The Bizarre World Of The Pro Anorexia Internet Community
Let's say you're struggling with drug addiction, and you decide to reach out to other suffering addicts for help. If you type "drug addiction chatroom" into Google, and scroll past the inappropriate ads, here's what you get:
It's the same for clinical depression: there's a wide variety of helpful chatrooms where you can connect with, and get advice from, other sufferers.
Makes sense, right? Searching for help with your addiction doesn't take you to a community of crack users talking about how sweet it is to use crack. Searching for clinical depression doesn't lead you to a fansite for sadness. But if you type "anorexia chatrooms" into Google ...
What? Who's pro-eating disorder? That's like being pro-herpes -- nobody really roots for health's bad guy, right? Wrong: I interviewed the administrator of one of these pro-anorexia chatrooms, and spent a night lurking there, before I set out to speak with experts about being "pro-ana," and just how dangerous that can be ...
The Pro-Anorexia Community Is Crazy, But Not How You're Thinking
"I am the admin of a pro-anorexia chatroom and have been running it, first as a mod and then as admin, for the better part of a year. I know there are a lot of people who are interested in/disgusted by the pro-anorexia online community, and I would love the chance to tell our side of the story."
This is how "Sarah," the admin of an anonymous pro-anorexia chatroom, introduced herself to me. At that point, I knew very little about the pro-ana community. One thing I did know was that it involved very sick kids literally worshiping the personification of anorexia ("Ana") as a goddess.
Sarah was adamant that this particular brand of crazy was fringe within pro-anorexia circles. Most of these people are not nutjobs, treating their eating disorder like a literal goddess: they're communities of sick people who acknowledge that they have an illness but also like that illness and don't want to get better. At least, not yet. Sarah said that many people with eating disorders don't want to hear, "'you're fine, you're beautiful the way you are' [because] that won't help you when you're in such a low place."
I spent hours lurking on her chatroom, reading conversations between members, and browsing MyProAna, one of the internet's largest pro-anorexia forums. I found users sharing the ugly details of their eating disorders in a thread called "Ed [eating disorder] moments that normal people would go 'wtf' at":
"Not brushing my teeth 2 times a day, because mfp says I consume 1 calorie every time I brush my teeth. Sorry not sorry"
"Lol, rubbing my hands along my dog's ribs because they're so prominent and I'm bloody jealous ... ye I do this in the living room with my mamaw right next to me"
"I ... drank mustard water to throw up because my gag reflex has turned to shit. And the mustard water didn't work. Probable calories and taste buds, just thrown out the window."
So these folks don't have a problem acknowledging that they have an eating disorder with awful, sometimes grisly, side effects. When we talked to Travis Stewart, director of regional outreach for Castlewood Eating Disorder Treatment Center, he was actually relieved to hear there wasn't much glorifying of ED in pro-ana communities. But he was also worried that ...
A Sense Of Community Is Not Always A Good Thing
The pro-ana communities I studied didn't view anorexia as a "good" thing necessarily, but they also really liked being skinny. I encountered very little talk of treatment, or overcoming their disorders. But "very little" isn't "none," and I also didn't notice people being discouraged from seeking help. One researcher I interviewed, Nicole Schott, a Canadian criminologist who co-authored a paper with Dr. Debra Langan that argues these communities have a substantial therapeutic potential. She's encountered a number of people who say their first step on the road to seeking help came from discussing their eating disorder in pro-ana communities:
"I think [its] definitely common that people talk about how [pro-ana communities] led them to treatment and recovery ... it's probably as common as those who are [against psychiatric medication] and claim these forums and communities help them deal with issues they're not able to deal with through psychiatric medicine."
Schott argues that, even though pro-anorexia communities are problematic, the fact that they provide sick young people with support can still lead to positive outcomes. As a therapist, Stewart understands where they're coming from.
"It's understandable ... everybody wants to be a part of a community. But they're in a community where they aren't being challenged."
One of the most active threads on MyProAna.com is titled "Please Review Doctors And Treatment Centers." But a lot of that "activity" is people complaining that the existence of this thread means the site has sold out:
"Might as well change the name to 'myprorecovery.' Pro-ana posts practically aren't even allowed outside of the South Beach Diet forum, and now this shit get pinned."
I don't have any demographic information on MyProAna, but most of the people in Sarah's chatroom seemed to be teenagers. At 22, she was one of the older members. Stewart understands how young people would find the acceptance of this community more attractive than, say, mom and dad panicking over the fact that they can count all their child's ribs through a sweater:
"People around them are freaking out and concerned and then they go to a community where people understand and get it."
He's worried that this sense of community will just reinforce people's identity as anorexics, "It's like if I was schizophrenic and thought I was being abducted by Martians, and you come along and say 'me too!'... it's totally understandable, I totally get it. That would feel good."
