Pro-anorexia and pro-bulimia websites, blogs, and social media: Moral panic isn’t healthy.

The Panic Over Pro-Anorexia Websites Isn’t Healthy

The Panic Over Pro-Anorexia Websites Isn’t Healthy

Notes on the culture of the Internet.
July 14 2015 5:45 AM

Let Them Blog

The panic over pro-anorexia websites and social media isn’t healthy.

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Photo illustration by Lisa Larson-Walker. Photo by Catherine Yeulet/Thinkstock.

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Illustration by Robert Neubecker

In 2001, a reporter for the New York Post came upon a secret corner of the Internet where teenagers conspired to starve themselves. In this “sick world of pro-anorexia Internet sites,” groups of girls lived by the “Thin Commandments,” worshipped the ribcage of Kate Moss, and cheered each other toward starvation. It had all the ingredients of a 21st-century moral panic: teenage girls using new technology to join supermodel-driven cults.

Amanda Hess Amanda Hess

Amanda Hess is a David Carr fellow at the New York Times. Follow her on Twitter.

The “pro-ana” alarm bells rang from Oprah to Boston Public to the New York Times. The National Eating Disorders Association said the blogs were as dangerous as “putting a loaded gun in the hands of someone who’s suicidal.” A feminist scholar refused to comment on them at all, fearing that just speaking their names could point more people toward “a life of misery and possibly death.” Tech companies banned them, censored them, and spammed them with public service announcements telling readers to get help. This spring, France extended the crusade to the offline world: Lawmakers passed a new criminal offense, “l’incitation à la maigreur excessive,” or inciting excessive thinness, that could finally put pro-ana bloggers in prison.

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But the pro-ana blogs have persevered. And now, a crew of researchers, activists, and therapists are on their side. These experts have scrolled back through the pro-ana Internet and discovered nuances they never noticed before. They’re beginning to wonder if we’ve been viewing the pro-ana problem all wrong. What if the best thing to do is just let them blog?

The pro-ana narrative of 2001 told of deranged webmasters who preyed on vulnerable girls and lured them to their deaths. That false distinction is finally being corrected. In April, researchers reported in the European Journal of Pediatrics that most webmasters of pro-ana sites (and their bulimia-focused cousins, pro-mias) are themselves young girls (and in a few cases, boys) with eating disorders. Social media has made this pattern obvious: On apps where every user is both publisher and consumer, pro-ana promoters are their own victims. One recent study of pro-ana Twitter accounts pegged the users’ median age as 17. France’s new law is harder to cheer once you realize it plans to fight anorexia by incarcerating starving teenage girls.

Pro-ana blogs are easier to understand when you stop seeing them as propaganda organs and start viewing them as expressions of mental illness. In a paper published last year, psychotherapist Tom Wooldridge describes one patient with anorexia who used pro-ana blogging as “a psychic retreat” where she could “withdraw from overwhelming emotional pain.” Some sites are less autobiographical diaries and more portraits of anorexia itself: Posting thigh gap after thigh gap to Tumblr helps some girls release the pressure of the images that anorexia pounds relentlessly into their heads. One pro-ana blogger, who blogs under the handle AnaGirl Empath, cautions that pro-ana’s more extreme manifestations are “creative alliterations” that should not be “interpreted literally.” As the French sociologist Antonio Casilli put it last year, “Criminalizing these websites means [criminalizing] mental illness—a double burden for sufferers.”

Early criticisms of pro-ana seemed more concerned with the girls who were not suffering but could soon be convinced to join the club. But while we know anorexia can kill, we’re not quite sure what happens to people who read about it online. In an article published last month, Canadian criminologists Debra Langan and Nicole Schott could find “no scholarly evidence” that pro-ana blogs pose a threat to their audiences. If they do, there’s no proof that any of our social remedies—censorship, PSAs, or prison time—do anything to help. These campaigns are most obviously effective at flattering the egos of the lawmakers and tech execs who champion them. When a girl searches Tumblr for a pro-ana–adjacent term like #thinspo or #thighgap now, Tumblr intercepts her request with bland concern (“Everything OK?”), then advises her to check out the cutesy motivational messaging on the National Eating Disorders Association’s Tumblr instead. However the girl responds, Tumblr can feel satisfied it’s performed its civic responsibility. The strategy recalls the one favored by a 19th-century doctor who believed that reading novels caused hysteria in women: He counseled men to confiscate their wives’ fiction and replace it with a book on “some practical subject,” like “beekeeping.”

