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Promotion of anorexia is the promotion of behaviors related to the eating disorder anorexia nervosa. It is often referred to simply as pro-ana or ana. The lesser-used term pro-mia refers likewise to bulimia nervosa and is sometimes used interchangeably with pro-ana. Pro-ana groups differ widely in their stances. Most claim that they exist mainly as a non-judgmental environment for anorexics; a place to turn to, to discuss their illness, and to support those who choose to enter recovery. Others deny anorexia nervosa is a mental illness and claim instead that it is a lifestyle choice that should be respected by doctors and family.
Pro-ana sites often feature thinspiration (or thinspo): images or video montages of slim women, often celebrities, who may range anywhere from being naturally slim to emaciation with visibly protruding bones. The scientific community recognises anorexia nervosa as a serious mental disorder. Some research suggests anorexia nervosa has the highest rate of mortality of any psychological disorder. Eating disorders – Complications of Anorexia . University of Maryland Medical Center (2012-12-03). Retrieved on 2013-04-29.
Members of such support groups may:
Many have popular blogs and forums on which members seek companionship by posting about their daily lives or boasting about personal accomplishments of weight loss. The communities centred on such sites can be warmly welcoming (especially in recovery-friendly groups) or sometimes clique and openly suspicious of newcomers. In particular, hostility is often leveled at:
Thinspirational clips circulate widely on video sharing sites, 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 (94% of sites in a 2003 survey).
Thinspiration often has a spiritual-ascetic flavour, referring to fasting through metaphors of bodily purity, food through allusions to sin and corruption, and thinness through imagery of angels and angelic flight. Exhortations like "Ana's Creed" and "The Thin Commandments" are also common.
A survey by Internet security firm Optenet found a 470% increase in pro-ana and pro-mia sites from 2006 to 2007. A similar increase was also noted in a 2006 Maastricht University study investigating alternatives to censorship of pro-ana material. In the study, the Netherlands blog host punt.nl began in October 2006 presenting visitors to pro-ana blogs on its service with a click-through warning containing a disparaging message and links to pro-recovery sites. Although the warnings were a deterrence (33.6% of the 530,000 unique visitors logged did not proceed past the warning), the number of such blogs actually increased tenfold, with their monthly traffic figures doubling on average by the end of the study.
Visitors to pro-ana web sites also 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).
Pro-ana sites can negatively impact cognition and affect. Women who viewed a pro-ana site, but not control sites focused on fashion or home décor, experienced an increase in negative affect and decreases in self-esteem, appearance self-efficacy, and perceived attractiveness. They also reported feeling heavier and being more likely to think about their weight. The effects of perfectionism, BMI, internalization of the thin ideal, and pre-existing ED symptomatology as moderators of negative affect were comparable to chance, suggesting that pro-ana websites can affect a broad spectrum of individuals, not simply those with ED characteristics.
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.
Similarly, girls in the 2009 Leuven survey who viewed pro-ana websites were more likely to have a negative body image and be dissatisfied with their body shape.
A 2012 report by Deloitte Access Economics, commissioned by Australian non-profit The Butterfly Foundation, estimated that eating disorders resulted in productivity losses totaling just over $AUD15 billion, with 1828 (515 males and 1313 females) dying that year from eating disorder-related complications.
People who use pro-ana sites report lower social support than controls and seek to fill this deficit by use of pro-ana sites. While pro-ana site users in this study perceived greater support from online communities than offline relationships, they also reported being encouraged to continue eating disorder behaviors. Users of pro-ana sites (n=60) cited a sense of belonging (77%), social support (75%), and support for the choice to continue current eating disorder behaviors (54%) as reasons for joining a pro-ana site. Reasons for continuing to use a pro-ana site included general support for stress (84%), meeting others with eating disorders (50%), and finding triggers for eating disorder behaviors (37%). Finally, behaviors first learned after visiting a pro-ana site include using thinspiration (63%), hiding eating disorder behaviors (60%), fasting (57%), using diuretics and laxatives (45%), vomiting (23%), using alcohol or other to inhibit appetite (22%), and self-harm (22%).
link It's possible that health professionals and academics are eager to place blame on these communities because of this increased visibility and being an "easy target"
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In July 2002, the Baltimore City Paper published an investigative report into pro-ana on the web.
"Growing up Online", a January 2008 episode of the PBS Frontline television program, also featured a brief discussion of pro-ana.
