Websites Encourage Eating Disorders with 'Thinspiration'

[Guest guest]

Websites that encourage teens to continue in their eating disorders tend to

do so via " thinspiration " -- a combination of images and prose that drive

the viewer toward continued weight loss, researchers say.

About 85% of these sites provide thinspirational photos (or " thinspo " ) of

ultrathin women and oaths to " Ana " or " Mia " -- nicknames for anorexia and

bulemia -- according to Dina L.G. Borzekowski, EdD, of s Hopkins, and

colleagues.

Nearly 80% of the so-called pro-Ana or pro-Mia sites are also interactive

and encourage users to post their own photos, artwork, and comments, they

reported in the June 17 issue of the *American Journal of Public Health*. " It's

a community, " Borzekowski said. " Some feel it's an exclusive community of

like-minded people who engage in similar behaviors. "

Some are even elitist. One site, for example, touts that an eating disorder

" is a gift and you cannot decide to have an eating disorder. So if you are

looking for a way to lose weight ... move on, try Craig. "

Borzekowski suspects the sites have been around as long as the Internet

itself, but to clarify the contents and the reasons patients use them, she

and her colleagues reviewed 180 of them.

The vast majority -- 91% -- of the sites were open access and most were

maintained by a single individual. Most offered pro-anorexia content (84%)

but many also provided pro-bulimia content (63%). Rarely did the sites

endorse only one eating disorder, the researchers said.

Although 85% provided " thinspiration, " 83% also offered overt suggestions on

how to engage in eating disorder behaviors.

" The tips and techniques were suggestions and strategies to achieve rapid

weight loss and even hide one's eating disorder from concerned parents and

friends, " Borzekowski said.

Although the majority of the sites did acknowledge that eating disorders are

a disease, 42% called it a " lifestyle. " In fact, 16% of these sites had a

written creed to " Ana " or a statement of the " Thin Commandements " -- " Thou

shall not eat without feeling guilty, " for instance.

" There are some [sites] that are quite blatant that they're trying to

promote eating disorders as a lifestyle, " said Rebecka Peebles, MD, of

Stanford University in Palo Alto, Calif., who was also an author on the

paper. " Those aren't the most common, but they do occur for sure. "

Only 38% of the sites included recovery-oriented information or links,

although the authors said they were surprised that this statistic was so

high.

" It represents what's out there, " Borzekowski said. " There are some people

who suffer from this disorder, who realize it's a disorder and want help,

while there are others ... who think it's a lifestyle. "

Celio Doyle, PhD, of the University of Chicago, who was not invovled

in the study, said that when she encounters patients who visit the sites,

she tries to " find out what they're learning, what kind of reactions they're

having. "

Since eating disorders disproportionately affect adolescents, she also works

with families to try to curb visits to the sites by encouraging limits on

screen time and use of parental controls.

" You can't control everything an adolescent does, but at least you're

sending a message and eliminating the chances they have [of getting onto

these sites], " she said.

But she cautioned that the more important factor may be keeping away

high-risk individuals who haven't progressed to a full-blown disease yet:

" You don't want them getting drawn down that path any more. "

The sites may also be valuable to the health professionals who treat

patients with eating disorders by providing insight into the conditions.

" [The sites] do help you get into the psychology more -- the isolation, the

desperation, and the desire for support, " Celio Doyle said.

Peebles said that initially, the content was " pretty upsetting to me as a

physician working to fight these illnesses. " But after she was able to watch

the sites' evolution, she noticed that they were " reflective of the

different feelings that people with eating disorders are having. "

" Sometimes they want to get better, sometimes they don't, and the sites

often reflect that duality. "

Her concern now is that the sites potentially speak to an underserved

portion of the population that is severely ill.

" We need more services for people with eating disorders, " she said. " We need

to be able to identify who is struggling and help them in a [more helpful]

way ... so they don't need to go online for these things. "

*Primary source: *American Journal of Public Health

Source reference:

Borzekowski DLG, et al " E-Ana and e-Mia: A content analysis of pro-eating

disorder websites " *Am J Public Health* 2010; DOI:

10.2105/AJPH.2009.172700.<http://ajph.aphapublications.org/cgi/content/abstract/\

AJPH.2009.172700v1>

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--

Ortiz, MS, RD

" I plan on living forever - so far so good "

" Cause of obesity, heart disease and cancer: Look at the end of your fork "

*A Forum on Health Communication*

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