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Pro-ana refers to the promotion of anorexia nervosa as a lifestyle choice rather than an eating disorder. It is often referred to simply as "ana" and is sometimes affectionately personified by anorexics as a girl named Ana.[1] The lesser-used term pro-mia refers likewise to bulimia nervosa[2] and is sometimes used interchangeably with pro-ana.

Pro-ana organizations differ widely in their stances. Most claim that they exist mainly as a non-judgmental environment for anorexics a place to turn to discuss their illness, and support those who choose to enter recovery. Others dispute the medical consensus that anorexia nervosa is a mental illness, and claim instead that it is a "lifestyle choice" that should be respected by doctors and family.[1]


[edit] Online groups

An example of what could be used as thinspiration.

Most pro-ana material is disseminated over the Internet, through tight-knit support groups centred around web forums and, more recently, social network services such as Xanga, LiveJournal, Facebook and Myspace.[3][4] These sites typically have an overwhelmingly female readership and are frequently the only means of support available to socially-isolated anorexics.[5]

Members of these support groups may:

  • Share crash dieting techniques and recipes (67% of sites in a 2006 study[6]).
  • Compete with each other at losing weight, or fast together in displays of solidarity.
  • Commiserate with one another after breaking fast or binging.
  • Advise on how to best induce vomiting, and on using laxatives and emetics.
  • Give tips on hiding weight loss from parents and doctors.[7]
  • Share information on maximizing the safety of anorexia.[8]
  • Post body measurements, details of their dietary regimen or pictures of themselves to solicit acceptance and affirmation.[8][7]
  • Suggest ways to ignore or otherwise suppress hunger pangs.[9]

As an encouragement to further lose weight, members often exchange thinspiration (or thinspo)[4]: image or video montages of slim women, often celebrities, who may be anything from naturally slim to emaciated with visibly-protruding bones.[10] Conversely, reverse thinspiration may be photographs of fatty food, overweight or obese people intended to induce disgust and motivate further weight loss. Pro-ana blogs often post thinspirational entries, and many pro-ana forums have threads dedicated to sharing thinspiration. Thinspiration can also take the form of inspirational mantras, quotes or selections of lyrics from poetry or popular music[11] (94% of sites in a 2003 survey[12]).

[edit] Impact

Visitors to pro-ana web sites include a significant number of those already diagnosed with eating disorders: a 2006 survey of eating disorder patients at Stanford Medical School found that 35.5% had visited pro-ana web sites; of those, 96.0% learned new weight loss or purging methods from such sites (while 46.4% of viewers of pro-recovery sites learned new techniques).[13]

A 2006 experimental study at the University of Missouri on 235 female undergraduates found that those subjected to a single viewing of a pro-ana site created by the study designers reported lower self-esteem and were more likely to become preoccupied with exercise and weight loss, as compared to control groups. A greater likelihood to exercise and a reduced likelihood to overeat or self-induce vomiting was also reported by the group viewing the pro-ana site.[14]

A 2007 survey by the University of South Florida of 1575 girls and young women found that those who had a history of viewing pro-ana websites did not differ from those who viewed only pro-recovery websites on any of the survey's measures, including body mass index, negative body image, appearance dissatisfaction, level of disturbance, and dietary restriction. Those who had viewed pro-ana websites were, however, moderately more likely to have a negative body image than those who did not.[15]

In a 2009 survey by the Katholieke Universiteit Leuven of 711 Flemish high school students, 12.6% of girls and 5.9% of boys reported visiting pro-ana websites. Girls who viewed such sites were more likely to have a negative body image and be dissatisfied with their body shape.[16]

[edit] Controversy, criticism and censure

Some anorexia sufferers take affront to pro-ana as they believe it glamorizes a serious illness.[17] Supporters of pro-ana sites often disclaim that they do not intend to teach people who are not anorexic.[17] Nevertheless, pro-ana groups do attract people who believe that inducing eating disorders will cause them to lose weight more effectively; such people are often unwelcome in pro-ana groups and derisively referred to as wannarexics.[18]

[edit] From the medical profession

Health care professionals and medical associations have taken generally negative views of pro-ana groups and the information they disseminate:[19]

  • The National Eating Disorders Association (NEDA) "actively speaks out against pro-anorexia and pro-bulimia websites. These sites provide no useful information on treatment but instead encourage and falsely support those who, sadly, are ill but do not seek help."[20]
  • The Academy for Eating Disorders (AED) takes the position that "websites that glorify anorexia as a lifestyle choice play directly to the psychology of its victims", expressing concern that sites dedicated to the promotion of anorexia as a desirable "lifestyle choice" "provide support and encouragement to engage in health threatening behaviors, and neglect the serious consequences of starvation."[21] However, one of its board members, Eric van Furth, has noted that pro-ana sites have relatively few visitors and advises against legal sanction of such sites, claiming instead that popular media play the more important role in establishing ideals of female thinness.[22]

