Monday, December 11, 2006

Pro-ana and Pro-mia sites

Someone sent me a link to an article from Newsweek entitled "Mixed Messages." It talks about websites taking us into the world of anorexia (called pro-ana sites) and bulimia (called pro-mia sites). Here's a sample of what they say:
Drink ice-cold water ("your body has to burn calories to keep your temperature up") and hot water with bullion cubes ("only 5 calories a cube, and they taste wonderful"). When a food craving strikes, give yourself a manicure ("applying extra layers of slow-drying polish. It will keep your hands occupied").
The article goes on to outline the debate that is occurring on whether these sites are good or bad. Those in favor of the websites state that the internet is a huge support group for these (in general) troubled teens who visit it. Others say that these sites promote and glamorize this type of lifestyle.

It's a pretty balanced article and I encourage you to check it out. The question comes back to this: Can a website CAUSE a change in behavior, especially in younger people? Here is one point of view from the article:
The pro-eating-disorder sites feed into anorexics' competitive nature, says eating-disorder specialist Dr. David S. Rosen, a professor of pediatrics and internal medicine at the University of Michigan. "They're constantly trying to be the sickest, the thinnest, the most unhealthy. If you go to a Web site where people are describing their eating habits, their vomiting practices, if you're in the throes of a serious eating disorder, no matter how that information was intended when it was put out there, it may be a challenge to eat less, to take more diet pills, to weight less. That's where the harm is."
Here is another point of view:
Could the sites somehow lure a completely healthy girl into becoming an anorexic? "You've still got to have some sort of predisposition," says John Levitt, director of the eating-disorders program at Alexian Brothers Behavioral Health Hospital in Hoffman Estates, Ill. "It's a little bit difficult to believe they went there and were pure." Most patients "don't need the advice," he says. By the time he sees them, they already know the tips and tricks. But, he says, "if you have a predisposition for something, you get reinforcement for it."
I have never been of the opinion that media (whether it be violent movies, certain video games, certain types of music, etc.) has a causal relationship with a person's behavior. People should be accountable for their choices and actions. For parents, they should be accountable for supervision of their children and teens.

But, this article does make some compelling arguments to make me think. I haven't changed my position. But, as I alluded to in Direct to Kid Advertising, it seems like it's getting more and more challenging for parents to de-program their kids from the media message saturation.


Anonymous said...

I agree that the science doesn't support that the media directly causes eating disorders. But what these sites do do is create a community of young women and make it seem normal and acceptable to be obsessed with one's body and to diet. The eating behaviors shared on these sites are definitely not normal eating or healthy relationships with food or their bodies. It is the serious dieting that physiologically increases (18 times) the likelihood of these young women ending up with eating disorders.

Dr. A said...

The thing that I'm concerned about is that too much attention will be given to these sites to possibly shut them down.

The real problem, in my opinion, is addressing the eating disorder phenomenon itself. These websites are just a symptom of that.

How to adequately address this problem is the real challenge. I'm not sure how to adequately do that at this point.

The Curmudgeon said...

I think the medical community sends out mixed messages, too.

I've seen the so-called obesity charts... in which everyone who is not a Kenyan marathoner is deemed obese, at least. Marilyn Monroe! Obese? According to some of these charts, yes.

Football players? Some (Refrigerator Perry -- remember him? -- comes to mind) probably are overweight -- but most are in incredible shape... and yet there are medical groups out there that claim that most football players are grossly obese.

It's not just the women's fashion magazines that create these ridiculous body image problems....

Dreaming again said...

Honestly ... I have mixed feelings on these issues. But, given the severity of my eating disorder, I may not have a valid opinion on this matter.

Those with ED's managed to find ways long before the internet to do this. I had a massive eating disorder, severe and with all the typical, stereotypical behaviors 2 years before I'd ever even heard of an eating disorder or saw anything about it. It was my little secret in my corner of the world.

However, these sites DO worsen an already existing eating disorder.

So does the focus on them.

In all honesty own is at a tug of war right now. I've been struggling with not going back to restricting and have skipped more than too many meals in recent days/weeks. It's 3:30, breakfast was skipped (unless 3 pretzels and half a grapefruit count) and I'm fighting with myself over lunch.

Right now, my body is fighting and it's winning ... and just reading your post reminded me of some of my more destructive 'coping skills' to deal with the body's winning.

However, I will be getting up out of my chair right now and do the right thing and get a balanced lunch.

In conclusion ..a die hard eating disordered person ... will do what they're going to do. Website or not.

Anonymous said...

