No Thinspiration

When you’re hungry, take a nap. Shower, drink tea, numb your taste buds with teething gel, give yourself a manicure. Do anything but eat. These are some of the tips that “pro-ana,” or pro-anorexia Web sites offer to those who choose to restrict their eating.

These Web sites gained popularity the last few years as a kind of support group and community for those who have accepted anorexia as a lifestyle rather than a disorder. They have also become a source of national concern as those with eating disorders reinforce self-destructive habits and ideals through the Web sites.

Before this year, there was no actual study on the effects of viewing the Web sites, but two MU researchers, Anna Bardone-Cone and Kamila Cass, have published a pilot study in “European Eating Disorders Review.” Their larger study about the topic is being considered for publication in an eating disorder journal.

There is a format that comes with a pro-ana, mia (bulimia) or pro-ED (eating disorder) Web site. There’s the “thinspiration” section filled with pictures of rail-thin runway models and celebrities, sometimes accompanied with their measurements, “to set better goals for yourself and to keep on track,” as displayed on “Shophisticated,” a pro-ana Web site. There’s also the “reverse trigger” section, composed of pictures of morbidly obese people, greasy food and “fat” celebrities.

Most sites feature a “letter from Ana,” written from the perspective of Ana, a controlling, consuming friend who will make you perfect and beautiful.

Many administrators use their site as a way to track their “progress” through a daily log of their calorie intake and weight.

“By May I wish to get to 107 (from 120…now 115.4 this mornin),” reads one entry on “Red Dragonfly,” another pro-ana site. Bloggers often berate or congratulate themselves according to whether or not they’ve met their goals.

The Web sites can get deeply personal as users share their secret obsession through ana poetry and stories about how they were introduced to the eating disorder.

“I am 23 yrs old (in April). I have been living with ana since I was 10,” begins the author of “What a Girl Eats,” another pro-ana site.

The Web sites contain the aspirations and angst of the young women who create them, and they are often narrated throughout with comments like, “You are what you eat, and you are fat. Obese. Wretched. Disgusting. A blob of disease rotting your pathetic life away, taking too much space on a planet only fit for thin,” as written on the “What a Girl Eats” site.

The “tips” section is what has generated the most outrage because it provides readers with a comprehensive list of ways to fast and purge. The sites also offer ways to hide an eating disorder from family, friends and doctors and explain how to avoid binges.

Most pro-ana Web sites have disclaimers stating that the content is for those already with eating disorders and not for people trying to recover or who are under 18 years old.

The pro-ana movement is not against recovery, nor a place for eating disorder recruitment, according to the Pro-Ana US Web site.

“It is merely to help people who suffer from anorexia find friendship in a place where they will not be judged,” the site’s home page says. It is about support and acceptance, said Pro-Ana US site administrator Anna Robbins.

“My entire hope for this Web site is that it helps others find peace with their (eating disorder),” she said. “That an ED doesn’t have to rule their lives. That they can manage this disorder, and live happily with it, or recover. That they do not get so far taken, that a hospital visit is their only solace.”

MU assistant professor of clinical psychology Anna Bardone-Cone was first introduced to pro-ana sites by her clients with eating disorders. The sites did give them support, she said, but “our concern, as people who work with eating disorders and are interested in women’s health, is that in addition to the support, they get stuck in the disorder.”

Suspicious of the negative effects of the sites, but supplied without evidence, Bardone-Cone and Kamila Cass, an MU doctoral student of clinical psychology, decided to perform the first experimental study on the psychological impact of pro-ana sites.

“There is nowhere else where you can find such a combination of dangerous elements together,” Cass said. “Pro-anas come out very blatantly and say you should be thin and you’re not good unless you’re thin.”

For the pilot study, which was published in July, the researchers randomly selected 24 women from an introductory psychology course. The women, who were between the ages of 18 and 20, were assigned to view one of three Web sites for 25 minutes.

One group viewed a prototypical pro-ana Web site that was created by the researchers from their review of more than 300 pro-ana sites. Another viewed a fashion Web site that used models sized 8-12. The third group was assigned to an appearance-neutral Web site about home decor.

The three Web sites had similar formats and were created by Bardone-Cone and Cass to ensure experimental control. After the study, the nine women who viewed the pro-ana site went through a debriefing in which the researchers discussed the dangers of eating disorders.

