Anorexia Nervosa and the Internet

Few advances in our times have had as much impact as the Internet. The easy access to medical information has been very helpful for many patients. However, a red flag has gone up with the proliferation of websites that promote anorexia nervosa, or pro-ana sites. Eric B. Chesley and Richard E. Kreipe of the University of Rochester arrived at some troubling conclusions in their study of 170 anorexia web sites.

The team evaluated 100 pro-ana sites, 50 pro-recovery sites, and 20 sites sponsored by professional eating disorders organizations. According to Drs. Chesley and Kreipe, the pro-ana sites were better organized, more comprehensive, and more numerous than the pro-recovery or professional services sites.

The pro-ana sites

The pro-ana sites provided specific instructions for initiating and maintaining AN, including sections on techniques and nutrition pages that outline ways to lose weight rapidly. Further, the pro-ana sites outlined ways to help evade clinical detection, and used motivational images, creeds and commandments to encourage continued weight loss. Support groups also offered competitions for weight loss—64% of the sites contained a biography, 75% offered ways to avoid detection, and 87% offered links to other pro-ana sites.

Pro-recovery and professional sites

According to Dr. Chesley, the pro-recovery sites offered introspective first-person views on AN but little sound advice. Of these sites, 94% offered biographies, 50% provided medical/weight advice, 69% had nutrition information, 25% listed support groups, and 56% offered links to other pro-recovery sites.

The professional sites offered clinical information about anorexia nervosa, but little nutrition information or advice about modifying disordered eating behaviors. More than half of the sites offered links to other professional sites and discussed mortality from AN. Eighteen percent offered information about finding support groups.

Because of the tremendous potential for harm from the pro-ana sites, the authors urge eating disorder professionals to become more aware of the existence and content of all Internet sites and to remember that despite efforts to eliminate the harmful sites, pro-ana sites are flourishing.