My Princess Ana, Fragile Innocence: The cutesy names disguise the dark agenda of pro-anorexia web sites and message boards.
On these sites, "Ana" means anorexia and "Mia" is bulimia. For many, "Ana" is a friend or enemy they all have in common.
Pro-anorexia web sites are controversial -- providing "how-to" sections on purging, tips and tricks on food avoidance, pro-ana chat rooms, distractions from hunger, "thinspiration" pictures of emaciated women and girls, and "LEAVE" messages for anyone who is anti-ana.
"There's no question that these sites have the potential to be quite harmful ... harmful not only to people with eating disorders, but to other vulnerable young women," says Doug Bunnell, PhD, a clinical psychologist in Wilton, Conn., with the National Eating Disorders Association.
With young girls, peer pressure is important -- and the web sites prey on that need, says Nancy Graham, LCSW, director of clinical outreach with Renfrew Center, an eating disorder treatment facility.
"The girls look to others for support," Graham tells WebMD. "They stick together. I've heard it from school counselors -- the girls group together, and it's 'we'll all go and purge after lunch together.' It's hard to break through that to get them to recovery."
Shutting Down Sites
Over the last few years, media attention and efforts by anti-anorexia groups helped shut down over 100 such sites -- only to be replaced by new sites. This "illustrates the resilience of the women who seek them out and recreate them," writes researcher Karen Dias, a counselor in Vancouver, British Columbia, who specializes in eating and body image issues.
Her paper appears in the online Journal of International Women's Studies.
"Most sites make it clear that their purpose is to support those who are struggling with an eating disorder, and to provide a space, free from judgment, where they can share ideas and offer encouragement to those who are not yet ready to recover," writes Dias.
Dias quotes letters posted by readers: "Dear Ana, I feel trapped by you. ... Where is the love you promised? The acceptance? When will I feel like I'm finally in control? Why is it that the more I control what I eat and weigh, the more out of control I feel? As I peel away the layers of fat, the old problems resurface ... the depression, the loneliness, the cutting, the insomnia."
Such narratives "illustrate women's struggles, emotional pain, and searching for acceptance and connection, as well as an ambivalence towards recovery," writes Dias.
Many Hidden Agendas
In fact, the web sites have a spectrum of agendas, Bunnell tells WebMD. "Some are 'way out there,' offering tips on how to get rid of food. Others are more mainstream and encourage people to get treatment. With others, there is intent to promote recovery -- but there will also be a pro-anorexic subgroup in that web site."
When a web site or message board "fuels" this lifestyle choice, it makes treatment all the more difficult, says Bunnell.
"The girls have a strong desire to maintain the disorder," he explains. "They love the disorder. It serves a purpose for them. When you ask them to give it up, you're asking them to give up something quite precious. Dieting or fasting becomes a political statement, a lifestyle choice, an identity statement. These are often very intelligent women, and you can get drawn into their philosophical arguments."
Australian researcher Megan Warin spent three years talking with anorexics. She found that they view their disorder as "empowering" rather than seeing it as a debilitating psychiatric illness. The message boards offer a sense of community much like an "exclusive sorority," which helps explain why treating the condition is so difficult, writes Warin.
The girls' strong competitive drive -- and perfectionism -- drew them into anorexia or bulimia. Those very qualities make the pro-anorexia chats dangerous, says Vivian Hanson Meehan, president of the National Association of Anorexia Nervosa and Associated Diseases. "Often what happens when you see anorexics in a group, they start to compete with each other. They are vying to be the best anorexic ever."
Often, a need to control some aspect of their lives is the driving force for an eating disorder, says Graham. "Eating is one of the very few things you have control over. That feeling of control is really powerful. They are helping each other feel powerful. 'Good job, that's great.' They make each other feel good about something that is very negative."But there's room for optimism on the Internet: One web site called "Something Fishy" is pro-recovery, with chat rooms, forums, and T-shirts geared to motivate girls to recover from eating disorders, Graham tells WebMD.
According to Something Fishy's home page: "It's support for visitors to strive for recovery ... to strive to find the strength to search for who you are, deep down underneath disordered behaviors. I speak to YOU now, for you are NOT your Eating Disorder, nor is your identity lost forever to behaviors you can't stop thinking about, or problems and stresses you feel trapped in. You can be free of your Eating Disorder ... so you can be free just to be YOU."
Does Your Child Have These Symptoms?
These are some signs of anorexia:
- Intense fear of gaining weight, even when obviously too thin
- Distorted body image -- thinking they're fat even though they're really too thin
- Denies seriousness of being underweight or losing weight
- Evaluates self-worth by body shape and weight
- Excessive dieting and/or exercising
- Abnormal food preoccupations
- Menstrual periods stop
If you suspect an eating disorder, it's important to seek help from a doctor, psychologist, or counselor, to figure out the best way to approach her. People can't get over anorexia just by changing their minds. They need professional help.
Published Sept. 22, 2004.