EATING DISORDERS
AND THE INTERNET A parental
overview of deadly eating disorder hazards on the Internet. How to identify
them, and what to do about them.
INTRODUCTION
Unfortunately many people still have
the incorrect belief that eating disorders such as anorexia nervosa and bulimia
nervosa afflict only rich skinny white girls.
The reality is that eating
disorders are deadly chronic diseases that afflict more than 8 million Americans
and cross all demographic, racial and ethnic boundaries. The vast majority of eating
disorder sufferers are female.
More than 80% of sufferers exhibit their first
symptoms prior to the age of twenty; some exhibit symptoms as early as the age
of ten or younger.
At best the sufferer of an eating disorder can expect a
fight for her/his life that can extend from one year to the lifespan of the
sufferer. At worst, the scenario can be a long slow death.
WHY PARENTS SHOULD BE CONCERNED ABOUT ONLINE PRO EATING DISORDER
LOCATIONS
The technology of the Internet
allows the spread or information about how to mimic or to be anorexic with
lightening-like rapidity. Unfortunately, many of the Internet locations that
advocate eating disorders as glamorous exhibit chameleon-like deviousness in
disguising themselves as something other than the deadly dangerous information
centers they are.
For example, the following warning appears on the front page of a popular
pro-anorexia internet discussion group, Hard Core Anorexic (Name
changed).
“For girls who are
hardcore about being skinny.
But on the contrary,
We are not in anyway trying to encouraging ED!
But, we ARE Pro-Ana/Mia.
If you are trying to/are recover/recovered, don't join.
It is on Internet locations such as
Hard Core Anorexic and countless others, women separated by geography; age and
lifestyle log in to share their struggles, goals, triumphs and failures in
living a "pro-ana" lifestyle.
Anorexia, long the staple of
after-school specials and public service announcements, may have fallen off the
national radar screen, edged out by public panic about obesity.
Nevertheless
with increasing access to new media, those with (or claiming to have) eating
disorders have congregated outside of hospitals and clinics, crafting a
thriving pro-eating disorder community on the internet.
While some of
those with eating disorders seek and develop recovery oriented spaces online,
others, such as the members of Hard Core Anorexic, specifically
cultivate "pro-ana" communities.”[i]
ANAD has been
battling pro-ana/pro-mia web sites since 2001 trying to remove these deadly
purveyors of information from the Internet and raise the awareness of parents
that their children may be obtaining information that can jeopardize their
health or eventually kill them. The advance of Internet technology has
seen a rapid increase in locations on the Internet because it has become
increasing easier and more appealing for
teens to create their own online content..
According to research done for the
PEW Internet & American Life project “57% of teens who use the Internet
could be considered Content Creators. They have created a blog or webpage,
posted original artwork, photography, stories, or videos.”[ii] It
is estimated that as many as one in four adolescents are worried about their
weight and they are either contemplating a diet or actually dieting.
The
predominant majority of these dieters are female, but males are also included
in lesser numbers. Many of these teens are preoccupied with shaping their
bodies to match the anorexic looking figures that the fashion and advertising
industries launch with authority.
The
result is a thriving online subculture characterized by specific symbols,
rituals and the identity of the wannarexic. The
confluence of teens who are often much more enthusiastic authors and readers of
blogs than their adult counterparts and the subculture of wannarexics that is
composed by teens create a fertile mixture for the spread of pro ana and pro
mia information on the Internet.
Teen bloggers, led by older girls,
are a major part of this tech-savvy cohort. Teen bloggers are more fervent
internet users than non-bloggers and have more experience with almost every
online activity in the survey. [iii]
[i] Pascoe, C.J.. 2008. "You're Just Another
Fatty:" Creating a Pro-Ana Subculture Online. Digital Youth Research
http://digitalyouth.ischool.berkeley.edu/node/104. January 22, 2008.
[ii]
http://www.pewinternet.org/PPF/r/166/report_display.asp
[iii] http://www.pewinternet.org/PPF/r/166/report_display.asp
WHO IS AND WHAT IS A WANNAREXIC?
A wannarexic could be your daughter or son.
