You can help your kids establish a good sense of self esteem, and that can make an enormous impact,” she says.
Rich says these sites are insidious and market illness to a vulnerable population. “Although these sites try to suggest otherwise, eating disorders are not a lifestyle choice,” he says. “It’s a dangerous as putting a gun to your head.”