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Anorexia Nervosa Health Center

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Pro-Anorexia Web Sites: The Thin Web Line

Are these web sites fueling an epidemic?

WebMD Feature

"Thinspiration." "Ana." "Mia." "I love you to the bones."

This is the vocabulary of a burgeoning subculture of web sites known as "pro-ana," meaning pro-anorexia. Created primarily by young women who have anorexia or bulimia, or are in recovery from one or both of the disorders, these sites have been making headlines and horrifying parents and doctors for several years.

The sites speak of anorexia and bulimia as if they were almost human, hence the names Ana and Mia. The illnesses are treated almost like beloved but demanding and relentless old friends. They feature photos of rail-thin actresses and models as "thinspiration," and offer tips on suppressing hunger pangs and hiding the evidence of missed periods or vomiting spells. But what's most important, say the sites' creators and visitors, is the support they find from people who understand what they're going through.

"It's a place where we can find like-minded people," says 19-year-old Lizzy, a young woman from the San Francisco area who's created one of the better-known "pro-ana" sites. "Most people don't understand what it's like: They see anorexia as a disease to be cured, but they don't realize that it's also a mental demon that you have to deal with every day. At sites like mine, people can talk about what they're feeling without being judged."

There's no doubt that sites like Lizzy's are shocking and troubling. "Imagine if there were web sites encouraging people not to get treatment for cancer, or celebrating how great it is to have diabetes," observes Doug Bunnell, PhD. "They promote a myth that eating disorders are choices, rather than a physical and mental illness."

But are they doing real harm, or are they just provoking a lot of controversy? Bunnell thinks they're doing serious harm. "In my group of patients, these things are really damaging. Patients are supported in their illnesses and encouraged to stay ill by these web sites," he says. "Anorexia and other eating disorders are notoriously difficult to treat, and one primary reason is because the patient's wish to get better is an ambivalent wish. Things drawing someone toward that illness can be quite damaging."

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