THE
URBAN DICTIONARY defines wannarexic as, “Someone who wishes or pretends they
have an eating disorder or deliberately goes out of their way to make it look
like they have anorexia.”[i]
The prevalence of fashion and media pressure to be thin
produces a result that means that there is better than a ten percent chance
that if your child is an adolescent girl she binges or purges.[ii]
While these activities don’t necessarily
mean the person exhibiting these conditions has as anorexia nervosa or bulimia
nervosa, or binge eating disorder it does mean she/he is undertaking activities
that can be harmful and lead to chronic and life threatening eating disorders.
Just a few unwanted results can include rotten teeth, and in adolescent females
the interruption of menstrual cycles.
In an effort to meet her frequently unhealthy and
unrealistically weight goal, the
wannarexic will go online to learn what laxatives, or diuretics or, extreme
diets, or other unhealthy advice she can use to force her body to conform to
the pressures of the body image with which the fashion and advertising industry
constantly bombard her.
The wannarexic may even learn online what intestinal
parasites are considered safe to take to lose weight.[iii]
Thus,
countless otherwise healthy adolescent women become preoccupied with starving
themselves and deifying anorexic role models rather than practicing good health
and having healthy body images.
[i]http://www.urbandictionary.com/define.php?term=wannarexi[ii] Neumark-Sztainer D, Hannan PJ. Weight-related
behaviors among adolescent girls and boys: results from a national survey. Arch
Pediatr Adolesc Med. 2000;154 :569 –577
[iii]ANAD opts to keep the reference to the web site that
discusses the use of internal parasites confidential in order not to provide
this source to wannarexics and those suffering from eating disorders.
WHAT PARENTS SHOULD LOOK FOR: INDICATORS
OF EATING DISORDERS
Being extremely thin is not necessarily
an indication a child may be suffering from an eating disorder.
In fact, a
downward and unexplained weight loss over a period of time could be a sign of
other health problems.
If a child or teen has an unexplained downward loss of
weight one should consider making appointment with the child’s medical doctor
for a complete physical examination. Also
prior to the examination the parents should be on the lookout for other signs
of eating disorders.
There are a range
of symptoms and activities that the sufferer of eating disorders will exhibit.
Symptoms. Not all victims display
all symptoms
Abnormal weight lossRefusal to eat, except for tiny portionsBinge eatingVomitingAbuse of laxatives, diuretics, emetics, diet pills,
and other over the counter and prescription medications.
Denial of hungerExcessive exerciseDistorted body image: see themselves as fat even
though they may be so thin they are emaciatedDepressionPreoccupation with foodAbsent or irregular menstruation in womenRotted teeth from vomiting[i]
Many times the sufferer will deny
she has a problem and attempt to disguise the symptoms.
It is not unexpected
sufferers learn how to hide their symptoms or weight loss online.
For example, the web site Tricks (name
changed) provides 40 tips on anorexic and bulimic behavior, another 15
suggestions on how to hide one’s anorexic or bulimic behavior, how to erase
history of the sites one has visited on the Internet, and more.
The picture
below shows the top portion of this web site.
[i] ANAD, Anorexia nervosa Bulimia, symptoms
THE INTERNET IS A PRIMARY SOURCE
OF UNHEALTHY AND EVEN DEADLY EATING DISORDERS INFORMATION.
The previous example should alert
parents to be concerned about the information the child may be getting from the
Internet.
The parent should be aware of
the likely places the child will receive dangerous information on how to lose
weight.
Many parents are surprised to learn that there
are Internet web sites and social networking communities, groups, and forums
that support anorexia nervosa, bulimia nervosa and associated disorders.
These
parents are unaware that the Internet supports web sites, communities, groups
and forums that espouse anorexia, bulimia and other eating disorders as a way
of life.
The
findings of a pilot study which was published in the Journal of Pediatrics
investigated “the awareness and usage of pro–eating disorder Web
sites among adolescents with eating disorders and their parents and
explored associations with health and quality of life.
The
conclusion of this pilot study was that Pro–eating disorder site usage was
prevalent among adolescents with eating disorders, yet parents had
little knowledge of this.
Usage may have a negative impact on
quality of life and result in adolescents’ learning about and
adopting disordered eating behaviors.”[i]
[i] PEDIATRICS Vol. 118 No. 6 December 2006, pp.
e1635-e1643 (doi:10.1542/peds.2006-1133)
HOW PREVELANT ARE PRO EATING
DISORDER LOCATIONS ON THE INTERNET?
