To: Rep. Tammy Baldwin
December 10th, 2009
Dear Representative Baldwin:
My name is Sapir Sasson and I am a student at the University of Wisconsin-Madison. As an Honors Project for one of my psychology classes, I chose to investigate the use of pro-anorexia websites by individuals with eating disorders and the effects that these websites have on viewers. Pro-anorexia websites (commonly referred to as pro-ana sites) are sites created by individuals suffering from eating disorders. These sites advocate eating disorders as a ‘lifestyle of choice’ and encourage individuals to continue with unhealthy eating patterns; these sites often include information about tips and tricks on how to lose weight the fastest, advice on how to purge food, and ways to punish oneself if the anorexic eats more than her self-determined caloric limit (which is often extremely low). These sites also offer forums in which individuals can exchange ideas and encourage each other to lose more weight.
While these sites present themselves as ‘support networks,’ they are far from it. Studies have shown that even site visitors who do not have eating disorders prior to visiting these sites suffer reduced self-esteem, more distorted body images, and an increased desire to lose weight after a single visit to these sites (this was regardless of the individual being of normal body weight). For a review of these studies, I encourage you to visit the blog I created, documenting my findings: http://antiproed.blogspot.com/
I am well aware of the restrictions regarding Internet censorship. I understand that it is against the First Amendment to censor any form of free speech. The prolonged and unsuccessful debates regarding the Child Online Protection Act, struck down for the third time in 2008, and the Communications Decency Act, struck down in 1996, are very discouraging. These Acts were meant to protect minors from harmful contents of the Internet simply by ensuring that minors would not have the ability to view these sites without parental supervision. Both were denied on grounds of violation of the First Amendment.
While I know that an amendment to the First Amendment is not ideal, nor is it likely, I urge you to find a loophole through which access to these websites can be restricted. Regarding COPA, the Supreme Court said there was a “potential for extraordinary harm and a serious chill upon protected speech had the law gone into effect.” However, in my view, there is just as great a potential for harm if nothing is done about this issue. From a purely economical standpoint, eating disorders cost our nation over $3.8 million each year on treatment alone. Individuals who visit these websites while in treatment are prolonging their disorder and reducing their chances for a successful recovery, and those who are exposed to these websites following treatment are bound to relapse quickly.
It is quite impossible for me to adequately convey the potential harm for those who view these websites through a single letter. But at the same time, not doing anything is neglectful of individuals who cannot make better judgments for their own health. Just as we would not want suicidal individuals to looks up ‘tips and tricks’ on the best ways to commit suicide, we do not want individuals with eating disorders to find ways of sustaining their disorders.
This issue is personally relevant to me. My cousin has been suffering from Anorexia Nervosa for the past six years. She has enrolled and un-enrolled at a university three times within the past two years. Her health insurance recently cut her off because she was not improving, so she is not sitting at home, with no insurance or a means to afford needed treatment. She spends hours each day on pro-ana websites, which serve as her only support system. While she cannot see herself surviving without these websites, I know that they are inadvertently prolonging her disorder and preventing her from getting better and moving on with her life.
If there is anything at all that can be done about these websites, I beg you to take this issue into consideration. The purpose of the First Amendment is to protect our rights as human beings, but I think it crosses the line when it endangers the lives of others.
Thank you for taking the time to read this letter. I know you are extremely busy, but I would love to hear your thoughts on this issue.
Sincerely,
Sapir Sasson
Madison, WI
Wednesday, December 16, 2009
Monday, December 7, 2009
12/7
I am no expert in this matter. I am not familiar with all the rules and regulations beyond the First Amendment that prevent censorship laws from being passed, nor am I familiar with those that may enable the passing of such laws. I’m half in my mind to refrain from saying what I’m about to say, but I strongly believe that it is a very reasonable suggestion.
Maybe, just maybe, we are being too rigid? Perhaps strict enforcement of the First Amendment, or any other law passed by the Founding Fathers for that matter, is no longer warranted? Maybe we are meant to have exceptions! After all, the creators of our Constitution did not anticipate the invention of the Internet. They did not, while initially constructing these laws, think “Hmm…We should make the First Amendment such that it pertains to ALL forms of speech, no matter what harm they cause…pornography, terrorism, eating disorders…Who cares? We believe in freedom of speech, and that’s that!” Seems ridiculous, right? They had no way of predicting the circumstances with which we are faced today. And just as they made amendments to the Constitution to include items which every human being rightfully deserves (i.e. Bill of Rights), we need to make amendments to items that no longer fit society’s needs.
