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Pro-Anorexia Web Sites: The Thin Web Line

Are these web sites fueling an epidemic?

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.

What's more, many pro-recovery sites, no matter how well done they are, are created by parents, doctors, counselors -- in short, adults.

"They're not specifically aimed at teens and very young adults, or created by them, and they don't necessarily provide the same level of understanding or forum for expression," says Peebles. "It illuminates what we need to be searching for in terms of a better forum: something that can make someone who's ambivalent, and needs to express both feelings, feel comfortable."

That's a complicated proposition: how do you create such a site that remains teen-friendly, but doesn't worsen the eating disorder, while at the same time not making it patronizing? Peebles hopes future research will shed light on that question, but acknowledges that it's a challenging task.

Lizzy, for her part, says she strives to make sure her site addresses the dark realities of eating disorders, rather than merely glamorizing them. "Most other pro-ana sites are just all, 'Yay ana! It's the best!' They don't show how awful and horrible and miserable it is," she says.

Often, people will email her asking that she "teach them" how to be anorexic or bulimic. "That scares me. I tell them to read the sections about how it's not fun and games. It's not glamorous. I want them to know about the pain and the physical damage that comes from it, how you're cold all the time and you can't walk up the stairs because you have no energy. How your hair falls out and your skin gets all gross and yellow, and you start burning your muscles and the organs. People don't think about that."

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