I don't think it's a good idea to have websites that might encourage girls with a predisposition to eating disorders, because many young girls are heavily influenced by their peer groups, especially those that are highly "emotional". But I think fashion advertising influences young girls the most. When I was a teenager I read fashion magazines constantly--and I wanted to look like the models. And today's models are bone thin.

Anonymous said...

I don't think these websites are a good idea. I also have to say that I don't agree that when teenagers fall into some of these disorders that it is always the result of poor parenting.

Dr. A. the truth of the matter is, that kids reach a certain stage and age, where they become almost unreachable to their parents. It is not just a myth, or a cliche, that teenagers believe their parents to be stupid or old fashioned. They turn away from parents and head straight for their peers. Mid teens has been where I have seen it the most at.

They are trying to enter the grown up world and are halfway between child and adult. It is when they need us the most, and fight us the hardest. As parents we have to be very strong in dealing with our teens.

Iam sick of media and web sites that tell our teenage girls that they are fat and need to do this, this and this and then they will be fine.

Dr. A said...

I'd like to apologize to Janet from Chocolate and Rasperries. She has been trying to post a comment here. But that darn Blogger is preventing her from doing that. So, I've cut and pasted her comment here....

Blogger is acting weird again and after trying three times I have been unable to post a comment on Dr.Anonymous so I'm going to have to sound off here. This is the link to that particular post.

His post is about websites that are pro-anorexia and pro-bulemia but he made a passing comment about media saturation that pushed my buttons.

I agree with him that people should be held accountable for their behavior and that parents should be held accountable for their children but, as a commenter said, it isn't that easy. It's part of the normal developmental process that children turn away from their parents and toward their peers.

IMHO, it's media saturation that is the greater problem. I recently read an article in a magazine that mentioned advertising posters being placed in grade-school restrooms and on school buses. Try to spend a day without being exposed to television or video screens. How many times a day are you faced with advertising in some form? News programs no longer report the news, they sensationalize one or two stories ad nauseum. We are all "plugged in" with our iPods and cell phones and blackberries.

So, where do we draw the line? And how do we go about it? Freedom of expression is essential to the Web and we have already had too many compromises to the First Amendment. Censorship is not the answer.

Unfortunately, I believe that images presented in the media create a distorted perception of reality in people's psyche. I do not doubt that ever thinner models and celebrities have contributed to eating disorders in a society that places such a high premium on appearance. Look at the crime rate and compare it to violence in movies and TV shows. And then there is the on-going discussion about the lyrics of rap and hip-hop music.

We are constantly coerced into buying more and more. We are told that if we use certain products we will be more sexually desirable or our lives will be easier. Advertising is all over the Net. More and more bloggers run ads in the hope that they can make a few bucks while blogging.

Are our lives so empty that we have to escape into the fantasies created by the media? If adults are vulnerable, how much more so are children and teenagers who do not have the life experiences to be able to tell the difference? Are we turning into a nation of sheep?

I wish I had some answers but I don't. Many people blame our problems on the breakdown of the traditional family and poor parenting. I don't think it is quite that cut and dried. Censorship would start us down a slippery slope toward totalitarianism and you can't legislate morality or values.

So what do we do?


HP said...

The issue I have with these sites is that they normalise such behaviours and such behaviours are anything but normal.

Of course, people with disordered eating practices will have already discovered/done much of what is covered on these sites but what about those who might be just curious/vulnerable and get sucked into the 'club' mentality. Adolescence is a time when you look to your peers for how to behave, you want to belong..that's the danger with these sites.

Lately these sites have received so much attention, it's probably inadvertently sending more people to check them out.

Anonymous said...

I want to comment here but argh, I don't know if I can offer anything helpful to the discussion that hasn't already been said.

Janet offers very valid points. Part of me just wants to blast all of these sites off the internet but you can you really do that? How would I feel if people read my recent post on cutting and took that as some sort of "instruction." I know that it's not quite the same but I don't believe in censorship. I just don't.

I also don't believe that these sites "cause" EDs either. They weren't around when I was younger and had my brief flirtation with anorectic behaviour. But I do see them as problematic. Absolutely.

Are they the only problem? No. But like everyone else says, drawing more attention to them gives them more of a presence than they deserve.

Anonymous said...

I meant to comment on this when you first posted, but I've been busy with school and now the after effects of the windstorm. Now that this post is in GR, I feel that I have to comment:

1. I am totally against the websites. I get many hits on my blog where people are obviously looking for those sites, and I even tried to stay away from using the A-word. However, using it is a sure way to increase hits from Google (not one of my goals).