A Google search will turn up
countless web sites and Internet locations where pro ana and pro mia
information and lifestyles are discussed, deified and GLORIFIED.
These sites and
communities are so prevalent on the Internet they even have their own
definitions. For example the web site
About
dot com defines:
“Pro ana Definition: An abbreviated form of
"pro-anorexia." A pro-ana web site is one which promotes anorexia
nervosa as noble and beneficial.Pronunciation: PRO-AN-aAlso Known As: Pro-anorexiaAlternate Spellings: pro anaCommon Misspellings: pro-annaExamples: Since recovery from her anorexia was so difficult, Katie was
very drawn to the pro-ana web site.
[i]
About dot com defines Pro Mia
Definition: An abbreviation of "pro-bulimia," a name applied
to a philosophy that promotes bulimia as noble and desirable. Generally applied
to certain web sites.Pronunciation: PRO-MEE-ahExamples: Noel decided that her bulimia was too important to her to give
up; she started visiting pro-mia web sites.[ii] [i] http://eatingdisorders.about.com/od/glossary/g/proana.htm
[ii]
http://eatingdisorders.about.com/od/glossary/g/promia.htm
HOW PREVELANT ARE PRO EATING
DISORDER LOCATIONS ON THE INTERNET?
A Google search will turn up
countless web sites and Internet locations where pro ana and pro mia
information and lifestyles are discussed, deified and glorified.
These sites and
communities are so prevalent on the Internet they even have their own
definitions.
For example the web site About
dot com defines:
“Pro ana Definition: An abbreviated form of
"pro-anorexia." A pro-ana web site is one which promotes anorexia
nervosa as noble and beneficial.
Pronunciation: PRO-AN-aAlso Known As: Pro-anorexiaAlternate Spellings: pro anaCommon Misspellings: pro-annaExamples: Since recovery from her anorexia was so difficult, Katie was
very drawn to the pro-ana web site.[i]
About dot com defines Pro Mia
Definition: An abbreviation of "pro-bulimia," a name applied
to a philosophy that promotes bulimia as noble and desirable. Generally applied
to certain web sites.Pronunciation: PRO-MEE-ahExamples: Noel decided that her bulimia was too important to her to give
up; she started visiting pro-mia web sites.[ii]
ANAD’S DEFINITION OF PRO-ANA, PRO-MIA AND OTHER EATING DISORDER
INTERNET SITES AND LOCATIONS
ANAD defines “Pro-ana, pro-mia
and other sites and communities as online locations that share and dispense
information to sufferers of eating disorders that glamorize eating disorders.
These sites and communities also share information and photos relating toThe deification of anorexia or bulimia Supporting those who are substituting on a few
hundred calories a day, exhorting them to be strongMisusing over-the-counter and prescription drugs
such as laxatives and diureticsSelf harm Purging Use of intestinal parasites; Triggering photos of anorexic individuals that are
used for inspiration,
Detailed information on extreme diets that are as low
as or lower than 400 calories a day.The creators of these web sites,
or bogs, or forums, or groups encourage and support sufferers to continue these
practices.
ANAD POSITION STATEMENT RELATIVE
TO THE INTERNET
Anorexia kills. Despite this hard
fact frequently the corporations that host pro eating disorder sites and social
networking communities will hide behind freedom of speech as an excuse for
allowing pro ana and pro mia Internet sites and communities to continue to
exist.
ANAD believes there is no excuse for corporations to host and harbor
online pro-ana, pro-mia and other pro-eating disorder locations.
ANAD believes
these champions of misery to innocent children must be removed.
ANAD
along with Therapists, Treatment Centers, and eating disorder health care
professionals everywhere all agree such information is at the very best
unhealthy and at the very worst is deadly.
Vivian Hanson Meehan, D.Sc, and founder and
president of ANAD writes “providing tips to anxiety ridden, prepubescent or
pubescent individuals who want to adopt this lifestyle promotes life adjustment
failures, shortened stature, osteoporosis, in female’s endangerment of the
reproductive system, heart attacks and death.”
Dr.
Maria Rago, Eating Disorder Therapist, ANAD Board Member and parent reviewed a
social networking group that claims to be the largest pro anorexia community on
the Internet.