He also points out that eating disorders can be powerfully addictive, and having a community to share "progress" with makes it even more addictive:
"That sense of accomplishment and power that comes from weight loss ... you get a compliment, hey you look nice ... I've heard many clients say, 'I wasn't good at anything else but I was good at losing weight' ... so there's a sense of accomplishment ... and it's tangible."
That's why one popular thread on MyProAna is dedicated solely to people posting their entire day's (miniscule) food intake:
In a radio discussion with Schott, Dr. Paul Garfinkel (a professor of psychiatry up in the distant wilds of Canada) agreed that these groups provide a sense of "community" for sufferers, but he also argues that the sense of community is "part of the problem." In his eyes, idealizing a dangerously unhealthy body is something that needs to be "overcome." His advice is exactly what you'd expect: treatment.
"These sites mostly don't advocate recovery, there are some ... the recovery sites, likely aren't harmful. The others are definitely harmful."
So if these sites are harmful, should search engines be forced to de-index them from search results? Even more severe, should admins, like Sarah, face criminal charges? Well ...
Attacking Pro-Ana Sites Only Makes Them More Dangerous
Some authorities have sought to ban these sites:
You can't 'ban' a website in the U.S., unless it's got naked pictures of kids or Game Of Thrones spoilers. But you can de-index them from search results (so they don't pop up as easily) and effectively "soft ban" them that way. But Schott believes going after these sites means more people will die:
"When you just decide to censor things based on taken-for-granted assumptions about a social phenomenon ... there are unintentional consequences which could be destroying someone's only lifeline."
In our interview, Sarah mentioned "harm reduction" several times. It's a philosophy I first encountered while taking shitloads of illegal drugs as a 19-year-old. The idea is that, if people are going to do something dangerous anyway, you should seek to minimize those dangers, because you just can't stop them entirely. Kids are going to take pills from street dealers, so legalize and regulate it instead. If you can't do that, then give them testing kits to make sure it's pure MDMA and not, say, rat poison.
In Sarah's chatroom, I immediately encountered users advising that somebody take an Uber, because she had been fasting and might not be good to drive. Users advised one another to keep small protein packets, etc., in their purses and such. A teenage girl entered, frantic, because a teacher she confided in about her eating disorder had told the school, which was forcing her into counseling.
Sarah stepped in and said "that sucks. I'm sure she was a mandatory reporter," providing valuable adult context for the scenario. She advised the kid to figure out if she wanted to break it to her family early, or not. And then advised her not to do anything "drastic."
Some of what the users discussed was unsettling -- there was plenty of cheering over weight lost and meals avoided -- but Sarah's claims of "harm reduction" were are least true in spirit. Driving these sites underground might stop that, and make pro-ana communities more dangerous, thanks to something known as the "toothpaste tube" effect. In 2012, after Tumblr and Pinterest opted to ban all "thinspiration" (more on that later), French researchers used a web-mining tool to graph the attempt to kill it.
Those jellyfish-looking suckers are clusters of websites and blogs. About half of the pro-ana sites from 2010 were dead by 2012, but they'd been replaced, and the surviving sites had changed to defend themselves. They started using different terms to hide from web filters, and "turned inwards" to protect against infiltration. The researchers found that surviving sites "control major flows of information within clusters, but do not bridge them." This served to increase fragmentation, and made pro-ana communities more difficult to reach with real help efforts, like awareness campaigns.
Again, no one, not even Sarah, is suggesting these communities are a force for good in the world. Just a measured portion of bad, which is better than an unmeasured one.
Preventing Suicide Is A Common Goal In The Pro-Ana Communities
Both criminologist Nicole Schott, and Sarah the pro-ana admin, pointed out that the greatest "good' these communities provide might be their ability to connect suicidal kids with slightly older people saying, "Hey, don't kill yourself maybe?"
"The one striking blog post I had read about how one girl argued without pro-ana/mia [pro-anorexia/bulimia] she would be dead because she was suicidal and she decided that, before she killed herself, she'd made a deep connection to someone else she'd met on a pro-ana/mia site and decided to call her friend first ... her friend called the police ... she said if it hadn't been for that intervention, she would be dead."
A couple hours into my time in Sarah's chatroom, a user came on who claimed to purge "every meal," and bragged that she'd lost 15 lbs. in less than a month. Her goal was to get down to 75 pounds in three months. Sarah advised that, at 5 foot 6, 85 should be her lower limit.
"75 lbs. at 5'6, you will die."
The girl says that she wants to die. And Sarah responds:
"Oh OK there it is. OK. please dont die."
Suicide threats are common in Sarah's chatroom. I heard two people express a wish to die in my few hours there. When we'd talked, Sarah had told me suicide threats were a regular occurrence.