2. You shouldn't come down so hard on parents. Anorexia and its evil sister are more about "control" than anything else. Women and girls afflicted with eating disorders have little control over other areas of their lives, so they seek control other areas. It's hard to force someone to eat, and harder yet to force them to keep the food in their bodies. Yes, part of it is body image, but you can't ignore the "control" piece.

Trust me, I've been fighting anorexia since high school. Walk a mile in my shoes, then post again.

(The link to my blog goes directly to a post on eating disorders.)

Anonymous said...

I spent last Saturday shopping for jeans for my 14 year old daughter. She grew through two sizes over the fall, and now the jeans she has are too short and too large around the hips. Instead of being happy that she is getting taller and thinning out, she was morose because she isn't any where close to a size 2. She was angry with me when I pointed out that a woman who is nearly six feet tall would be in medical danger if she wore a size two and that when I at 5'2" wore a size two it didn't make me feel any better about myself. She refused to buy any of the jeans because they were the "wrong size". The next day she was sitting beside her best friend and I noticed that she was somewhat thinner than B. So later I asked her if she considered B as fat. She responded no, that she wished she looked like B. I showed her a picture that I'd snapped of them sitting next to each other and asked her who was thinner, her or B. She responded that B was thinner. The point being that my daughter is responding to unreasonable expectations that are being placed on her from everywhere but me, and I can't make her see that they are a dangerous and false picture of what her body should be. As a parent I don't need to compete with a website that teaches her how to self destruct herself into this false image. It is more than enough for me to keep up with her grades, and who her friends are, and where is she really when she goes out, and to continue to guide her into a reasonable career path and make sure that she isn't self medicating etc...into infinity. If the websites are offering a support group to self destruction they are bad. And as has been well pointed out in other comments, I am no longer the peer group or the support group. I can make sure my daughter eats when I'm around, and doesn't automatically excuse herself to the bathroom when the meal is over, but anorexics and bulemics are sneaky little beasts and this is a control issue.

I say take the sites down and would the rest of the world follow the example of Milan and ban underweight models?

Nancy L. Brown, PhD said...

Nice post! I had a little different take on this and focused on letting parents know about these sites and encouraging them to know where their kids are going on the Internet. You can check my post out here: (

Anonymous said...

People that think this illness only has to do with image are totally wrong.
It has to do with control, and it can hit men and women at any age. This illness does not discriminate.
I agree with one of the previous comments from 'difficultpt' that it's about control. When everything else in life fails, at least you have control over this.
It's hit me 2 times in my life, and it's hitting me again. Same thing as before, it's not always about image, rather control. And I'm not a high school or a college student.
I have not had anything to eat in about 30 hrs, and I praise myself in my mind at least I have this under control. This I've been doing for a few weeks now.

Websites or not, it'll still be there

Anonymous said...

Before I begin my comment- let me make it clear that I am not purposely criticising you, or your beliefs, considering how this article is based upon a different article I’ve yet to read, and how you aren't totally closed-minded to others opinions etc. I would just on the grounds on what you have stated, and those that have taken the time to comment, like to make a couple of points. Without being patronising I find it important to address the association of anorexia with women, and the discrimination (whether it is viewed as a lifestyle-choice or mental illness) against men, if you have been visiting these sites or researching anorexia, I am sure that you have come across the growing male population, so is not to condemn the female population alone, and to bare that in mind when talking about media-influence to be extremely thin.

The fact of the matter is, whether I personally agree with it or not, anorexia in the psychological and medical world is a term given to a person that is indeed suffering from a mental illness, as is a person suffering from ocd or schizophrenia or alcoholism. Whether it is viewed as neurosis psychosis, addictions, or an eating disorder it is a mental illness. Those that do not believe their food/weight/exercise/emotional/attitudes/health and many, many more 'problems' or ways of life, are an illness such as anorexia refer to this 'lifestyle choice' as ana, which is not a medical term for a mental illness, but of course there is question of what makes people act in this manner and surely to have such a lopsided perception to feel such a way and act in such a manner is seen as incorrect and shows this person is psychology ill, for what 'sane' 'normal' person without depression, ocd, bdd, and many other 'psychological' disorders that go hand-in hand with anorexia, would view such a 'lifestyle' as healthy, normal, and appealing?

To be quite honest, I don't know. I am of a sure mind that I, for someone my height, age, weight, gender and for my bodies demands energy and health-wise and in comparison to others do not have a 'normal' relationship with food, exercise, and self-acceptance. I am also aware that there are many habits, feelings, thoughts, moods, etc. I have that don't seem to be either, so who knows what it is I really see and why. I however do know that as much as I question 'ana' to be a mental illness I also question whatever name given to depression, paranoia, obsessive-ness etc. to be a mental illness as well. I work around and with people with mental illnesses and not as a nurse, or doctor of any sort, but sometimes for the life of me I can't tell the difference between the patients and the nurses. I also see sometimes that a lot of the 'problem' is the personality of the person, which the nastiness is usually enhanced by how spoiled this person is. So as of yet, I am not fully convinced life is as simple as the sane the insane and the mentally challenged.