Dr. Rago’s observations about the content of the “World’s
Largest Pro-anorexia Community” provide some very key insights in establishing
whether or not the questionable Internet location is pro ana or pro mia and a
potential danger to impressionable adolescents. Here is what she had to say
about the location.
“As a parent I am
especially frightened of this site.
To imagine a young person coming
across this site or pictures like this and being affected is an unnecessary
danger.
We will need to work together to stop children and other
vulnerable people from being exposed to this kind of propaganda. Viewing this
site is disturbing, sad and frightening.
Anorexia and Bulimia are not fun
ways to chat and get to know new people. They are deadly illnesses rooted
in depression, anxiety and starvation. This site glamorizes and feeds
into Anorexia and Bulimia Nervosa.
The site’s very purpose is to support
and strengthen the desires to starve and purge. It also serves to promote
new information about ways to use more and more dangerous methods to lose
weight and avoid eating.
Anorexics and Bulimics naturally compare to each
other as part of the disease. This site creates the opportunity to
compare to more and more dangerous methods of weight loss and increase the
drive and interest, and to increase the severity and frequency of eating disorder
behaviors.
I would compare this site to a pro-suicide site which would
give depressed and suicidal people methods to kill themselves and feed into a
negative, depressed and hopeless view on life.”[i]
[i] Email from Dr. Maria Rago, Clinician and Therapist, Linden Oaks Hospital, IL
HOW TO IDENTIFY PRO-EATING DISORDER
INTERNET LOCATIONS
Don’t be mislead by claims the
location’s purpose and content are to help, or that those who are not anorexics
should not enter.
If anorexia nervosa or bulimia nervosa are glamorized,
treated as deities or lifestyles and support is given to sufferers to maintain
this deadly lifestyle, then despite claims to the contrary, the online
location’s purpose is not to help anyone.
Nor is it beneficial if the location
provides increasingly dangerous methods to lose weight and avoid eating, the
online location’s purpose is not to help anyone.
If
there are disparaging comments about how individuals and/or organizations such
as ANAD are wrong in condemning pro ana, pro mia or similar sites, the online
location’s purpose is unlikely to be positive.
If
you as a parent have bad feelings about the content and the information the
online location provides its visitors then trust your instinct and question if
the online location’s purpose is not to help anyone.
If you aren’t sure, review
ANAD’s list of signs of pro ana and pro mia Internet locations that contain
information that can kill.
Here is a more complete lists of
tale tell indicators that the onsite location could be dangerous or deadly to
your child.
Six
Signs of Life Threatening Eating Disorder Internet Locations
1. Glamorize,
reinforce, anorexia nervosa and associated disorders as desired
lifestyles.
2. Focus
on weights that are below the generally accepted standards of the medical
profession body mass index (BMI).
3. Provide
instructions on how to obtain weight reduction goals through the
explanation of diets that are so low in calories these diets are far under
accepted standards of nutritionists and health officials.
4. Reinforce
behaviors that help eating disorders sufferers to reach weigh reduction
goals that are harmful and possibly deadly.
5. Provide
information of the misuse of drugs in order to induce weight loss through
vomiting or bowel movements.
6. Use
photos or videos of celebrities, fashion models, or other individuals as
roll models who are identified as anorexia.
WHAT PARENTS CAN DO AT HOME TO
PROTECT THEIR CHILDREN FROM THE ODIOUS EATING DISORDER SITES
Most Internet guidelines for
parents about internet safety are written from the point of view of protecting
the child from pornography or child predators.
Some of the general guidelines
make equally good sense for protecting children from pro eating disorder sites.
These suggestions include:
1.
Purchase good software monitoring. According to web
monitoring software reviews dot org some of the features and benefits of child
monitoring software include:
A.
For effective monitoring make sure the program lets
you to see all web pages visited, read sent and received email, and see
both sides of IM chats conversations of your child (children)
B.
Remote web access that allows you to keep an eye on
things from anywhere.
(Imagine keeping an eye on the kids' Internet activity from your office for
instance.)
C. Be able to see what your child does when they
think no one's looking, you need a program that's completely invisible
D.
Other features to look for are ability to block, the
ability to filter data, and the ability to take screenshots.[i]
2.
Keep your child’s computer in a public room of your
home so you can indiscreetly monitor activities when you pass by the computer
work station.
3.