The 2009 novel Wintergirls features a protagonist with anorexia, who at one point in the novel seeks support from a pro-ana forum, referring to the people there as "her sisters" and "the only people that understand".
In April 2009, The Truth about Online Anorexia, an investigative documentary about pro-ana on the Internet, aired on ITV1 in the United Kingdom presented by BBC Radio 1 DJ Fearne Cotton.
In April 2012 speech at Harvard University, Vogue Italia editor Franca Sozzani conceded that the fashion industry may be a cause of the recent rise in eating disorders, but that the industry was being unfairly singled out for blame: "How can all this be possibly caused by fashion? And how come that Twiggy, who would be surely considered an anorexic today, did not arise controversy in the Sixties and did not produce a string of anorexia followers?" According to Sozzani, pro-ana sites were more effective at promoting eating disorders, and obesity was the more pressing public health problem that food industry was not being likewise attacked for exacerbating.
The existence of pro-ana blogs and forums was featured in the 2014 Lifetime film Starving in Suburbia, which starred Poland actress Izabella Miko as "ButterflyAna", a beautiful model and moderator on the internet who promotes anorexia religiously to the followers of her blog. This entices teenager Hannah (Laura Wiggins) to become severely anorexic; this was also the first Lifetime film to address the subject matter of anorexia among men and boys, when Hannah's brother, Leo, is revealed to suffer from anorexia and later dies due to health complications from the disorder.
LiveJournal has not made a position statement on 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:
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.
MySpace does not ban pro-ana material and has stated that MySpace has chosen instead to cycle web banner for pro-recovery organizations through pro-ana members' profiles.
In November 2007, Microsoft shut down four pro-ana sites on the Spanish-language version of its MSN Spaces social networking service at the behest of IQUA, the Internet regulatory body for Catalonia. A Microsoft spokesperson stated that such sites "infringe all the rules on content created by users and visible on our sites".
In September 2008, San Sebastián-based Spanish-language web portal removed its pro-ana forums at the request of the provincial prosecutor for Guipúzcoa and the , who stated that "while not illegal, the harmful and false information in such forums being disseminated to minors will impair their proper development."
In February 2012, after consulting with NEDA, the blog-hosting service Tumblr announced that it would shut down blogs hosted on its microblogging service which "actively promote or glorify self harm," including eating disorders, and display warnings with names of organizations that can help facilitate recovery in people affected by eating disorders, on searches for common pro-eating disorder terms. Despite this, Tumblr remains a large hub for pro-ana microblogging. Pinterest, a social photo-sharing site, similarly amended its TOS in March 2012 to ban pro-ana content, but was similarly unsuccessful. Instagram followed suit and announced in April 2012 that it would summarily disable any accounts on its photo-sharing service with pro-ana specific on images.
TikTok's algorithm has been criticized for amplifying pro-ana content.
In the United Kingdom, Jo Swinson, the Liberal Democrat member for East Dunbartonshire, called for advertisers to voluntarily adopt similar disclaimers in an adjournment debate in October 2009, and later in an early day motion tabled in February 2010. She has stated that such "photos can lead people to believe in realities that, very often, do not exist," and that "when teenagers and women look at these pictures in magazines, they end up feeling unhappy with themselves."
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. 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." The bill passed the National Assembly, but stalled in the French 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.
Boyer subsequently introduced another bill in September 2009 to mandate disclaimers on photographs in which body parts have been retouched, with the aim of reducing the impact of unrealism in photography on young girls and women. The bill was ostensibly targeted at advertising photography but could be broadly applicable to digitally manipulated photography in general, including thinspirational montages. It imposes a penalty of €37,500 per violation, with a possible rise to 50% of the cost of each advertisement. The bill did not pass its first reading and was relegated to the Committee of Social Affairs.
In April 2009, Dutch Minister for Youth and Family André Rouvoet called for click-through warnings to be added to all pro-ana sites on Dutch hosting services, citing a successful trial of such warnings by blog host punt.nl in 2006. The Dutch Hosting Provider Association, however, has stated that "the Internet is simply a reflection of a world with many undesirable things", and that its members cannot be held responsible for monitoring and disclaiming all hosted content.
In March 2012, the Israeli Knesset passed a bill sponsored by Kadima MK Rachel Adato and Likud MK Danny Danon requiring advertisements which have been retouched to alter the body shape of models to fully disclose the fact. The bill, which applies to both foreign-produced and locally produced advertising, also sets a lower BMI limit for models featured in advertisements of 18.5 (the threshold of underweight under World Health Organization guidelines).
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