Is It Healthy When Anorexics Network?

Linda A. Cicero

Websites promoting anorexia and bulimia started popping up in the mid-1990s. By 2000 there were more than 500 “pro-ana” and “pro-mia” sites, and they continue to proliferate today. Physician Rebecka Peebles, an instructor in adolescent medi­cine, and third-year medical student Jenny Wilson, ’01, surveyed 54 adoles­cent eating-disorder patients and 91 parents, and found that young people who regularly visited the websites spent more time in the hospital and less time on home­work than those who did not. There were no significant differences in body weight, number of missed menstrual periods or bone density between the two groups of patients.

Stanford: What do you find on pro-eating disorder websites?
Wilson: They give tips and techniques on how to purge better, or how to hide it from your parents. They also have “thinspirations,” which are images of anorexic women. And a lot of them have message boards. We found that two-thirds [of patients] learned about new weight-loss and purging techniques from the websites, and one-third learned about diet pills, laxatives and supplements. So there is an indication that they are learning about unhealthy behaviors that are impacting their health.

Peebles: And the websites offer a community where people feel like they can express whatever it is that they’re thinking. When someone says, “I’m going to a treatment program,” or “I’m tired of this, I want to quit,” she’ll get a “Good job” or “Good luck.” But people also say, “How can I lose weight before the prom?” And then there will be a lot of, “Well, these diet pills helped me,” and, “You can vomit without your parents hearing by being in the shower.” What web support means to patients suffering from [an eating disorder] is complicated.

Have there been many studies about the impact of these websites?
Peebles: The effects of the Internet on [eating disorders] is an emerging field. I think physicians are just starting to understand how much their adolescent patients are online, and what kinds of impacts that usage has.

As a physician, what are your concerns about eating disorders?
Peebles: The most pressing concern is the risk of death. Disordered eating does damage to almost every organ system—to the heart, hormonal system, kidneys, liver, brain. There’s a myriad of complications that occur.

Do young women understand how serious an eating disorder is?
Peebles: I think many patients do see how serious it is, and they ask for help. But there’s also a huge number of patients who are dragged in by their parents, and who are really not at all cognizant that this is a problem.

Do you spend time on websites yourself?
Peebles: I do because many of my patients give me their log-ins. They feel more comfortable expressing their feelings on a site.