Pro-anorexia (pro-ana for short) and pro-bulimia (pro-mia) websites are usually decried as encouraging women's eating disorders — so much so that social networking sites like Pinterest have banned pro-ana content. But a new study of pro-ana bloggers claims that many of them are getting a sense of understanding and support online that they can't find anywhere else.
For a study published in the journal Health Communication, telecommunications grad student Daphna Yeshua-Katz and her coauthor Nicole Martins interviewed 33 girls and women, aged 15 to 33, who had posted pro-ana content — defined as instructions for anorexic behavior, "thinspiration" photos of emaciated bodies, or poetry or song lyrics about anorexia — on platforms like Blogger, Tumblr, or LiveJournal. Excerpts from the interviews offer a rare window into a practice that many recognize as unhealthy, but still feel they need. Below are some of the responses the study authors got from bloggers:
• "All my friends and teachers and pretty much everyone knows about it but I can’t go up to them and say 'oh, I had a really bad day today because I ate too much' or 'I had a great day today, I swam miles and miles.' You can’t do that. You can’t say all that stuff. Online you can say all that stuff ’cause no one can hold you accountable for that."
• "Nobody 'normal' understands why you want to starve yourself for days on end. Nobody 'normal' can understand your frustrations when you fail and your gleefulness when you can go through a day of fasting or a day of perfect restricting — only people like myself would."
• "I think it was the fact that having an ED was so socially unacceptable that it pushed me to seek others that I could tell my story to. That they would listen and tell me what I wanted to hear."
• "I often call myself an actress on a stage playing out a part in my real life. My blog is who I am backstage when I’m stripped of the makeup and costume."
• "My mother calls me 'greedy' when I binge, and my boyfriend praises me, as he doesn’t realize they are a part of the disorder no matter how many times I tell him. However, online, other bloggers tell me that it’s not the end of the world, they say encouraging things which stop me from wanting to purge or self-harm, and I know they all understand and have been there. That gives me hope that I can get through the binge."
• "I receive support for healthy eating and exercises but I also receive support for unhealthy eating.”
• "I wanted to have a voice that I didn’t have to censor for fear of upsetting people I knew or having them judge me. For me, writing my blog was the only way I could have a shoulder to cry on or a way to celebrate my successes."
Some bloggers acknowledged that the unconditional backing they found online wasn't always good — said one, "I tend to find the wrong kind of support online. When I don’t want to get better, and I want permission to keep this up, I go online." But as Yeshua-Katz and Martins point out, eating disorders are heavily stigmatized — sufferers are often seen as overdramatic, attention-seeking, or in denial. And some pro-ana bloggers clearly feel that their particular slice of the online world is the only place they can escape this stigma.
Unqualified support of both healthy and unhealthy behaviors may not be the best path to recovery, but Yeshua-Katz and Martins also note that the traditional therapeutic methods don't work particularly well — one study found that fewer than half of those who received treatment had recovered after 10 years, while a more recent study put the share of patients whose disease reached full remission after a year of individual therapy at a paltry 23 percent (the family-based Maudsley approach had a higher success rate). Yeshua-Katz and Martins write, "Efforts to censor an outlet for a group who cope with a mental illness that has no effective treatment might not be the right step." Instead, they advocate for better online resources pointing sufferers to treatment. Contrary to the stereotype of the oblivious, thinspo-obessed pro-ana blogger, many of the women they interviewed did show interest in getting better. But they may need a way to escape stigma and judgment in order to do it.