When was the last time you asked your clients about their on-line activity? You know, you really should- especially if they may be at risk for an eating disorder.
As I wrote about in a 2007 issue of The Los Angeles Psychologist, (Download l.A. Psychologist article 3-07.pdf), the new millennium has seen a surge of Web content that promotes an eating disorders "counter-culture", one that disseminates inaccurate, misleading, and even dangerously provocative misinformation about these illnesses. You may have heard of them. They are called "pro-ana (pro-anorexia) and pro-mia (pro-bulimia) websites. You may have seen your clients wearing colored bracelets, symbols of their "membership" in these on-line communities - red for pro-ana, purple for pro-mia, green for pro-E.D.-N.O.S., or black, for pro-self-injury. "Surely you can't be serious", you may be thinking. But, sadly, I am.
Visitors to these websites are mostly teenage girls who engage in unhealthy dialog about eating disordered behaviors and the pursuit of "the perfect body". It is not unusual to find images of waif-thin men and women posted for "thin-spiration". Web-hosts of these sites alarmingly promote denial of symptoms, promote eating disorders as a "life-style choice", and encourage hiding eating disordered behavior from family and friends.
A recent study in Pediatrics found that teens who look for eating disorders information on-line are more likely to be hospitalized for their condition than those who do not seek web-based eating disorders information. Perhaps that is because 96% of teens who used pro-E.D. sites reported getting new weight-loss techniques or "tips" about eating disordered behaviors. A study published in the September, 2007 issue of International Journal of Eating Disorders showed that viewers of pro-E.D. websites report lower self-esteem, perceived themselves as heavier, and said that they were more likely to think about their weight in the near future. This was just after a single viewing of these websites! And most of sites are certainly not just innocent attempts at catharsis. Pro-ED web-hosts usually post "disclaimers" to warn visitors that the images and text they see can be "triggering" to those with "food issues".
The "new generation" of eating disorder sufferers may not be as different as they appear. Regardless of new technologies, many of these individuals simply long for connection and community. Unfortunately, too many of them find make-shift communities at these pro-ED websites. As caring professionals, we need to offer them more substantial connections and point them to healthier communities for support. Talk to your clients about their on-line communities. Encourage families to talk about it together as well. And if your clients are pat of the "new generation" of web-users, suggest sites such as www.eatingdisordersblogs.com, www.something-fishy.org, along with two websites hosted by individuals who are recovered after having been a part of the pro-ED community : www.webiteback.com and www.unitedwestarvenomore.com.
Postscript note: In February 2008, in the U.K., 40 MPs signed a motion urging government action against pro-ana sites. The motion was timed to coincide with the UK National Eating Disorder Awareness Week. In April, 2008, a French bill was proposed which would outlaw material which "provokes a person to seek excessive thinness by encouraging prolonged restriction of nourishment".
Wise man have their mouths in their hearts, fools have their hearts in their mouths.
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