Yes, this is a complicated process. It will not be easy to determine clear-cut boundaries between what is considered harmful material and borderline, but acceptable, material. Nevertheless, we already have clear-cut definitions for other, unrelated issues. We have very clear, very precise definitions of what constitutes sexual assault and what constitutes consensual sex. We even distinguish between homicide and accidental murder, even though both result in the death of another human being.
So why can’t we distinguish between educational websites about eating disorders and those advocating disordered eating? Such as task seems, to me, conveniently simple compared to the aforementioned distinctions we have already accomplished.
It IS possible to create change. It IS feasible to decide that the First Amendment no longer applies to ALL speech and that it may be restricted in some cases; after all, the Courts made such an exception for broadcast media! They gave clear explanations of why an exception was needed and passed the bill without regard for the public’s approval or disapproval. Claiming that nothing can be done about pro-ana websites would be, quite simply, making excuses for our own lack of initiative in the matter.
Prior to the termination of this Honors project, I will write a letter to Congresswoman Tammy Baldwin. I will post the content of the letter once I have it drafted, but it most likely include much of the information I have already posted on here: All the reasons why pro-ana sites should be banned, and every reason why not banning them is quite simply neglect of individuals who cannot make healthy judgments for their own good.
Just as we would not want a suicidal individual to look up ‘tips and tricks’ on how to end his/her life, we do not want those with eating disorders looking up ways to sustain their disorders! Approximately 17.6 million individuals in the US suffer from depression; of those, 265,000 commit suicide each year. An estimated 8 million Americans have an eating disorder; twenty percent of individuals with anorexia will die prematurely due to complications related to their eating disorder, including suicide and heart problems (South Carolina Department of Mental Health, 2006).
While viewing pro-ana websites does not directly cause death, it no doubt sustains disordered eating—and that certainly does increase risk of death. We must take preventative measures while we can, not just for the sake of those with eating disorders, but for the sake of anyone who has a pre-existing condition that makes him/her vulnerable to harmful contents of the Internet—be it pornography, tips on how to commit suicide, self-mutilation methods, or means of maintaining a body mass 15% below the individual’s normal weight.
Ban Pro-ED Websites!
Maybe, just maybe, we are being too rigid? Perhaps strict enforcement of the First Amendment, or any other law passed by the Founding Fathers for that matter, is no longer warranted? Maybe we are meant to have exceptions! After all, the creators of our Constitution did not anticipate the invention of the Internet. They did not, while initially constructing these laws, think “Hmm…We should make the First Amendment such that it pertains to ALL forms of speech, no matter what harm they cause…pornography, terrorism, eating disorders…Who cares? We believe in freedom of speech, and that’s that!” Seems ridiculous, right? They had no way of predicting the circumstances with which we are faced today. And just as they made amendments to the Constitution to include items which every human being rightfully deserves (i.e. Bill of Rights), we need to make amendments to items that no longer fit society’s needs.
Yes, this is a complicated process. It will not be easy to determine clear-cut boundaries between what is considered harmful material and borderline, but acceptable, material. Nevertheless, we already have clear-cut definitions for other, unrelated issues. We have very clear, very precise definitions of what constitutes sexual assault and what constitutes consensual sex. We even distinguish between homicide and accidental murder, even though both result in the death of another human being.
So why can’t we distinguish between educational websites about eating disorders and those advocating disordered eating? Such as task seems, to me, conveniently simple compared to the aforementioned distinctions we have already accomplished.
It IS possible to create change. It IS feasible to decide that the First Amendment no longer applies to ALL speech and that it may be restricted in some cases; after all, the Courts made such an exception for broadcast media! They gave clear explanations of why an exception was needed and passed the bill without regard for the public’s approval or disapproval. Claiming that nothing can be done about pro-ana websites would be, quite simply, making excuses for our own lack of initiative in the matter.
