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"Pro-ana" websites reflect users' conflicted inner worlds

In the world of disturbing web content, it doesn’t get much worse than so-called “pro-ana” and “pro-mia” sites. The virtual community boards, where anorexic and bulimic young women gather to share weight-loss tips and view “thinspirational” photos, are windows into troubled minds.

But according to a study published today in the American Journal of Public Health, the sites are not all bad.

In the first large-scale analysis of its kind, Lucile Packard Children's Hospital pediatrician Rebecka Peebles, MD, and collaborators at the Johns Hopkins Bloomberg School of Public Health looked at 180 pro-eating disorder websites. Contrary to what you might expect, they found that most of the sites recognized eating disorders as a disease, and more than a third included recovery information. However, about a quarter earned high perceived-harm scores (4 or 5 on a scale of 1 to 5).

Peebles says that mix reflects the conflicted inner worlds of the sites’ visitors:

“Many people with disordered eating behaviors have days when they want to get better, and days they have no interest in getting better.”

It’s important that clinicians and family members of eating-disorder patients be aware the sites exist and can intensify unhealthy behaviors, she concludes.

“If these sites make us uncomfortable, the focus at the public health level should be asking how we can reach and treat more people struggling with disordered eating, and how we as providers can become more comfortable with the difficult feelings that people with eating disorders feelRight now, many patients are going to the web to express those feelings, instead of handling them through traditional models of care, such as psychotherapy.”

Peebles also found (.pdf) in a 2006 study that eating-disorder patients who viewed pro-ana and pro-mia sites were sick longer and spent less time on schoolwork. And even those who viewed pro-recovery sites were admitted to the hospital more often than nonusers.

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