Web of deceit

In an age of social networks, it's possible to find online communities dedicated to everything from knitting to breeding rare marine fish. It also creates a space, however, for darker forms of community to emerge, such as those that encourage eating disorders.

In previous years, a wave of pro-anorexia (pro-ana) sites caused much concern, which resulted in many being shut down. But this only drove them further underground, and made them more difficult to get information about, says Megan Kleyn, a part-time lecturer in the sociology department at the University of KwaZulu-Natal.

“Previously, pro-ana Web sites were easily accessible, but following the clampdown on these sites, they began moving from one site to the next, and from free servers to private ones,” notes Kleyn.

She adds that many are now password protected and have rigorous 'approval' processes to prevent just any one from logging in.

Others have taken on a 'supportive' element, with followers encouraging each other to engage in harmful eating disorder (ED) behaviour.

This turn has been documented by a research team from the University of Cincinnati (UC), in a recent study observing social networking sites, blogs, forums and public-access pro-ana sites between October 2006 and May 2007.

The study identified a new type of Web society - the 'Online negative enabling support group' (ONESG) - which adds a sinister twist to the idea of community support by 'nurturing' potentially harmful behaviour.

According to the authors, the Internet has allowed pro-anorexia followers to interact in anonymous virtual communities where they encourage one another to be thin.

The researchers note that members of these groups often advocate that anorexia is a lifestyle they choose rather than an illness they suffer from. According to Stephen M Haas, lead author of the study, the ONESG pro-anorexia movement features four themes and various communication strategies to encourage members to engage in harmful behaviour.

To psychologically healthy people, the idea of promoting an illness seems abhorrent.

Megan Kleyn, University of KwaZulu-Natal

These include staying 'true' to the anorexia movement - by sharing tips for starving, binging and exercising, and 'confessing' guilt if they feel they have not stayed in line with the movement - as well as promoting self-loathing, of both their physical body and inner being.

Other behaviours involve pro-anorexia advising, such as offering tips on dieting and how to deal with confrontations from family members and 'outsiders', and pro-anorexia encouragement - exchanging messages that foster group intimacy, and form a barrier against the disapproval of non-anorexics.

Another hallmark of these groups is that members accept negative messages without correction from others, creating “an 'enabling in-group' that evolves online 'weak-tie' support into 'strong ties' used to combat stigma in their offline world”, says the study.

Researchers note that embracing negative commentary is a communication technique unique to this community, and one that helps build a shared identity through the recognition of each others' failures.

The authors say it will be increasingly important to understand the role of ONESGs as the prevalence and influence of new forms of social media grow. “By gaining deeper insight, we can potentially increase our efforts to help those whose online interactions revolve around 'communicating thin'.”

However, the Internet is usually an enabler of dangerous behaviour, rather than the cause of it, say both Kleyn and Romy Kraut, a psychologist based in Johannesburg with a special interest in eating disorders.

“While these sites can help fuel eating disorders, other precipitating factors play a much greater role,” says Kraut. “Research has shown that starting to diet in early adolescence or having a family where a lot of emphasis is placed on weight and physical attractiveness can lead to a predisposition to this kind of behaviour.”

She adds that an individual's personality and circumstances, as well as their response to stress and communication around weight, will be greater influencing forces in developing an eating disorder.

If a person already engages in or shows signs of ED thinking, visiting pro-ana sites could hasten the onset of the disorder, but it's unlikely to cause it directly, explains Kleyn.

“Teens were most likely well aware of eating disorders prior to the Internet, thanks to high profile cases like Princess Diana's struggle with bulimia.”

Nonetheless, the Internet has made the specifics of eating disorders available, beyond just the awareness that they exist. “With the technological divide lessening, there's new exposure of eating disorders among previously disadvantaged communities,” notes Kleyn.

Kraut adds that social pressures during adolescence can seem overwhelming, with teens who aren't taught how to cope with these anxieties becoming susceptible to negative self-image. The media easily feeds into these feelings of inadequacy by perpetuating perceptions of ideal body types, and the level of media access teens have usually compounds the effect.

“The media often sensationalises and trivialises thinness, which is equated with success,” she explains. The damage to one's health, however, is not as frequently explored, and while the media may point this out, it's often ignored or used as motivation, says Kraut.

While these sites can help fuel eating disorders, other precipitating factors play a much greater role.

Romy Kraut, psychologist

She explains that circumstances such as a lack of parental supervision and support, resultant low self-esteem, and rejection by peers can turn any young person to a world like the Internet, where they can find someone to offer them support and help pass the time and loneliness.

“It provides a sense of belonging, especially if we're talking about teenagers who are grappling with their identities,” says Kraut.

While pro-ana sites cannot be cited as a direct cause of eating disorders, they do seem to play an aggravating role.

“My experience at a psychiatric hospital with an eating disorders unit is that some patients with anorexia or bulimia who visit these sites were sometimes motivated by this. They would log down words like 'fat' and 'pig' in their journals, or write it on their skin,” says Kraut.

She adds that certain actions, such as looking at pictures of overweight naked women, can further drive disordered behaviour out of fear or self-loathing, while viewing emaciated anorexics could encourage starvation and self-hatred. ”Or can have the opposite effect, depending on the person.”

Kraut notes that there's a great deal of indoctrination on pro-ED sites, which tell young girls how anorexia will help them get ahead in life, for example, and offer tips on dieting, hiding weight loss and so on.

She explains that due to the massive volume of information online, especially images, simply typing in seemingly unrelated terms that form part of pro-ana jargon could bring up a flood of material.

Like any tool, the Web can be both enlightening and endangering. While it has the potential to fuel destructive behaviour, it can also help educate parents and loved ones on the signs and symptoms of the illness, and connect recovering individuals with legitimate support networks.

Kleyn, who co-authored a journal article exploring identity construction within the pro-ana community, points to another feature of these secret communities, which constitutes something of a grey area.

However destructive they may seem, Kleyn says these sites can serve a need not always met in conventional recovery channels.

“In psychological practice, certain topics are out of bounds, but these sites provide a space where individuals with eating disorders can speak about issues in an uncensored environment,” she explains.

Many recovery sites delete 'trigger' posts and moderate content to protect members. Some of these 'pro-ana' communities therefore offer sufferers freedom to express thoughts prohibited elsewhere, because they contain off-limit topics such as references to specific foods or amounts.

“To psychologically healthy people, the idea of promoting an illness seems abhorrent,” says Kleyn. But, in some cases, these sites can serve as an outlet or 'safe space' for sufferers who may feel maligned elsewhere, she adds.

With regards to fears that sites provide sufferers with new starving or purging techniques, Kleyn says most of the 'tricks and tips' offered are things an anorexic or bulimic is likely to know anyway. While conducting her research, Kleyn says many of the sites she looked at contained warnings to those in recovery not to enter.

When it comes to teens going online, Kraut says it's better to be on the safe side, although curbing access is difficult because it's so readily available.

“Parents could, without being intrusive, try to cut down on time spent online and talk to their children about things, versus them going to sites for 'support'.”

She also stresses the importance of getting professional help and receiving positive support from loved ones, and legitimate community networks.

* Speak your mind: Do you think spending more time online contributes to eating disorders?