Prior to the termination of this Honors project, I will write a letter to Congresswoman Tammy Baldwin. I will post the content of the letter once I have it drafted, but it most likely include much of the information I have already posted on here: All the reasons why pro-ana sites should be banned, and every reason why not banning them is quite simply neglect of individuals who cannot make healthy judgments for their own good.
Just as we would not want a suicidal individual to look up ‘tips and tricks’ on how to end his/her life, we do not want those with eating disorders looking up ways to sustain their disorders! Approximately 17.6 million individuals in the US suffer from depression; of those, 265,000 commit suicide each year. An estimated 8 million Americans have an eating disorder; twenty percent of individuals with anorexia will die prematurely due to complications related to their eating disorder, including suicide and heart problems (South Carolina Department of Mental Health, 2006).
While viewing pro-ana websites does not directly cause death, it no doubt sustains disordered eating—and that certainly does increase risk of death. We must take preventative measures while we can, not just for the sake of those with eating disorders, but for the sake of anyone who has a pre-existing condition that makes him/her vulnerable to harmful contents of the Internet—be it pornography, tips on how to commit suicide, self-mutilation methods, or means of maintaining a body mass 15% below the individual’s normal weight.
Ban Pro-ED Websites!
12/6
While United States’ efforts are not comforting, other countries are actively taking appropriate action to ban pro-ana sites. Australia has announced its intention to enact a compulsory internet censorship to control access to anorexia- and bulimia-related sites. Facebook and MySpace are also among the list of 2,000 sites to be banned. The reasons for including these social networking sites in the are extreme and not related to eating disorders, and thus are beyond the scope of this discussion (Just as a side note…imagine the reactions of US citizens if the government ever proposed such a ban!)
Other countries, such as China, Cuba, Iran, and North Korea, which have known and experienced Internet censorship, know firsthand the effects that lack of knowledge can have on a population. Most likely, they would strongly oppose this movement. The problem with Australia’s proposal is, perhaps, its extremity. Not all websites that have unconventional content need to be banned—they need to restrict their censorship solely to websites that harm minors or unprotected individuals, and only then could they have the chance of receiving positive feedback regarding their chosen course of action.
With the case of eating disorders, the purpose of banning pro-ana websites would be to protect anorexics from themselves. Let me call your attention to a Supreme Court quote regarding COPA: “there is potential for extraordinary harm and a serious chill upon protected speech had the law gone into effect.”
Now, let me pose this question: Isn’t there potential for extraordinary harm and a serious chill upon the well-being of eating-disordered individuals if the NO law goes into effect? Yes-it is arguable whether pro-ana sites directly cause harm to their visitors. Yes-most who visit these sites already have eating disorders. Correct-these websites most likely do not directly cause eating disorders in individuals. But aren’t we doing a disservice to these individuals by enabling them to engage in this risky ritual of connecting with others over dysfunctional and harmful behaviors? If we have the power to do so, shouldn’t we stop them from further harming themselves? Why aren’t we do so?
It would be regrettable if the only way to prove this point as to conduct an ethical study where cause and effect of these sites would be determined. Is making individuals browse these sites continuously and (potentially) causing an eating disorder in individuals the only way to convince the government that censorship must be enforced on these sites? Do we really have to resort to this?
Clearly, this would never happen. The IRB would never agree to such a preposterous idea—nor would (I hope) any experimenters wish to cause significant harm to their participants. But what exactly are we supposed to do? Sit back and hope that individuals with eating disorders will no longer find these websites appealing? Hope that the administrators of these websites will independently decide to shut down their website (quite an unrealistic hope, more so than the one aforementioned, since those who created these websites often suffer from severe eating disorders themselves).
Other countries, such as China, Cuba, Iran, and North Korea, which have known and experienced Internet censorship, know firsthand the effects that lack of knowledge can have on a population. Most likely, they would strongly oppose this movement. The problem with Australia’s proposal is, perhaps, its extremity. Not all websites that have unconventional content need to be banned—they need to restrict their censorship solely to websites that harm minors or unprotected individuals, and only then could they have the chance of receiving positive feedback regarding their chosen course of action.
