February 1st, 2013

Pro-ana Web sites pose risks

Type “thinspiration” into Google’s blog search: 320,000 results appear.

The phrase appears over images of bone-thin women posted on Pinterest, Tumblr, Youtube and other platforms offering encouragement to be ultra thin. These easily accessible pro-anorexia or pro-ana Web sites pose serious risks to young people with eating disorders, a United Kingdom review finds.

“Virtually Anorexic – Where’s the Harm?” examined 126 non-password protected pro-eating disorder Web sites and online communities that promote dangerous advice such as recommending a daily intake of 400-500 calories, and encouraging bullying and competitive behavior to eat less. About 90 percent of sites analyzed contained thinspiration images of celebrities like Keira Knightley, Victoria Beckham and Mary-Kate and Ashley Olsen.

The Nominet Trust-funded report by sociologist Emma Bond, senior lecturer at University Campus Suffolk, was conducted between January and June 2012 in partnership with Beat and Childnet International. It concludes health professionals, educators and parents should be aware of these sites while not unnecessarily advertising their existence to vulnerable young people.

Walden Behavioral Care President & CEO Stuart Koman, Ph.D., learned about pro-ana Web sites after founding the eating disorder treatment and recovery program’s inpatient unit in Waltham in 2003.

“There was a blog that was all about how to trick the staff at Walden,” Koman says.

“It led to a complete change in terms of our philosophy about use of electronics. In fact, we had people who tried to take pictures of other patients on the unit to post.”

Today Walden patients can use electronic devices under supervision. Patients are allowed privacy for phone calls but are checked on every five to 10 minutes. Long phone calls are discouraged.

The blog about Walden “sort of died out,” Koman says. “It wouldn’t surprise me if there was another one, because that’s what happens with them.”

Some sites the study reviewed had not been updated for years. Nearly 40 percent had been inactive for a few months while others had regular updates as much as several times per day. Some Web sites were shut down by their internet service provider and set up elsewhere with a different name and similar or identical content.

The sites’ secretive nature is part of their appeal and engaging them reinforces an eating disordered self-identity. The study found some sites advocated the wearing of a red beaded bracelet to express this identify.

“These pro-ana Web sites are essentially glorifying a disease that frequently leads to death. This is extremely dangerous. The Web sites are set up in user friendly and appealing kinds of ways,” says Perry Belfer, Ph.D., director of Newton-Wellesley Eating Disorders & Behavioral Medicine and a clinical instructor in psychology at Harvard Medical School.

“If you look at some of the pictures that are presented, you see individuals who look literally like they are about to expire, like they’re about to die at any time.”

Belfer is troubled that advertising appears on pro-ana sites through cookies advertisers inject into users’ browsing history. He called up one site where banner ads for Neiman Marcus and DeVry University appeared.

Online programs with positive messages about recovery can counter the negative influence of pro-ana sites, Belfer says. One model is Student Bodies, an interactive course developed at Stanford University and Washington University in St. Louis for women troubled by poor body image.

It’s important to find out where eating disorder patients are getting their information and work with parents to provide structure at home, Koman says.

“As a person proceeds in recovery they have less and less need for this. Particularly if you’re an outpatient therapist and you’re working with someone, I would think that you’d want to always be checking in with them about how much time they’re spending on these Web sites as opposed to going out with friends,” Koman adds.

By Janine Weisman

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