To answer the main question- should these sites be shut down, my answer remains 'no'. Besides the true fact that these sites do not create the problem, but rather encourage or support it, I don't think it's the right step. This idea of eating disorders being a lifestyle choice isn't created by the internet it's an age-old story. And isn't denying that one has a problem the core symptom of most disorders and the one thing preventing 'us all' from getting help? The truth is you cannot prevent people from obsessing, and sharing 'tips and secrets' with one another. The internet is only one way of meeting and whereas you may want to close down these sites, you can't prevent people from feeling or thinking a certain way, and for voicing their opinion. You can't prevent such groups or as referred to 'cults' from forming, and in a sense isn't it better to be virtual rather than in the flesh, can you imagine how that would go down? Constantly being surrounded by 'these others' and meeting face to face rather than screen name to screen name? You can also call it an age-old excuse but until you experience it yourself there is no doubt that it is a form of support. Even if in the end it can end up somewhat damaging, I know it prevented me from killing myself, and many others too. Sometimes it helps people to get the courage to go into recovery which I've seen many a time as well, other times it can go in the opposite direction, I'm not going to lie. But I do firmly believe we all have a right of speech, and just because others disagree with it, no matter how strongly they feel doesn't give them the right to stick their nose in where it doesn't belong, at the end of the day it's none of their business, I'm sick of hearing all this bullshit about having to protect their children when evidently 'worried parents' aren't all that concerned if their young children have uncensored access to the internet, they're open to anything, forget pro-ana sites, what about porn? Pro-harm, pro-suicide, chat rooms, and general 'unsuitable' topics for children? Hum?

Which is another topic I'm dying to address. What is with all the focus on pro-ana/mia sites when at the end of the day they are the least of your worries in comparison to what else the internet has in store for you...what about all these sites promoting death, terrorism, murder, showing films and pictures of rape/sexual-abuse kidnap, torture/mutilation, murder, suicide, child-abuse, etc. or the child porn, or the pro-self harm and pro-suicide sites. At least pro ana sites favour the introduction of 'do not enter if you are 'looking to get' an eating the disorder' rather than 'you are worthless you do not deserve to life go kill yourself now' and I've come across it...

And then there are those stereotypes, take for an excellent example the whole 'emo' craze. What about that promotion of self harm and depression, I'm sorry aren't they mental illnesses and not a 'lifestyle choice'? and if I take walk in my own neighbourhood there is without a doubt ten times the amount of 'emos' to 'anas' hum?

Also when we refer to eating disorders we so ignorantly forget about the 'other end of the stick' it is so easy *even in medical and psychological terms* to forget that anorexia and bulimia aren't the only eating disorders, and whilst we are over-preoccupied with becoming emaciated there is also the risk factor of one becoming morbidly obese...bed, coe, ednos, and even in some respect orthorexia are all other forms of eating disorders so to speak, and in many cases as dangerous. Yet we are much quicker to criticise those that are underweight, in comparison to those that are overweight- and this is for some reason justifiable, well, please, justify that for me. Because although there are sites that promote emaciation there are also sites that promote obesity, and I find that a tad discriminative to not obsess over that and condemn it as much as we do this 'thin obsession' because it's just as dangerous and life-threatening, and if you take one look at society you cannot deny the alarmingly high rate of obesity amongst our societies. And why aren't we so bothered by this?

The last thing I'd like to discus would be the role media and the fashion industry has to play. Firstly I'd like to disagree with someone said about thinking the rest of the world should follow and ban models that are under a certain weight, I think, in my personal opinion that that is disgraceful, and yes discriminative, it doesn't resolve anything, but further adds to the misfits created by society and the fashion-culprit worlds. There shouldn't be an ideal image at all, as that is what leads to this obsession, striving to look the perfect way that we are oppressed to feel like. If models weren't stereotypically anyway but free to be anyway that would go down much better in society. Otherwise I find it unfair there still has to be a certain height restriction, that is unrealistic, or one must look a certain way- facially that's discriminative, and if models that are under a certain weight are banned, shouldn't models over a certain weight be banned as that too creates an unhealthy unrealistic image and bad promotion? Let's say anything with a bmi over 27.5? That seems only fair to me- don't you think?