With the case of eating disorders, the purpose of banning pro-ana websites would be to protect anorexics from themselves. Let me call your attention to a Supreme Court quote regarding COPA: “there is potential for extraordinary harm and a serious chill upon protected speech had the law gone into effect.”
Now, let me pose this question: Isn’t there potential for extraordinary harm and a serious chill upon the well-being of eating-disordered individuals if the NO law goes into effect? Yes-it is arguable whether pro-ana sites directly cause harm to their visitors. Yes-most who visit these sites already have eating disorders. Correct-these websites most likely do not directly cause eating disorders in individuals. But aren’t we doing a disservice to these individuals by enabling them to engage in this risky ritual of connecting with others over dysfunctional and harmful behaviors? If we have the power to do so, shouldn’t we stop them from further harming themselves? Why aren’t we do so?
It would be regrettable if the only way to prove this point as to conduct an ethical study where cause and effect of these sites would be determined. Is making individuals browse these sites continuously and (potentially) causing an eating disorder in individuals the only way to convince the government that censorship must be enforced on these sites? Do we really have to resort to this?
Clearly, this would never happen. The IRB would never agree to such a preposterous idea—nor would (I hope) any experimenters wish to cause significant harm to their participants. But what exactly are we supposed to do? Sit back and hope that individuals with eating disorders will no longer find these websites appealing? Hope that the administrators of these websites will independently decide to shut down their website (quite an unrealistic hope, more so than the one aforementioned, since those who created these websites often suffer from severe eating disorders themselves).
12/5
A second federal law, the Child Online Protection Act (COPA), which was more narrowly focused on commercial purposes of the Internet, aimed to fix the constitutional defects of the CDA by requiring commercial Web publishers (rather than the Internet as a whole) to ensure that minors do not access harmful material directly concerned with commercial purposes on their website. COPA was enacted in October 1998 and was issued a temporary restraining order one month later. In 1999, an injunction was issued against the enforcement of this law, also on First Amendment grounds. In 2000, the Court of Appeals upheld the injunction and determined that COPA was more likely than not to be found unconstitutional by attempting to impose civil and criminal penalties against commercial website operators that publish harmful material.
Under COPA, a three-part test would have determined whether material was harmful to minors: (1) average person would consider material as harmful to minors (2) material represents offensive material to minors by means of depicting an actual or simulated sexual act or contact or exhibition of genitals or post-pubescent female breast (3) materials lacks serious literary, artistic, political, or scientific value for minors.
Please note that while the main purpose of COPA was to address exhibition of sexually inappropriate content, “harmful material” was purposefully stated in a vague manner so as to include other harmful content (i.e. pro-ana websites…cough cough)
COPA also provided Web publishers with affirmative defenses such as age-verification systems by use of credit of debit card, adult access codes, adult personal identification numbers, digital certificate that verifies age, or any other reasonable measure under available technology. Had a minor gained access to restricted material despite these measures, no liability would attach to the Web publisher.
While COPA was initially passed by the Supreme Court after the Court struck down the CDA, the 2008 Circuit Court of Appeals’ decision that COPA violated the First Amendment was the third time in nearly 10 years of litigation over the law’s constitutionality that the injunction against the law’s enforcement was upheld. The first and second decisions to uphold the injunction were issued in May of 2002 and March of 2003, respectively.
Critics of COPA said that the law did not make clear how to distinguish between sexually explicit internet content and educational web sites, such as those showing young women how to perform self-examinations for breast cancer. While this distinction may be clear-cut to the average person, this was clearly not the case in the eyes of the Supreme Court.
Many campaigns are advocating the protection of online free speech, such as the Blue Ribbon Campaign. It seems that these campaigns are more effective than those working against Internet free speech, because on January 21, 2009, the US Supreme Court refused to hear appeals over the law’s injunction, thereby killing the bill and any chance it had to pass. The Court stated that “there is potential for extraordinary harm and a serious chill upon protected speech had the law gone into effect.”
Under COPA, a three-part test would have determined whether material was harmful to minors: (1) average person would consider material as harmful to minors (2) material represents offensive material to minors by means of depicting an actual or simulated sexual act or contact or exhibition of genitals or post-pubescent female breast (3) materials lacks serious literary, artistic, political, or scientific value for minors.
