By Marjorie Slater
In today’s modern, high-tech world, it has become increasingly important to recognize all of the different possibilities that are made available on the Internet. The Internet has opened up lines of communication for business, pleasure, medicine, sports and even support-groups for commonalities ranging from depression and over-eating to alcohol abuse. However, the positive outcomes of these new forms of communication, which have been made readily available over the Internet, are being drowned by the ever-growing negative support-groups that are popping up exponentially. Such support-groups, which work against recovery, health, and wellbeing, include pro-anorexia nervosa websites and pro-eating disorder Myspace profiles. The approximately 400 pro-anorexia websites, or “pro-ana ” sites, as the virtual phenomenon has been lovingly named by the makers and viewers of the sites, are Internet websites dedicated to promoting pro-eating disorder ideals, teaching others about how to achieve perilous levels of thinness and arguing that eating disorders are lifestyle choices rather than the diseases they really are (Collins, 2004), (Song, 2005). These meeting-grounds for those with eating disorders and those wishing to develop eating disorders have begun to cause serious problems for clinicians in the treatment process as they place young, vulnerable, Internet-surfing teens in a dangerous position. The print media that pervades our lives places thin models and celebrities on pedestals, but “experts sayÖ[that] the impact of these Web sites goes beyond any other media,” highlighting that “fashion magazines may feature very skinny models, but they don’t endorse eating disorders. These sites say that anorexia and bulimia are good things” (Elliott, 2002).
It is impossible to remain at ease when recognizing the severity of the mental and medical disease that is anorexia nervosa. Since these website makers are encouraging other young women to develop and maintain eating disorders and their “most popular tagline” is that “Anorexia is a lifestyle, not a disease,” we are obliged to take a stance against the negative support-communities that have developed with the availability and ease of the Internet (Collins, 2004). The health complications associated with eating disorders, especially those associated with anorexia nervosa, illuminate that the gravity of the disease is very severe and sometimes life threatening. These physical health consequences include the fall of blood pressure, the slowing of heart rate, the development of kidney and gastrointestinal problems, the decline of bone mass, changes in hormone levels, anemia, hair loss, as well as the development of lanugo (a growth of soft, fine hairs all over the body) (Garner, 1997). Low levels of electrolytes also occur, which are necessary for the process of neural transmission, and lowered levels can lead to tiredness, weakness, cardiac arrhythmia, and even sudden death (Lambe, Katzman, Mikulis, Kennedy, & Zipursky, 1997). In fact, anorexia nervosa is so life threatening that death rates are ten times higher among patients with the disorder than among the general population, and are twice as high among anorexic patients than among those with other psychological disorders (Sullivan, 1995). The endorsement and glamorization of eating disorders, and more specifically of anorexia nervosa on pro-anorexia websites, leaves the world of simple print media idolization of the thin ideal and enters a realm of dangerousness and possibly fatal harm, which places the Internet’s negative support-groups in a level of their own. These websites’ deadly effects can poison the minds of those curious about eating disorders, can perpetuate the problems for those suffering from eating disorders, and can completely upturn the recovery process for those working toward health and recuperation.
When women look in popular female magazines today, such as People, Us Weekly, Cosmopolitan, and Vogue, they will undoubtedly see underweight women speaking of their successful lives and modeling the latest fashion fads. Although model and celebrity photographs depict thinness of unattainable levels, women have generally become accustomed to these types of pictures and are no longer shocked when they see these skeletal figures in the pages of their magazines. Since the insistence on thin being beautiful is so commonplace today, it can be easy to overlook the real evil that is brewing underneath the media’s glossy pages, advertisements and billboards. The print media is able to maintain an air of innocence since it never says outright that unattainable thinness is ideal; rather, it tacitly approves of these messages by placing models and celebrities on “beauty” pedestals and by supporting the beauty and diet industries that feed off of female insecurity to keep women spending and coming back for more. When the veil is ripped off of the media, the true evil of printing pictures of scarily thin models and celebrities is uncovered through the discovery the of pro-anorexia communities, which use the same images seen in print media as motivators for unhealthy weight loss and as idols of the ideal female body.
