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Anorexia nervosa, as defined by psychologists, is a serious psychological disorder characterized by a distorted body image and an obsession with thinness. It has the highest fatality rate of any psychiatric disorder.

Pro-ana/mia sites

The distorted viewpoint that comes with the disease leads many anorexics to not want to recover. The label "pro-ana" describes this decision. It’s based on the idea that the disease is a choice, not a disorder. Pro-ana is the decision to live as an anorexic and not try to recover, while pro-mia is the decision to live as a bulimic.

A growing number of websites known as pro-ana and pro-mia sites are popping up online. These sites offer advice on how to lose weight fast, how to induce vomiting, how to hide weight loss from parents or doctors and other advice beneficial to individuals with eating disorders. Many sites have disclaimers telling people not to use their advice unless they are actually anorexic.

Pro-ana is not so much a movement as a mentality. The thought processes behind these websites aren’t new. The Internet has simply provided a forum for people with eating disorders to congregate. Users reinforce their habits by talking to other people who do the same things.

Therapist Dorit Osher compares pro-ana to an abusive relationship. She said people using pro-ana sites justify their actions and beliefs by talking to other people who are experiencing the same things, thus normalizing them.

By subverting the disorder into conscious choice, anorexics can turn their disorder into something that seems normal, said Osher.

The dialogue on the sites often sounds kind and compassionate, she said. However, the users are writing in the voices of their eating disorders, not in their own voices.

Pro-ana websites could be dangerous because they can inspire competition between users, said Tracy Vaillancourt, associate professor in the school of psychology at the University of Ottawa.

"It could only exacerbate symptomology," said Vaillancourt. Symptoms can get worse as users try to see who is a better anorexic.

Here are the stories of four individuals, each of whom is forming an online identity based on an eating disorder.

A user of pro-ana/mia sites

Peggy Elizabeth, 18, lives in St. Paul, MN and is a senior in high school. She is like most other girls her age: she likes reading Harry Potter, watching Lost and she works a part-time job.

But she has a secret that makes her different from many of her peers – Peggy is a recovering anorexic.

Standing 5’2", Peggy had a goal weight of 80 pounds and consumed a mere 750 calories a day.

Like many other 21st century anorexics, Peggy frequented pro-ana and pro-mia websites.

Although she didn’t intentionally seek out these sites, she was directed to one after googling the word ‘laxatives.’ After following a link Peggy entered a secretive world where anorexia isn’t considered a problem, but rather a glamorous lifestyle.

She was instantly hooked.

"I went onto these sites feeling like…is there something wrong with me? And then it’s like no…there is something totally right with me."

On the pro-ana and pro-mia sites Peggy found information on everything from losing weight using laxatives to hiding your eating disorder from your parents – tips she would use.

"There are all these girls who think the same way I do and have tips on how to do it better than I do," she said.

Members didn’t use their real names; rather, they made up usernames with words ‘ana’ and ‘mia’ in the name. This new name is what they became known as and became their new online identity.

On one of Peggy favourite pro-ana sites, all of the members wear red bracelets as a symbol of their unity and commitment to being anorexic. The red bracelet became a universal symbol of their identity as anorexic.

Pro-ana as a pseudo-religion

"It’s almost a religion," said Peggy. "The belief on most of the sites is that they are chosen."

And what religion is complete without a god?

The members of many pro-ana sites call their god Ana, said Peggy, and there is a common belief among the members: I have anorexia therefore I was chosen by Ana to become perfect.

Although Peggy had never met any of the other members she shared intimate details with them. The members are like sisters, said Peggy. They post their height, weight and desired weight on their profiles.

Support

While each site is different, Peggy said there is a consistent message across all of the sites. "The only common theme is support…we are united against fatness."

The sites gave Peggy courage – courage to start starving herself, she said.

And yet, she still does not view the sites as harmful.

"I’m special; we’re all special," she said. "We’re all becoming beautiful; we’re all doing the same thing."

Today Peggy is focusing on her recovery and has been staying away from pro-ana and pro-mia sites. But she admits it’s been difficult.

"They do draw you in. They have a pull to them. It’s extremely hard for me some days not to go back to them. It’s like a sisterhood."

The online moderator

Dylan, who only wanted to be known by his first name, is a moderator for a pro-ana website called Pro-ana Live Journal. The site has over 38,000 members, he said in an online chat discussion.

Dylan replies to discussion posts and advises users on recovery treatments. He uses a method called "calorie restriction" to advise the girls on nutrition, diet tracking and exercise.

Many of the people he interacts with on the site suffer from depression, obsessive-compulsive disorder, distorted body image and damage to their brains and metabolic systems, he said.

Withdrawn from life, drawn to online life

"Anorexics withdraw from the world," he said. "In the communities they have the ability…to be able to finally discuss this with others who understand and will be supportive."

The anonymity of the site allows many anorexics to open up to him in a way they never could to anyone else, said Dylan.

"It’s not unusual for me to have young anorexics tell me their eating disorder history in the site application when no one else in their life is aware of it."

Pro-ana sites aren’t just for tips on losing weight, said Dylan. They also help users cope with suicidal thoughts and anorexic related health problems,

The site is all about providing support- regardless of the hour, said Dylan.

"Twenty-four hours a day there is posting activity. A girl who is alone and suicidal at 3 a.m. anywhere in the world can log on and get support from others who know and understand what they are going through."

And the site is saving lives, said Dylan. "There are hundreds, maybe thousands of members who will say they would not be alive today were it not for these communities."

Although the Live Journal site is intended for the pro-ana community, said Dylan, the site is "pro-health," because it attracts anorexics so they can be persuaded to find recovery.