Please note that while the main purpose of COPA was to address exhibition of sexually inappropriate content, “harmful material” was purposefully stated in a vague manner so as to include other harmful content (i.e. pro-ana websites…cough cough)
COPA also provided Web publishers with affirmative defenses such as age-verification systems by use of credit of debit card, adult access codes, adult personal identification numbers, digital certificate that verifies age, or any other reasonable measure under available technology. Had a minor gained access to restricted material despite these measures, no liability would attach to the Web publisher.
While COPA was initially passed by the Supreme Court after the Court struck down the CDA, the 2008 Circuit Court of Appeals’ decision that COPA violated the First Amendment was the third time in nearly 10 years of litigation over the law’s constitutionality that the injunction against the law’s enforcement was upheld. The first and second decisions to uphold the injunction were issued in May of 2002 and March of 2003, respectively.
Critics of COPA said that the law did not make clear how to distinguish between sexually explicit internet content and educational web sites, such as those showing young women how to perform self-examinations for breast cancer. While this distinction may be clear-cut to the average person, this was clearly not the case in the eyes of the Supreme Court.
Many campaigns are advocating the protection of online free speech, such as the Blue Ribbon Campaign. It seems that these campaigns are more effective than those working against Internet free speech, because on January 21, 2009, the US Supreme Court refused to hear appeals over the law’s injunction, thereby killing the bill and any chance it had to pass. The Court stated that “there is potential for extraordinary harm and a serious chill upon protected speech had the law gone into effect.”
12/3
There are hundreds of studies that support the idea that pro-ana sites maintain the individual’s disorder and may even cause further harm by providing additional dysfunctional ideas or cognitions. While it would be informative if I summarized each of them on here, it is not actually addressing the problem. I am well-aware of the implications of these websites. What I am currently struggling with is finding a possible course of action. After extensive research, it seems that current anti-censorship laws, specifically ones concerning internet use, are very extensive and all-inclusive. I could not find any loopholes through which banning pro-ana websites would be legal.
The First Amendment to the US Constitution states that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof, or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
This is a very specific, well-defined amendment, and it is consequently very difficult to create censorship laws that do not violate it.
The US Government has attempted to enact two federal laws intended to censor online content. As of 2002, neither of these laws are in practice. The Communications Decency Act (CDA), which prohibited publishing materials that would be offensive or harmful to minors, stated that sites were to use some sort of an age-verification system or another effort to restrict access by minors. The Supreme Court struck down this law on First Amendment grounds. One of the main problems with the CDA was that it was very vague and did not limit itself to commercial speech, but was rather open-ended in its prohibitions. The Court also explained that judgments regarding potential harm to minors were to be judged by the community to which the sites apply, and thus could not be generalized to the entire US population. Since 1996, during which the initial restraining order was issued against the enforcement of this law, four US states have passed Internet censorship legislation that restricted online distribution of harmful material. These laws have all been struck down on Constitutional grounds.
Some have argued that Internet regulation would be similar to telephone, radio, or TV regulation; thus, since supervision of the media is allowed, so should the supervision of Internet publications. However, the censorship enforced on these other media communications is far less than the one initially proposed by the CDA.
Oddly enough, government involvement in radio and television is based on the fact that censorship is justified by government’s role in assigning broadcast frequencies. The Supreme held that indecent language cannot be completely banned from telephone, radio, or television; current regulations allow indecent speech on broadcast media after 10pm. This was the main rationale for allowing partial censorship of broadcast media—the fact that speech was not banned entirely, but rather channeled to a time where children cannot normally access it (late hours).
Even more ironic is the fact that the US Congress passed the Children’s Internet Protection Act (CIPA) in 2000, requiring schools and public libraries to install blocking software on their computers to censor material deemed inappropriate for school settings.
Another the main rationale of the CDA was that censorship impermissible for printed words was appropriate for electronic word, and that word protected on paper were subject to censorship on a computer screen. Even by means of common sense, this argument has none. As the Supreme Court ruled, there was no justification for treating printed and electronic word differently. Since Internet did not exist at the time of the enactment of the First Amendment, it is doubtful that the Founding Fathers would have decided to make Internet censorship the exception to the Amendment. Simply put, the CDA approached their goal from an illogical and non-sensible manner.