Bardone-Cone and Cass found that after viewing the pro-ana site, women had lower self-esteem and a poorer perception of their general attractiveness. They also felt that they weighed more, while simultaneously feeling less confident in their abilities to attain a desired weight. Among women who viewed the two control Web sites, there were no such changes.

The researchers had consistent findings in a larger study with a sample size of 235 women, which is currently under review for publication, Bardone-Cone said.

While most pro-ana Web sites may have disclaimers, they do not detract from their potential harm, the researchers said.

“It’s disturbing to say the least, the messages that do get communicated, disclaimer or no disclaimer,” Bardone-Cone said.

Besides, many disclaimers on pro-ana sites seem insincere alongside “reasons to be thin” and “pep talk” sections on pro ana sites.

“These are my own reasons,” writes the author of “What a Girl Eats.” “But feel free to make them yours.”

The same goes for the “recovery” sections placed at the bottom of some pro-ana pages. The recovery portions are often small and have what Bardone-Cone refers to as a “cut and paste kind of feel,” with information about the dangers of eating disorders apparently coming from other sources. Suddenly the narrating stops in the recovery section, and the writing takes on an absent, professional tone.

“These guys want to appear to be more equal in the sense that they represent both sides of the argument, and they just choose to be pro-ana,” Cass said. “But really nobody ever talks about the recovery section in the chat room.”

What is apparent from the chat rooms and other interactive portions of pro-ana Web sites is the young age of those viewing them.

In the guest book of “What a Girl Eats,” “Nicole” writes to the administrator on Aug. 2 how inspirational her site is:

“I am 14 and am taking up the lifestyle of Ana. Slowly but surely I am cutting food out day by day and I love it. You may think I am stupid. But it’s what I want. I want to see the beautiful me and I know I can do it. Your site is supporting me in my struggle as are a lot of others, and I thank you.”

And while Pro-Ana Nation clearly states in its disclaimer that you must be 18 or older or have parental consent to enter the site or join the forum, its eating disorder buddy list tells another story.

Exempting repeated or ageless entries, there were 5,299 buddies as of Aug. 28 on the Web site, which is copyrighted for 2006. Of those entries, 36.3 percent were 17 years old or younger.

Bardone-Cone worries about the effects of the Web sites on the body images of young people.

“Being able to reach out very easily to people who give you maybe unhealthy ideas, especially as a teen, a pre-teen,” she said. “That’s a very vulnerable population.”

Bardone-Cone recommends that parents place computers in a public area of the home and consider blocking pro-ana Web sites from being viewed on home computers. Parents should also encourage critical evaluation of the media, the researchers said.

Since the sites came to national attention in 2001, major Internet servers have removed some sites, but in their place, more have been created, sometimes in commemoration to those preceding it. In light of Web site censorship, many pro-ana groups have been founded on Facebook, Myspace and other social networks.

But Pro-Ana Nation argues that censorship is not the answer.

“Some people ask if it is ethically acceptable to allow pro-ana Web sites,” the site reads. “In my opinion, if they start banning pro-ana sites, they may as well censor the pages of the major fashion magazines, with their features on… ‘The latest diets to help you fight the flab.’

“Fashion magazines will often provide advice on exercise and ‘healthy’ eating alongside pictures of genuinely underweight models, many of whom appear on the “thinspiration” sections of pro-ana Web sites. To censor pro-ana sites in the face of this kind of material seems hypocritical, to say the least.”

MU researcher Cass said she has read Seventeen Magazine since she was 12 and has had a fascination with the media images and culture that contribute to the development of eating disorders.

“I just felt like I got it,” she said. “I got why people had eating disorders.”

Bardone-Cone also said she recognizes the negative impact that fashion magazines can have on female body image. But, she said, pro-ana Web sites are further harmful because of their extremity and because of the encouragement online peers give each other. The models are thinner, sometimes digitally manipulated, and the advice can be dangerous, she said.

This new kind of media pressure is particularly relevant to Cass now that she has a young daughter, she said. And Bardone-Cone, who has had friends that suffered with eating disorders, has seen the effects the disorders have on ambitious, accomplished women.

“This disorder is just devastating,” Bardone-Cone said. “It really will sap their mental energy and their potential.”

Eating disorders, particularly anorexia, carry a high resemblance to obsessive compulsive disorder, she said, because food and weight consume the thoughts of those with the disorder.

“I’ve worked with clients with anorexia who have asked me, ‘If I didn’t think about food and weight, what would I think about?’” she said.