Two of the key features of these websites, and one of the most shocking aspects to outsiders, is that they are plastered with “thinspirational” photos, tips and tricks-of-the-trade for achieving the goal of perfection. The photographs of rail-thin celebrities, such as Mary-Kate Olsen, and models, such as Kate Moss, with “jutting hipbones, blade[s] of clavicle[s], [and] rib cage[s] in relief” serve as motivation for starvation (George, 2002). If the reader were to click on the “Thinspiration” link within a pro-anorexic website, such as http://anorexics.net, she would find countless images of these celebrities, and of even more gaunt models. With bones and ribs jutting out, these women are frightfully scary to the outside observer, and rightfully so. Imagine young, impressionable girls seeing such pictures in conjunction with reading the “Thin Commandments,” where they are told that they are fat and ugly. Very many girls, who are in the throws of identity formation and body maturation changes, would probably have a hard time reading and seeing such negative propaganda in support of eating disorders and not be at all affected. To highlight the gravity of what is said on these sites, the above-mentioned “Thin Commandments” read as follows,
If you aren’t thin, you’re ugly.
Being thin is way more important than being healthy.
You must do anything to make yourself look thinner.
Thou shall not eat without feeling guilty.
Thou shall not eat fattening foods without punishing yourself accordingly.
Thou shall always count calories.
The scale is everything.
You must become thin.
Being thin and perfect are signs of true determination.
In addition to such statements, which highlight the mindset of those who teach others about and/or seek advice concerning eating disorders, the details and often upsetting tips and suggestions given expose an even more frightening and dangerous side of this virtual world. These include such tips as, “Live by the scales. It’s right and you’re FAT;” “Nothing tastes as good as thin feels;” “When you get hunger pains, curl up in a ball. It really helps them go away;”1 and “try the good, old spit-in-the-cup routine. Get an opaque cup, chew up the food and spit it back into the cup when pretending to take a sip.”2 Myspace profile names range from “*NiCCi* 68.is.the.perfect.weight”3 to “I want bones for Christmas.”4 Tips have become so dangerous and fantastic that one website even told girls to “cut the fat off their bodies with a serrated knife!” and another reader said that she might try to “cut up [her] gums so it hurts to eat so [that] [she] won’t want to” (George, 2002), (Collins, 2004).
Pro-anorexia websites have been such a huge hit within the eating disorder community, not only because of the advice, tips, and competition they provide, but also because in a disorder that leaves the sufferer so isolated and detached from others, “the Web provides instant friendship” (Morris, 2002). Where print media only sparks imagination and tries to sell products with thinness and beauty, these websites create a community that relates to and validates these girls’ inner feelings of loneliness and frustration from not being understood. These websites become a place where girls with anorexia can go for support and understanding and where they can be free from judgment, ridicule, and nagging from families and doctors. Finding people who can relate to them and people to whom they can relate is highly attractive. Although the websites are filled with “misspellings, muddy graphics [and] stream-of-consciousness entries,” which make them seem “amateurish – even harmless,” it is the “casual tone and imperfections,” which “are, in fact, their power” (Morris, 2002). “Like a voice of a friend,” the makers of these websites are able to connect with their readers on extremely deep and personal levels.
One student from the University of North Carolina, who has suffered from anorexia since the age of nine, described these sites as “morale booster[s]” since they act as “something to keep you going, to make things easier” (Morris, 2002). When these girls feel that there are others out there, who are perhaps worse off than there are, they can validate their choices and actions, or perhaps more accurately, their inactions. Margo Maine, a Connecticut-based therapist and the author of Body Wars: Making Peace With Women’s Bodies, points out that girls will go to these sites, read diary or blog entries, and decide that they are “not [as] skinny” as the maker or have “not gone to the hospital three times” like the maker has, which validated their misconceptions about the severity of their disease (Morris, 2002). Maine underscores that this is the type of “illogical thinking” that accompanies anorexia, especially the denial of the gravity of the disorder. In the same vein as denying the possibly serious health complications that can accompany starvation and purging, these website readers are able to find inspiration from the other women on the sites since “anorexics tend to be a competitive bunch” (George, 2002). In fact, anorexic women will try to “outdo each other – in illness, not in success,” using each other’s diseases as motivation to become the thinnest, the most ill (George, 2002). When a girl suffering from anorexia reads information about the physical statistics of the maker of the website or other readers of the website though message boards, she feels compelled to also lose a similar amount of pounds, so she “ups her [anorexic] activities” so to become the “sicker” one (George, 2002), (Collins, 2004).