The First Amendment to the US Constitution states that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof, or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”
This is a very specific, well-defined amendment, and it is consequently very difficult to create censorship laws that do not violate it.
The US Government has attempted to enact two federal laws intended to censor online content. As of 2002, neither of these laws are in practice. The Communications Decency Act (CDA), which prohibited publishing materials that would be offensive or harmful to minors, stated that sites were to use some sort of an age-verification system or another effort to restrict access by minors. The Supreme Court struck down this law on First Amendment grounds. One of the main problems with the CDA was that it was very vague and did not limit itself to commercial speech, but was rather open-ended in its prohibitions. The Court also explained that judgments regarding potential harm to minors were to be judged by the community to which the sites apply, and thus could not be generalized to the entire US population. Since 1996, during which the initial restraining order was issued against the enforcement of this law, four US states have passed Internet censorship legislation that restricted online distribution of harmful material. These laws have all been struck down on Constitutional grounds.
Some have argued that Internet regulation would be similar to telephone, radio, or TV regulation; thus, since supervision of the media is allowed, so should the supervision of Internet publications. However, the censorship enforced on these other media communications is far less than the one initially proposed by the CDA.
Oddly enough, government involvement in radio and television is based on the fact that censorship is justified by government’s role in assigning broadcast frequencies. The Supreme held that indecent language cannot be completely banned from telephone, radio, or television; current regulations allow indecent speech on broadcast media after 10pm. This was the main rationale for allowing partial censorship of broadcast media—the fact that speech was not banned entirely, but rather channeled to a time where children cannot normally access it (late hours).
Even more ironic is the fact that the US Congress passed the Children’s Internet Protection Act (CIPA) in 2000, requiring schools and public libraries to install blocking software on their computers to censor material deemed inappropriate for school settings.
Another the main rationale of the CDA was that censorship impermissible for printed words was appropriate for electronic word, and that word protected on paper were subject to censorship on a computer screen. Even by means of common sense, this argument has none. As the Supreme Court ruled, there was no justification for treating printed and electronic word differently. Since Internet did not exist at the time of the enactment of the First Amendment, it is doubtful that the Founding Fathers would have decided to make Internet censorship the exception to the Amendment. Simply put, the CDA approached their goal from an illogical and non-sensible manner.
Sunday, December 6, 2009
11/28
Kempt (2002) has said that pro-ana websites may cause individuals in the early stages of anorexia to believe that anorexia is an acceptable lifestyle; in other words, they create an illusion of normalcy (this is often seen in many prevention efforts, i.e. when schools talk about suicide as if it is a normal response to stress; this leads individuals to accept suicide as an acceptable cop-out. The important thing to note is that pro-ana websites are not in the least attempting prevention of eating disorders, which highlights the dysfunctional cognitions of individuals who interact with these sites and believe anorexia is a lifestyle. They believe so because of disordered thinking and not because of backfired prevention efforts).
In 2001, the National Association of Anorexia Nervosa and Associated Eating Disorders and the National Eating Disorders Association requested that Yahoo shut down these websites. Yahoo complied, and MSN followed soon after. While this forced sites to move to different servers, these sites still exist today—they are merely underground.
Pro-eating disorder, as previously mentioned, implies a willingness to accept the eating disordered behavior without encouraging treatment and, in most cases, implies an aim to motivate continuation of disordered eating. Those who want to “adopt” the eating disordered so-called lifestyle seem to think that they can adopt and discard it at their will; however, once they become overly engrossed in their disorders, their disorder takes charge and they are no longer able to control their behaviors as they once thought they would be able to. Philosopher Kant once stated that “in order to be free, humans must transcend the domain of natural causation to which appetite belongs” (1981). While Kant simply meant acting from pure reasons alone, individuals with eating disorders seem to have taken his viewpoint quite literally.
