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Pro-Anorexia Web Sites: The Thin Web Line

Are these web sites fueling an epidemic?

First Study of Anorexia Sites continued...

Did those who spent time on "pro-ana" sites have more health problems, or more difficulty in recovery, than those who didn't? Yes and no. Although respondents who visited the sites reported spending less time on school work and more time in the hospital, in terms of many other health measures, they seemed no different than the other respondents. Factors included their weight compared with their ideal body weight, the duration of the eating disorder, their number of missed periods, and whether or not they appeared to be developing osteoporosis.

"They didn't necessarily seem to have a 'sicker' health profile, which surprised us," says Wilson. "Now, there are a lot of things that make someone sicker beyond just their weight or how many times they were in the hospital, but it's very interesting that the basic health outcomes didn't show an enormous difference." She and Wilson want to follow up their initial study with a larger, prospective study that may help them understand their initial findings better.

"We as providers worry that these sites are harmful, and of course we feel that they must be. We counsel teens to not use them, and I think we probably need to know more accurately just what kind of effect they have," Peebles says. "There are so many battles that we have to fight when we treat a patient with anorexia or bulimia who's an adolescent, we deserve to know if they're truly harmful or just shocking. If it really doesn't have an effect on their outcomes, there are other things to invest time in."

Anorexia Sites Offer Lessons to Be Learned

While it's far too soon to come to that kind of conclusion, Peebles notes that there are things that parents and health professionals can learn about young people's needs from the "pro-ana" sites.

"It appears that there is a subset of patients who are particularly curious and vulnerable to web sites. They're really seeking information about their illness, really questioning," she says. "How can we address that need for information in a way that's more positive?"

It's not easy. There are a number of good pro-recovery sites, Peebles observes. One of the best-known and most popular is www.somethingfishy.org. But even such sites can be misused to encourage unhealthy behaviors.

"No matter how positive we try to be in our portrayal of information, when you have an eating disorder, you have a very distorted world view and hear what you're interested in hearing," Peebles says.

If, for example, a bulimic in recovery posts the story of how she used to make herself throw up by using a toothbrush, an adolescent with bulimia will likely skip the paragraphs about how horrible the experience was and simply walk away with a new tool for purging.

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