She related the story of one user, a girl, who "would consistently cause problems, interpersonal problems ... picking fights with other people. I was thinking about asking her to leave ... and then one day I came back from class after about eight hours ... and she'd been online alone, and was just kinda waiting around for people to chat with her. And this person came in and their username was just 'help,' and so this person had never been there before, and it was essentially a suicide threat ... And this girl who I'd never seen have a positive interaction with anyone, she spent hours talking this person out of taking her own life."
Even Stewart, who actually treats kids with eating disorders, and considers these communities generally harmful, agreed that this might be a real benefit:
"I think it's challenging ... you're not going to be able to stop them ... and it is sort of interesting to hear that take on it, that it helps prevent suicide, and I think there's probably some good in that ... a lot of these folks are struggling. There's a lot of self-hatred and shame that goes along with these eating disorders ... so I think that's commendable in some sense."
"Harm Reduction" Sounds Good; Might Not Work
Most of the users in these communities are teens. The pace of the chatroom is somewhat anarchic. At one point, a user comes in and announces that she feels "so bad" because she "ate cake." Minutes later, another user comes on, claims she needs help "Asap" because she "really needs" to lose weight, but doesn't know how. Sarah gives her the standard advice:
"1200 calories a day and an hour of exercise."
That diet is seen as "healthy" enough to avoid real harm, but hard enough that crash dieters can't maintain it. "Our goal is to keep people who are already anorexic as safe as possible ... and getting crash dieters out of the community because the last thing we want to do is give someone an eating disorder."
Schott's professional study of the online pro-anorexia community found the same thing across multiple sites, "the admin being careful as to not increasing eating disorders ... 'this is not something you want,' they're not glamorizing eating disorders. They're saying, if you don't have one you don't want one. And they often kick them out of the site."
By far the most visited thread on the "Anorexia Discussion" subforum of MyProAna is dedicated to giving people the ugly, brutal truths of eating disorders:
"ok so about all of the people on here who keep asking how to lose weight as quick as possible ... and for tips and motivation please let me just say ... there are some people here who actually have a problem. Why would you wish this apon yourself?? Do you think that starving is fun?? Is anorexia cool?? Does it make you look cool?? Is it in style?? Why?? I would NEVER EVER EVER wish it on anyone.
Please tell me ... do you actually know anything about this horrid disease.
Well for those of you that think this is a joke please let me tell you what happens.
Mood swings (BIG ONES)
Bad breath (better start carrying your toothbrush everywhere)
Pain, joints, headaches, hunger pains (ibeprophen is your best friend)
You pretty much live at the drs office (hope you have a hot doctor)
Coldness (all the god damn time)
Your hair falls out (hope you didn't like it)
Everyone hates you (even you)
You lose all of your friends (better find some as fucked up as you)"
But Stewart brought up a good question:
"Would there be freedom for someone in one of those chatrooms to go, 'I'm getting treatment' and be supported?"
I did run into the odd talk of treatment, but always in the past sense: While these women didn't seem to have a romantic view of their illness, the focus was clearly NOT on healing. Sarah's been to therapy several times; it hasn't worked.
In an article for The Telegraph, psychiatrist Dr. Helen Sharpe said: "We know from a small number of studies that viewing pro-eating disorder content is harmful as it makes healthy women experience greater body dissatisfaction and feel less positively about themselves. We also know that individuals likely to seek them out are particularly vulnerable."
So for all Sarah's attempts at harm reduction, pro-ana communities probably do foster some eating disorders, and keep other people sicker, for longer, than if they'd avoided the place altogether. But most eating disorders don't start in chatrooms ...
Eating Disorders Come From All Sorts Of Places
Here's a thread on MyProAna where users debate the merits of an "ab crack":
Sarah was open about what she viewed as the most dangerous aspect of the pro-anorexia subculture: "meanspo." You might've heard the term "thinspo" -- people posting pictures of incredibly skinny models, celebrities, etc., as inspiration to keep up with their weight loss. Meanspo is its even uglier cousin: Users can request to have someone basically shit-talk them into keeping their diet:
"'You're fat, you're ugly, you are those things and you have to stop eating ... It can only be conducted if it's requested. 'I'm worried I'm going to binge, I need meanspro to keep from eating'... I discourage that practice but I think people should have the option."
And all that sounds super messed up to us, but Sarah feels, "This desire for particular women to get very thin ... is not necessarily irrational because in our society we privilege and provide benefits for thinner women."
Schott as well noted that:
"In our society now there are benefits to going to these extreme measures, and they're all often connected to gender imbalances. And if you look into the massive amount of fat phobia our society has ... fatter people have a harder time getting jobs, all these other types of social achievements."