One very ironic aspect about pro-ana websites is that they give advice on how to practice anorexia “safely,” almost as if it is a routine to go through. While anorexics identify themselves as being “ana,” they do not associate their behaviors with the disorder anorexia nervosa. Almost seems cult-like. And yet, when individuals post comments such as “I want to lose 40 pounds in two months. Help me,” they are bombarded with comments such as “We do not endorse 'wannarexics'. Go somewhere else.” Seems contradictory? It is.
In the present study, 150 participants (147 female), mainly the United Kingdom and the United States (ages 13-49) completed the EAT-26, a self-report measure disordered eating. One hundred and twenty seven reported an eating disorder (29% anorexia nervosa, 22% bulimia nervosa, 26% ED-NOS, 15% combination of AN and BN, 3% binge eating disorder, and 7% unspecific eating problems). Given the option, only 9 participants visited the pro-ana website once. Forty-one percent visited the site several times a day, and 16% visited the site at least once a day. Majority of participants found the site through internet searches and others through the media or word of mouth.
Twenty-nine percent felt the websites were harmful to them. Seventeen percent reported websites as helpful in maintaining disordered eating and 43% reported receiving emotional support from these sites.
Correlational studies found that visiting the websites frequently was correlated with subjective but not objective self-esteem improvement (r = .306, p < .005).
Those who were active site participants believed they had more in common with other visitors and felt better after visiting the sites. They were also more likely than passive participants (those who did not visit sites often) to report sites as encouraging treatment. Both actives and passives reported sites as helping them maintain their disordered eating.
The term ‘lifestyle’ can be interpreted in two ways. First, it could imply a chosen manner of living one’s life and embracing certain attitudes and behaviors that characterize or promote the lifestyle. However, it could also imply a ‘way of life’ that intrudes on every aspect of an individual’s thoughts, perceptions, and actions, without regarding personal choice in the matte.
While 54% believed anorexia and bulimia to be disorders, they also reported using them as a lifestyle that pervaded every aspect of their life; they did not, however, feel as though they were choosing this lifestyle.
While these findings suggest that these websites do offer social support, whether because of counteracting the sense of isolation that anorexics often feel or because increasing sense of relatedness among visitors, participants also reported visiting these sites to obtain information on food and exercise, thinspiration, and tips/tricks. They admitted that these websites helped maintain their disordered behaviors and that showed an overall trend of worsened body image.
Active participants reported more positive effects of the sites than did passive participants, but negative effects were equal for both; these sites were harmful regardless of frequency of visits.
While it is possible that participants were not completely honest in their responses, it is unlikely; participants freely reported that these sites enabled them to sustain their disordered behaviors. Moreover, the fact that these findings were of self-reported nature should heighten alarm around these issues—the harm that these websites are associated with is not simply an assumption of experimenters, but rather the opinion of eating disordered individuals. Assuming participants reported their true opinions, this should increase the construct validity of this study. While these data are correlational in nature and do not infer causation, the perceived impact of these sites on the well-being of individuals must be taken into consideration.
These sites will continue to appear unless a unified movement to abolish them is adopted. Shutting down one or two extremely harmful websites is not going to stop others from being created or available to individuals. Clinicians must acknowledge the effects of these sites, be aware that their patients may be visiting them often, and address these effects in treatments of patients. As clinicians begin to address these issues, society at large must work to find a loophole in the anti-censorship internet laws and demand for these sites’ removal. While this may cause patients to initially be upset due to a loss of an “important” support system, this is the only way to prevent society from dwindling into a never-ending pattern of disordered eating. This is not meant to sound overly dramatic, but simply to state the facts as they are. This is something that cannot, and should not, be ignored.
Csipke, E. & Horne, O. (2007). Pro-eating disorder websites: User’s opinions. European Eating Disorders Review, 15, 196-206.
In 2001, the National Association of Anorexia Nervosa and Associated Eating Disorders and the National Eating Disorders Association requested that Yahoo shut down these websites. Yahoo complied, and MSN followed soon after. While this forced sites to move to different servers, these sites still exist today—they are merely underground.