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We know now how these strategies can backfire. The 19th-century husband was trying to protect his wife, but he angered her, and now she can control bees. Similarly, Casilli has warned that censorship and criminalization of pro-ana doesn’t reduce the number of such sites on the Web. But it can push them into “densely-knitted, almost impenetrable ana-mia cliques” that are “suspicious, secluded and inward-oriented.” When pro-ana bloggers feel scrutinized, they reinforce the wall between themselves and the outside world. That strengthens their influence over their audience and reduces opportunities for pro-ana and pro-recovery communities to mix.

Consider what happens when doctors can’t listen in on pro-ana chatter: In 1985, psychologists discovered that young women were abusing syrup of ipecac, an over-the-counter drug designed to induce vomiting in the case of poisoning; by the time they caught on, they believed that 30,000 or more girls were already hooked, no online tipoff required. That’s why, when experts at the University of Washington and Seattle Children’s Hospital concluded a study of pro-ana Twitter cliques this February, they championed them as “novel opportunities to identify and gain insight into disordered eating, which is invaluable given the covert nature of this illness.” The scariest pro-ana message may be the one we can’t hear: The Snapchat thinspo that dissolves before parents and press find it, or the WhatsApp group that organizes fasts where Google searchers can’t follow.

But lift the institutional pressure, Casilli argues, and pro-ana sites “tend to evolve towards moderate orientations.” Many sites have done just that. Early critics slammed pro-ana bloggers for framing anorexia as a “lifestyle choice” elected by people who don’t understand they’re ill, but now the typical pro-ana site embraces the language of mental illness. One popular LiveJournal recently analyzed by researchers from the University of Alabama in Huntsville and Louisiana State prohibits fasting and purging tips, calling them “dangerous” and “disgusting.” Instead, people log on to “relieve tension and anxiety” and work through the “stress that they experience in dealing with their mental illness,” often by role-playing through interactions with doctors and friends. As Langan and Schott put it, pro-ana sites allow users to “collectively communicate, connect, and potentially resist.”

Mostly, they let them speak. Many people first arrive on these forums having never discussed their disorders with anyone else. Chatting there can be a strategy for avoiding recovery, sure, but also the first step toward professional help. Wooldridge describes a psychotherapy patient who used pro-ana forums to “imagine different thoughts, feelings, and ways of being in the world.” She went on to articulate those thoughts in her therapist’s office and, eventually, with a man she’d become close to offline. In light of everything that happens there, pro-ana feels like a misnomer. The well-trafficked MyProAna forum, for instance, welcomes anyone who identifies with having an eating disorder—fat or thin, teen or parent, fasting or recovered. Some members convene in a recovery group, some fawn over Lena Dunham’s fearless body image, and some obsessively post pictures of their emaciated ribs and label them “fat.” That last activity might be censored from a recovery-oriented site, deemed “triggering” to people fighting to get better. But pro-ana defenders argue that those rules only hurt the people who need help the most.

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Or perhaps this kinder, gentler image is just pro-ana’s latest trick. One study published this February contests the emerging image of pro-ana sites as ethically neutral: University of Connecticut psychologists Talea Cornelius and Hart Blanton argue that the sites boost visitors’ self-esteem by praising their commitment to mental illness, then sell it as a psychological wash. Pro-ana has persisted, in part, thanks to its uncanny ability to absorb the media’s fiercest critiques. Covering pro-ana sites in therapeutic jargon could reflect the bloggers’ real affinity for treatment, or it could be a cynical strategy for deflecting criticism so they can thinspire in peace.

