For three years, when Alison Devenny wanted weight-loss tips, she turned to the Internet. But she didn’t look for typical dieting Web sites. The George Washington University sophomore visited Web sites that encourage visitors to embrace anorexia and bulimia as “lifestyle choices” and provide instruction on how to do so.
The sites provide “thinspirational” pictures of extremely underweight women, menu suggestions, discussion boards and tips on topics including ways to overcome hunger pangs, such as doing household chores and drinking lemon water.
Despite attempts to encourage Internet service providers to close down such sites, many continue to exist. A recent Google search using the term “pro-anorexia” yielded 30,000-plus results. Many were links to pages by health authorities warning about the pro-anorexia movement, while others were links to sites no longer in operation. But many linked to live sites.
Carol Day, director of health education services at Georgetown University and a member of the school’s eating disorder treatment team, called the sites “dangerous and disturbing.” Experts say the sites can reinforce unhealthy behaviors, slow the recovery process and discourage people from seeking help.
“I think anyone who is working in the field of eating disorders realizes how unhealthy” the sites are, Day said.
“I always kind of knew that what I was doing was stupid,” said Devenny, now 19, who has since begun treatment for multiple eating disorders. She used to visit the sites about twice a week, she said, picking up tips on how to avoid eating and how to keep her illness a secret from her family.
The terms “Ana” and “Mia”–short for anorexia (a condition characterized by eating so little that one’s health and life are at risk) and bulimia (overeating and then purging by vomiting or taking laxatives)–are often used by those with eating disorders who don’t want treatment.
Frequent visitors to these sites refer to themselves as “Anas” and “Mias” and say the sites offer a safe haven where they can talk, share advice and commiserate away from the harsh criticism of family members, friends and other “outsiders.”
The sites’ creators are typically teenagers and young adults who have eating disorders. Many sites are directed at women, who experience eating disorders more often than men.
About 0.5 percent to 3.7 percent of women suffer from anorexia in their lifetimes, according to the National Institute of Mental Health. About 1 percent to 4 percent are bulimic. NIMH estimates that about 2 percent to 5 percent of Americans experience binge-eating disorder.
About half of people with anorexia or bulimia recover completely through treatment, according to the Harvard Eating Disorders Center. About 30 percent make a partial recovery, and 20 percent have no substantial improvement.
The mortality rate for anorexia is about 5.6 percent per decade, according to NIMH. Cardiac arrest and suicide are common causes of death for anorexics.
But “Anas” and “Mias” say they are not sick, don’t need to be “fixed” and don’t want sympathy. They applaud one another for reaching low weights.
A site called Blue Dragon Fly sells red bracelets to encourage “solidarity” among pro-anas. “So you can go out into the world and not have to wonder, ‘Is she or isn’t she?’ … You see the red bracelet, and you know,” the site explains.
Providers crack down on sites
Some Internet service providers shut the pro-eating disorder sites down in 2001 after the non-profit National Eating Disorders Association and other groups complained that the sites contained content that could harm minors.
Many sites disappeared briefly, only to re-emerge later under different names and on different Internet domains.
Seattle-based NEDA has since changed strategies, opting to create increased awareness and education about eating disorders on the Web and elsewhere.
“There’s the whole free-speech issue” in trying to have sites removed from the Web, said NEDA Chief Executive Officer Lynn Grefe. Unless sites encourage or reflect specific crimes, most Internet service providers have been reluctant to shut them down.
America Online, which has about
23 million U.S. subscribers, has removed several pro-eating disorder Web sites in the past few years under its policy prohibiting “material that defames, abuses, threatens, promotes or instigates physical harm or death to others, or oneself,” according to company spokesman Andrew Weinstein.
“Encouraging an eating disorder would fall into the category of promoting physical harm to others,” Weinstein wrote in an e-mail.
Grefe said NEDA realized that its time was better spent getting the word out about eating disorders and treatments, rather than pushing to eliminate the sites.
“We can’t rid the world of these sites … but we can be more proactive in trying to get real information out to the public,” Grefe said.
Health professionals said people who think they may have eating disorders should seek medical treatment, rather than surf the Web for advice.
“I would prefer that individuals not access that particular door [pro-eating disorder sites] because I think there are dangers involved,” said David Herzog, president of the Harvard Eating Disorders Center.
Most sites offer a disclaimer on their home pages: “If you are currently in recovery from an eating disorder or if you are offended or otherwise disturbed by the existence of pro-ana, I suggest you go no further,” warns a site called The Thin Files. Others discourage visits by those under 18.
— The Washington Post.
TREATABLE ILLNESS
Eating disorders are often accompanied by depression, substance abuse and anxiety disorders. Treatments include hospitalization or outpatient treatment as well as various types of therapy, nutritional counseling and antidepressants, according to the Harvard Eating Disorders Center.
Help is out there
To reach the National Eating Disorders Association’s confidential help line, call 800-931-2237. For more information about eating disorders and treatments, visit http://www.nationaleatingdisorders. org, www.hedc.org or www.nimh.nih.gov/ publicat/eatingdisorders.cfm.
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Edited by Cara DiPasquale (cdipasquale@tribune.com) and Kris Karnopp (kkarnopp@tribune.com)