Set age appropriate rules and guidelines for computer
use with your child.
A.
Discuss these rules with children and put a copy near
the computer as a reminder. B. A child or teenager’s excessive use of online services or
bulletin boards, especially late at night, may be a clue that there might be a
hidden problem.
4.
Don’t be afraid to learn more about the interests of
the people with whom your child is chatting.
Unfortunately,
too many people still believe anorexia nervosa and bulimia nervosa pose little
threat and are primarily conditions that white middle class girls suffer.
The
truth is eating disorders know no socio-economic or ethnic or national borders.
The facts are eating disorders have the highest mortality rate of any mental
illness and the mortality rate associated with anorexia nervosa is 12 times
higher than for all causes of death for females 15-24 years of age.[i] Eighty
six percent of sufferers report the onset of illness by the age of 20. This is
the demographic that goes to the Internet for information and to
socialize.
Once a sufferer has an eating
disorder, she/he only has a fifty percent chance of being cured.
Those that are
cured report suffering from their eating disorder from one to fifteen years,
and it is estimated that between five and six percent of serious cases die.
l
DURATION OF ILLNESS/MORTALITY:
–
77% report
duration from one to fifteen years
–
30% report duration from one to five years
–
31% report duration from six to ten years
–
16% report duration from eleven to fifteen years
–
It is estimated that between five and six percent of
serious cases die
Treatment for
anorexia nervosa and/or bulimia is often extremely expensive. For example cost
of inpatient treatment can be $30,000 or more a month, and the cost of out
patient treatment, including therapy and medical monitoring can be as much as
$100,000 a year.
In addition there are the thousands
of dollars a sufferer and/or her/his family may lose from lost time at work,
the cost of transportation, and other related costs.
The mental hardship and anguish to
the sufferer and friends and family are incalculable. Marriages are destroyed
by eating disorders and families are damaged in ways that are irreparable.
HOW PARENTS CAN
FIGHT THE PROLIFERATION OF ON-SITE PRO EATING DISORDER LOCATIONS
Join ANAD and
make your voice count. Enlist as an ANAD Internet Militia Member. Help us raise
the alarm and to
·
Fight to get responsible corporations to police
the pro ana and pro mia web sites, social networking communities, blogs, and
forums.
·
Draw attention to those corporations who
disregard the safety of your children by continuing to harbor online pro eating
disorder locations.
Send emails to those
corporations announcing your displeasure
Send emails to the sponsors and
to the advertisers found at those locations
All rights reserved, Copyright 2008 by
ANAD (The National Association of Anorexia Nervosa and Associated Disorders)
In her presentation of the ANAD award
Dr. Meehan cited Dr. Grotmaker’s “humanitarian concern and groundbreaking
development of prevention programs through the Planet health curriculum for middle
schools and the Eat WEll and Keep Moving curriculum for elementary schools to
assure the health of children and youth. For his vision and leadership
advancing knowledge to improve nutrition and physical activinty resulting in
the reduction of chronic disease risk behaviors.
In addition, Dr Bryn Austin, (left) Harvard School of Public Health
was given a special award, The ANAD Healthy Living Award, by Dr. Meehan “for
her outstanding research demonstrating the protective effect of the Planet
Health curriculum on the development of eating disordered behaviors in early
adolescent girls.”
The awards were presented by Dr. Meehan at the recent
Healthy Living In A Challenging World eating disorder conference for
professionals.
The conference was co-sponsored by ANAD, Linden Oaks at Edwards
and The Awakening Center.
Speakers at the conference included Internal Family Systems
expert Dr. Richard Schawarz and Dr. Bryn Austin.
In her presentation of the ANAD award
Dr. Meehan cited Dr. Grotmaker’s “humanitarian concern and groundbreaking
development of prevention programs through the Planet health curriculum for middle
schools and the Eat WEll and Keep Moving curriculum for elementary schools to
assure the health of children and youth. For his vision and leadership
advancing knowledge to improve nutrition and physical activinty resulting in
the reduction of chronic disease risk behaviors.
In addition, Dr Bryn Austin, (left) Harvard School of Public Health
was given a special award, The ANAD Healthy Living Award, by Dr. Meehan “for
her outstanding research demonstrating the protective effect of the Planet
Health curriculum on the development of eating disordered behaviors in early
adolescent girls.”