Dylan believes anorexia arises from the physical repercussions of malnutrition and fasting, and is not a mental disorder; therefore, his methods focus on getting back to healthy eating levels which can result in improved mental states.

"During this process, they become happy again for the first time they can remember," he said.

The recovering bulimic

Robin Batchelder, 29, has suffered from bulimia since middle school.

Trapped inside her disease for more than a decade, she finally became desperate enough to make her recovery a priority, dishing out $45,000 to go to rehab in January.

"I had to cash in my retirement fund just to go to rehab," said Robin. "That’s how bad it got."

She took on the personal expense to take charge of something she felt controlled her life. "It’s a mentally driven disorder that has physical results."

After rehab she began a recovery program to stay on a healthy course. Robin learned about a Facebook group called "Dear Eating Disorder" from a fellow recovering bulimic.

"It’s a good way to vent and get it out and connect with other people who have the same battles that you have," she said. "You feel a sense that you’re not by yourself. You’re not alone. There are people that are going through the exact same thing that you are."

Online community

She posts on the site every day, expressing her anger with her bulimia. She finds it therapeutic to be able to vent and track her progress, as well as the progress of her online friends.

But Facebook isn’t the only place where Robin found support. She also uses Somethingfishy.org, a website that helps people cope with and understand their eating disorder.

"A lot of online stuff you can remain anonymous," she said. "And I think that’s a lot of the appeal of the whole thing. You can…tell your deepest darkest secret and no one could trace it."

But Robin warns that eating disorders can’t be treated online, even though the support networks have helped her once she made the decision to recover.

"You need to go to rehab," she said. "It’s a diverse disease that needs therapy and psychology and retraining your body to eat…and you can’t do that online."

Robin said she’s glad she never got involved with pro-ana and pro-mia websites.

"I try myself not to go on those sites because it would be totally triggering for me. So I would stay as far away as I possibly could."

She wants to change the perception among teens that eating disorders are cool. She plans to speak to high school students about eating disorders.

"If I can change one girl’s perspective or if I can keep one girl from heaving 15 times a day then I feel like I’ve done something," she said.

But ultimately, anorexia and bulimia are illnesses Robin will always identify with, she said.

"There will always be a part of me that likes what I’m doing because it worked for so long," she said. "I don’t think this is a disease you can ever actually recover from because I will never look at food in the same way."

Some use both pro-ana/mia and pro-recovery sites

Em, 17, lives in Kentucky where she is a senior in high school. She has been battling an eating disorder since she was in seventh grade.

She avoids eating on Monday, Wednesday and Friday. On Tuesday and Thursday she will only eat dinner. But on weekends she’ll eat lunch and dinner. The longest Em has ever gone without purging is 24 days.

Social networking sites

Like many of her peers, she uses social networking sites such as Facebook and Myspace. On Facebook she joined both pro-anorexia and pro-recovery groups.

Her membership may seem contradictory, but it’s actually representative of Em’s constantly changing attitude towards her condition.

"I go through cycles where I really don’t want to eat, but then there are cycles where I really want to get better," said Em.

Facebook has helped her with both her disorder and her recovery, she said.

"When I didn’t want to eat, it was easy to find people who could encourage me and keep me on track. But then, when I wanted to do better, I could also find people who would encourage me to eat healthier and eat more instead of not eating or throwing up."

Em turned to online social groups because she said she had nobody to talk to about her eating disorder.

"Facebook was an easy way for me to connect with other people who are going through what I’m going through," said Em. "I can’t really talk about my eating disorder with my friends because they don’t understand it. When I try to explain it to them they just get frustrated."

She cannot get support from her family because her mother views her condition "as an extreme form of dieting," said Em.

Through visiting pro-ana groups on Facebook, Em said it helps her feel like she’s not suffering through her eating disorder alone.

"It’s comforting to find people who think the same way I do … So when I go there I can talk to these people and have them understand what I’m thinking without having to explain a lot."

But Em feels guilty about visiting pro-ana groups on Facebook when she is going through one of her recovery cycles, she said.

"I don’t feel like I deserve the right to go there and still be able to say ‘Yes, I have an eating disorder’ because I’m trying to get better," she said. "I don’t feel like I deserve a title or a labeling of having one when I’m trying to get better."

The dangers of pro-ana/mia sites

These are just four stories of individuals battling – or in some cases – embracing eating disorders through the creating of an online identity. Complete with an online username, these four individuals sought online communities to express their frustrations, seek advice and support, meet other, feel normal and above all – find acceptance for a disorder that is often seen as taboo.

Eating disorders are nothing new, but the Internet is changing the way people deal with the disorder. Although many pro-ana and pro-mia sites have a disclaimer, they’re still detrimental in the sense that they’re providing a forum for vulnerable and influential individuals to meet like-minded people and that’s a dangerous combination.

Users of these sites have created an online community where anorexia is a way of life – instead of what it’s considered everywhere else: a serious psychological disorder.

 

Erin Albert, Amy Barrington, Dale Carruthers, Laura Downs and Claire Michalewicz are students in the MA Journalism Program at the University of Western Ontario.

Who R U? An Exploration of Identity at the Edge of Tech, is a collaborative feature series created by the students of the 2008 Online Journalism class at the University of Western Ontario, Instructed by Wayne MacPhail. The series looks at how technology is changing our identities and our idea of identity. Each of the nine episodes includes a feature article, a podcast (part of the rabble podcast network) and a video segment on rabbletv. We’ll feature one episode a week, each Thursday here on rabble.ca. Hope you enjoy Who R U? We welcome your feedback, as do the great students who produced the series. Thanks to all of them for sharing their work with the rabble audience.