[edit] In the media

In October 2001, the Oprah Winfrey Show hosted a special on anorexia; the pro-ana movement was discussed briefly by the guest panel, who expressed alarm at the appearance of pro-ana websites and recommended the use of filtering software to bar access to them.[24]

In February 2002, the television series Boston Public aired an episode that centered around a teacher becoming upset at a student's eating disorder and discovered that another student was running a pro-ana website.[25]

In July 2002, the Baltimore City Paper published an investigative report into pro-ana on the web.[26]

A December 2006 episode of the Boston Legal television series involved a pro-ana young woman attempting to emancipate from her mother.

Growing up online, a January 2008 episode of the PBS Frontline television program, also featured a brief discussion of pro-ana.[27]

An April 2009 TV documentary, The Truth about Online Anorexia, shown on ITV1 in the UK, investigates pro-ana websites. It describes the dangers of extreme dieting, and includes interviews with a mother who lost her teenage daughter to anorexia, a survivor, a representative of the mental health charity SANE, and a woman who runs a pro-ana site.[28]

[edit] From social networking services

[edit] Yahoo!

In July 2001, Yahoo—after receiving a letter of complaint from ANAD—began removing pro-ana sites from its Yahoo Clubs (now Yahoo Groups) service, stating that such sites endorsing self-harm were violations of its terms of service agreement.[29]

[edit] LiveJournal

LiveJournal has not made a position statement regarding pro-ana. In August 2007, however, a staff member declined to act on an abuse report filed against a pro-ana community hosted on its network, stating that: "Suspending pro-anorexia communities will not make anyone suffering from the disorder become healthy again. Allowing them to exist, however, has several benefits. It reassures those who join them that they are not alone in the way they feel about their bodies. It increases the chance that the friends and loved ones of the individuals in the community will discover their disorders and assist them in seeking professional help."[30]

[edit] Facebook

Facebook staff seek out and regularly delete pro-ana related groups. A spokesperson for the online service has stated that such pages violate the site's terms of service agreement by promoting self-harm in others.[31]

[edit] MySpace

MySpace does not ban pro-ana material and has stated that "it's often very tricky to distinguish between support groups for users who are suffering from eating disorders and groups that might be termed as 'pro' anorexia or bulimia. Rather than censor these groups, we are working to create partnerships with organisations like b-eat." MySpace has chosen instead to cycle banner advertisements for pro-recovery organizations through pro-ana members' profiles.[19]

[edit] Microsoft

In November 2007, Microsoft shut down four pro-ana sites on the Spanish-language version of its Spaces social networking service at the behest of IQUA, the Internet regulatory body for Catalonia.[32] A Microsoft spokesperson stated that such sites "infringe all the rules on content created by users and visible on our sites".[33]


In a Maastricht University study investigating alternatives to censorship of pro-ana sites, the Dutch blog host from October 2006 presented users entering pro-ana blogs on its service with a click-through warning[34] containing a disparaging message and links to pro-recovery sites. Of the over 530,000 visits logged by the year-long study, 33.6% did not proceed past the warning. However, the number of such blogs increased tenfold and their unique monthly visitors doubled by the end of the study.[35][36]

[edit] In politics

In the United Kingdom, 40 MPs signed an early day motion tabled in February 2008 by the LibDem member for Cheadle, Mark Hunter, urging government action against pro-ana sites.[37] The motion was timed to coincide with the UK National Eating Disorder Awareness Week.[38][39]

In April 2008, a bill outlawing material which "provokes a person to seek excessive thinness by encouraging prolonged restriction of nourishment" was tabled in the French National Assembly by UMP MP Valérie Boyer. It imposes a fine of €30,000 and two years imprisonment (rising to €45,000 and three years if there was a resulting death) on offenders.[40][41] Health minister Roselyne Bachelot, arguing for the bill, stated that "giving young girls advice about how to lie to their doctors, telling them what kinds of food are easiest to vomit, encouraging them to torture themselves whenever they take any kind of food is not part of liberty of expression."[42] The bill passed the National Assembly[43]. However, it stalled in the Senate, where a June 2008 report by the Committee of Social Affairs emphatically recommended against such legislation and instead suggested early-screening programs by schools and physicians.[44]

[edit] References

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  3. ^ Williams, Alex (2006-04-02). ""Before Spring Break, the Anorexic Challenge"". New York Times. 
  4. ^ a b Head, Jacqueline (2007-09-08). "Seeking "thinspiration"". BBC News. Retrieved on 2007-11-06. 
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