Because of the competitive nature, perfectionist predisposition, and willingness to try anything and everything to lose more weight (and hide it from their doctors and families) of anorexic patients, doctors are hesitant to bring up the phenomenon during therapy sessions. “Eating disorder experts say they do not bring up the websites during treatment, for fear of leading patients to them” and, in effect, showing their patients the doorway to everything that is counter to the therapy itself (Elliott, 2002). These websites serve as “roadblocks to those who desperately try to treat [anorexic patients]” (George, 2002). Since “much of treatment is cognitive” and involves “talking” as a “cure,” “having voices talking about how not to recover [on pro-anorexia websites] interferes with getting better,” says Joseph Donnellan MD., a psychiatrist and medical director of the eating disorder program at Somerset Medical Center in Somerville, New Jersey (Elliott, 2002). In fact, there have been battles in the past few years regarding removing pro-anorexia websites from Internet search engines, such as Yahoo!, and from the Internet in general, but these efforts to “lead public battles” were made “reluctantly, again for fear of “lead[ing] patients” to these websites, rather than eliminating their existence (George, 2002).
However worried doctors are to raise their patients’ awareness of these websites by discussing their existence, they are not ignoring the sites’ “dangerous” consequences (Elliott, 2002). “To health professionals, pro-anorexiaÖWeb sites represent the inversion of the Web’s potential to help sick people” (Morris, 2002). In fact, online chat rooms “for people with eating disorders, run by professionals, predate the pro-anorexia sites,” which is why doctors were so struck by their explosion (Morris, 2002). “We didn’t see it coming,” says Dr. Ira Sacker of the Brookdale University Hospital and Medical Center in Brooklyn, New York (Morris, 2002). To help illuminate the severity of the problem that has arisen with the development of these websites, Dr. Diane Mickley, the director of the Wilkins Center for Eating Disorders in Greenwich, Connecticut asks the reader to “imagine a site that told women how to make themselves likely to get breast cancer” or, “if people with heart disease had online communities where they egged each other on in eating Big Macs?” These are the “analog[ies] that put these sites in perspective” (Morris, 2002), (Collins, 2004).
Being made aware of the seriousness and pervasiveness of this growing trend is only the first step in making a difference in patients’ lives. Since “freedom of the press means that you can’t close [pro-anorexia websites] down,” clinicians and families must be ever more vigilant in noticing changes in females’ bodies and attitudes, reacting immediately to the signs that there is something very wrong with tremendous weight loss, and must be equally aware of what young women are surfing on the web. Myspace creates a unique dilemma for parents and clinicians alike. Since Myspace is much more user-friendly and easy to set-up than actual websites, which sometimes require the purchasing of a domain name/web address and always require the setting up of the actual web design and layout, it presents an even more dangerous future of pro-anorexia sites. Myspace is a personal webpage where the profile is all about the actual maker, as opposed to general pro-anorexia websites, where the material covers vast types of information and most often includes pictures of others, such as models and celebrities, but not of the maker herself (Norris, Boydell, Pinhas & Katzman, 2006). When girls post pictures of themselves and of their weight loss successes, the realm of pro-eating disorder Internet material transforms itself from a more distant form of influence to an extremely personal form. 5 Attention, therefore, should equally or perhaps to an even greater extent, be focused on Myspace as an extremely successful form of pro-anorexia web material and its innocent faÁade should be questioned thoroughly. Although pro-anorexia websites may still be unknown to the general public, and even to some within the psychological community, their ability to transform media-accepted ideals of thinness into communities that breed competition, promote emaciation and, in effect, encourage near-death results, make them a force to be reckoned with and one that must be confronted head on in this life and death battle.
- Anonymous. (2006). Beauty and body image in the media. Media Awareness. Retrieved October 5, 2006.
- George, Lynell. (2002). Nurturing an anorexia obsession; ëPro-ana’ web sites tout the eating disorder as a choice, not an illness, to the horror of experts. Los Angeles Times. Pg. E1.
- Meredith Collins, Jill. (2004). Nurturing destruction: Eating disorders online. Off Our Backs. 34, 20-23.
- Norris, Mark L., Boydell, Katherine M., Pinhas, Leora, and Katzman, Debra K. (2006). Ana and the internet: A review of pro-anorexia websites. International Journal of Eating Disorders. 39, 443-447.
- Rothman Morris, Bonnie. (2002). A disturbing growth industry: Websites that espouse anorexia. The New York Times. Pg. 15.8.
- Song, Sora. (2005). Starvation on the web. Time, 166.
- Stagg Elliott, Victoria. (2002). Doctors decry “how to” websites for anorexia, bulimia. American Medical News.
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