Pro-eating disorder, as previously mentioned, implies a willingness to accept the eating disordered behavior without encouraging treatment and, in most cases, implies an aim to motivate continuation of disordered eating. Those who want to “adopt” the eating disordered so-called lifestyle seem to think that they can adopt and discard it at their will; however, once they become overly engrossed in their disorders, their disorder takes charge and they are no longer able to control their behaviors as they once thought they would be able to. Philosopher Kant once stated that “in order to be free, humans must transcend the domain of natural causation to which appetite belongs” (1981). While Kant simply meant acting from pure reasons alone, individuals with eating disorders seem to have taken his viewpoint quite literally.
One very ironic aspect about pro-ana websites is that they give advice on how to practice anorexia “safely,” almost as if it is a routine to go through. While anorexics identify themselves as being “ana,” they do not associate their behaviors with the disorder anorexia nervosa. Almost seems cult-like. And yet, when individuals post comments such as “I want to lose 40 pounds in two months. Help me,” they are bombarded with comments such as “We do not endorse 'wannarexics'. Go somewhere else.” Seems contradictory? It is.
In the present study, 150 participants (147 female), mainly the United Kingdom and the United States (ages 13-49) completed the EAT-26, a self-report measure disordered eating. One hundred and twenty seven reported an eating disorder (29% anorexia nervosa, 22% bulimia nervosa, 26% ED-NOS, 15% combination of AN and BN, 3% binge eating disorder, and 7% unspecific eating problems). Given the option, only 9 participants visited the pro-ana website once. Forty-one percent visited the site several times a day, and 16% visited the site at least once a day. Majority of participants found the site through internet searches and others through the media or word of mouth.
Twenty-nine percent felt the websites were harmful to them. Seventeen percent reported websites as helpful in maintaining disordered eating and 43% reported receiving emotional support from these sites.
Correlational studies found that visiting the websites frequently was correlated with subjective but not objective self-esteem improvement (r = .306, p < .005).
Those who were active site participants believed they had more in common with other visitors and felt better after visiting the sites. They were also more likely than passive participants (those who did not visit sites often) to report sites as encouraging treatment. Both actives and passives reported sites as helping them maintain their disordered eating.
The term ‘lifestyle’ can be interpreted in two ways. First, it could imply a chosen manner of living one’s life and embracing certain attitudes and behaviors that characterize or promote the lifestyle. However, it could also imply a ‘way of life’ that intrudes on every aspect of an individual’s thoughts, perceptions, and actions, without regarding personal choice in the matte.
While 54% believed anorexia and bulimia to be disorders, they also reported using them as a lifestyle that pervaded every aspect of their life; they did not, however, feel as though they were choosing this lifestyle.
While these findings suggest that these websites do offer social support, whether because of counteracting the sense of isolation that anorexics often feel or because increasing sense of relatedness among visitors, participants also reported visiting these sites to obtain information on food and exercise, thinspiration, and tips/tricks. They admitted that these websites helped maintain their disordered behaviors and that showed an overall trend of worsened body image.
Active participants reported more positive effects of the sites than did passive participants, but negative effects were equal for both; these sites were harmful regardless of frequency of visits.
While it is possible that participants were not completely honest in their responses, it is unlikely; participants freely reported that these sites enabled them to sustain their disordered behaviors. Moreover, the fact that these findings were of self-reported nature should heighten alarm around these issues—the harm that these websites are associated with is not simply an assumption of experimenters, but rather the opinion of eating disordered individuals. Assuming participants reported their true opinions, this should increase the construct validity of this study. While these data are correlational in nature and do not infer causation, the perceived impact of these sites on the well-being of individuals must be taken into consideration.
These sites will continue to appear unless a unified movement to abolish them is adopted. Shutting down one or two extremely harmful websites is not going to stop others from being created or available to individuals. Clinicians must acknowledge the effects of these sites, be aware that their patients may be visiting them often, and address these effects in treatments of patients. As clinicians begin to address these issues, society at large must work to find a loophole in the anti-censorship internet laws and demand for these sites’ removal. While this may cause patients to initially be upset due to a loss of an “important” support system, this is the only way to prevent society from dwindling into a never-ending pattern of disordered eating. This is not meant to sound overly dramatic, but simply to state the facts as they are. This is something that cannot, and should not, be ignored.
Csipke, E. & Horne, O. (2007). Pro-eating disorder websites: User’s opinions. European Eating Disorders Review, 15, 196-206.
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