Some of those smiley pro-ana sites hide secret forums that unlock only for those who have proven themselves worthy. And even on open spaces, scientific opinion can be distorted into a glamorous sheen. Acknowledging that a girl doesn’t choose to be anorexic easily twists from medical fact to modern fairy tale: Anorexia chooses the girl. Crash-dieting “wannarexics” are shunned out of concern for their safety but also because rejecting them helps “real” anorexics better cultivate a rarified air of tragedy. The PSA that Pinterest attaches to #proana searches—“Eating disorders are not lifestyle choices, they are mental disorders that if left untreated can cause serious health problems or could even be life-threatening”—in this scenario seems counterproductive.

Co-opting the language of recovery is actually an old trick. Before the Internet, fasting tips spread in recovery wards, after-school specials were mined for thinspiration, and young adult novels were repurposed as ana bibles. The Thin Commandments were originally conceived by a therapist, Carolyn Costin, hoping to help parents understand the anorexic mindset in her 1996 book Your Dieting Daughter. Growing Pains actress Tracey Gold picked up anorexia tips from the 1978 novel The Best Little Girl in the World; when she recovered, she filmed the 1994 TV movie For the Love of Nancy, which in turn helped fuel Christina Ricci’s eating disorder. Now, Ricci is an unwitting pro-ana poster girl, and Best Little Girl serves as a retro prop in thinspirational selfies.

It’s easy to see these twists as further confirmation of pro-ana’s corruptive influence, but they’re more likely testaments to the historical failure of medical professionals to treat eating disorders effectively, from the insurance companies that deny treatment to girls above an emaciated body mass index to the doctors who stigmatize their own patients. One recent study found that more than half of nurses and pediatric residents at one hospital believe that adolescent eating disorder patients are “responsible” for their disease “always” or “in most cases”; these are the people who should be shamed for calling anorexia a “lifestyle choice.” Many pro-ana members come to vent about therapy, not replace it. Half of visitors are also in treatment. One woman credits her experience running a pro-ana community with helping her see her disorder from the outside in. Now, she runs a recovery site, We Bite Back, that seeks to borrow the “appreciated supportive environment” of pro-ana but ditch the purging tips. She calls it “post–pro-ana.”

The outside world is less eager to move on. The long cultural battle against pro-ana is something of a coping mechanism for the rest of us. The criminologists Langan and Schott note that pro-ana confronts us with a sight both disgusting and familiar. Shunning the sites helps distract from all the other women who “experience disordered perceptions of their bodies” and all the ways in which we’re complicit. Various studies have suggested that visiting pro-ana sites can stoke body anxieties, that visiting pro-recovery sites can stoke body anxieties, and that visiting Facebook can stoke body anxieties. The first Thin Commandment, “If you aren’t thin, you aren’t attractive,” sounds like a literal translation of Pinterest’s dominant aesthetic. Online #thinspo transforms seamlessly to #fitspo, where fitness-minded users obsess over #healthyicecream and #fitfood and extreme exercise while bowing to photos of the same skinny models. The cognitive dissonance of pro-ana should be familiar to readers of women’s magazines, which recite body positive mantras as they Photoshop the hips off of gorgeous movie stars.

Even media coverage of pro-ana is littered with garbage about women’s bodies. It often focuses on young white women who remain thin even after their triumphant recovery arc concludes. It’s telling that pro-ana inspires infinitely more coverage than pro-mia, as if body dysmorphia and dangerous diets aren’t really a problem for people who are at or above a “normal” weight, as most bulimics are. And ironically, years of media focus on pro-ana’s most shocking sites have helped inspire copycat blogs run by young girls who recycle those old commandments in an attempt to strike a more convincing pro-ana pose. Vice’s Nadja Brenneisen recently spent a week posing as a teen in a pro-ana WhatsApp group where girls praised an old-school “goddess of emaciation” and monitored each other’s diets with tyrannical zeal. The group disbanded a few days later—a mom found out—but the story perpetuated the narrative of the techno-anorexic cult that would ruin teenagers’ lives. “I heard stories of those kind of nutty ana religion groups or whatever but I doubted that it was an actual thing,” one MyProAna poster wrote after reading the piece. It’s good to shine a light on the darkest corners of the pro-ana Internet, but these fringe groups are echoes of our own panic. Perhaps it’s time we illuminate all the diverse and complicated ways people with eating disorders express themselves online.