Even Stewart agreed -- to an extent:
"I think it plays into it, but ... we can't blame the magazines so to speak. I think it plays into it in the sense of, it shows this is what an accomplished, admired woman looks like ... it's not necessarily the trigger that causes the eating disorder, but it's the soil ... in other cultures that don't have that emphasis, they don't have the same types of eating disorders."
What does he mean by that? Well, let's look at Fiji. Harvard psychiatrist Anne Becker first visited the country in 1983. At that point, Fijians were a culture that embraced lavish feasts, and celebrated larger-figured women. Power was scarce and TV was unheard of; they still lived and died by the harvest. Eating disorders didn't seem to exist.
Then, in 1995, TV started getting popular in Fiji. Dr. Becker conducted a study on eating disorders. By 1998, 11.3 percent of Fijian girls reported "purging" for weight loss at least once. By 2007, 45 percent reported having purged in the last month.
Stewart referred to our media-wide fascination with unhealthy thinness as the "soil" that eating disorders grow in. And in his view, "thinspo" is "... the fertilizer. It's more concentrated, it's purposeful. The ads are trying to sell a dress. Thinspiration's trying to sell a lifestyle, or a behavior."
Anorexia Is Extremely Dangerous, And Not Easily Treatable
Sarah did not attempt to convince me that there was anything healthy about her lifestyle.
"Right now I am 5'7" and I weigh 104.3 pounds. I have a BMI of 16.3 ... what most people would call severely under weight ... my goal is 15.4, my worry is I'm going to get there and either lose it or realize it's unhealthy to maintain at this level. There's a lot of worries that come with it. I also worry I'm going to die when I'm 50, have a heart attack when I'm 45 ... we're all aware of it. It's just something we don't talk about that often."
Between 5 and 20 percent of all anorexics will die of their disease. And the heart is one of the "most vulnerable" organs to the damage anorexia causes. Anorexia has the highest death rate of all mental illnesses. And the longer you're anorexic, the more damage you suffer. Sarah knows there's a good chance what she's doing is part of the problem:
"The other [worry] that I have is I will wake up some day and realize I've been harming people this entire time."
This isn't a situation with a clean solution. The best-case scenario for therapy is a 40-50 percent success rate. Many people can't afford it to start with. And the general governmental approach is "scary" PSAs like this ...
Which might make the problem worse. Schott's research suggests:
"It reaffirmed their position that everyone in the world is against them and made them go more into their specific community."
Stewart also doubted the ability of PSAs to reach kids:
"I think how you're going to reach kids is that, as a culture we're going to have to talk differently about bodies. I think on one hand you're not gonna compete with sorta, the secret community ... it's kinda like the kids who have a racist club at school, they see a PSA on diversity and they chuckle at it."
We don't get the joke.
And he thought the best way to treat an eating disorder is with a part of what the pro-ana chatrooms and forums offer: community. Just a community where people don't talk about avoiding toothpaste for the half-calorie they might swallow.
"On one level what works is people not feeling alone and feeling cared for and heard and knowing how to get a sense of accomplishment outside of my eating disorder."
And maybe a little less of this, too.
Post Script: Shortly after the final draft of this article was finished, Sarah reached back out to us with an update on her life: "...I'm currently being voluntarily hospitalized for my eating disorder. I'm no longer an admin at that or any chatroom. I don't visit that site or any thinspo sites anymore, and I'm active in some local chapters of mental health advocacy. They know about my past and are non-judgemental - they're actually using my 'expertise' to try and infiltrate and fight harmful pro-ana communities in more effective ways. I don't know if recovery will stick this time, but I'm trying to commit to it fully after I had a few seizures a month or so after we spoke.
I left a message on the old room once I got out of the hospital for the seizures and tried to shut the chat down. Unfortunately, the original admin was called in by some users, and I am now aware that it's being run with a full force of new administrators and mods. I'm blocked, so I can't tell you what it's like now, and I can no longer reach out to any of my friends there, though I doubt they'd be interested in speaking with me at this point. Going into recovery tends to be allowed, if a bit looked down upon, but trying to cut these girls off from each other? That's a crime you don't really get forgiven for.
I'm still ambivalent about the pro-ana community. I maintain that it does a lot of good, but I realize now just how harmful it is on the surface and at its core. I certainly feel guilty for taking a position of 'leadership' in it, especially as an adult. I just can't think of a better alternative for those who refuse to seek real help.
Best of luck, Sarah.
The National Eating Disorder association attempts to help people like Sarah. Maybe check 'em out.
Robert Evans wrote a book about how partying, douchebaggery and hard drugs built human civilization. Buy it, maybe?
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For more insider perspectives, check out 6 Things You Learn As A Guy With An Eating Disorder and 5 Unexpected Things I Learned From Having an Eating Disorder.
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