College of Psychiatrists say 'pro-ana' sites affect girls' body image and self-esteem

Urgent action is needed to tackle the soaring number of websites encouraging adolescent girls to starve themselves, doctors say today. The proliferation of "pro-ana" and "pro-mia" websites, which promote anorexia and bulimia, is encouraging growing numbers of young women to wage war on their bodies, they say.

The websites support anorexia as a lifestyle choice rather than a medical disorder. They include messages such as, "I am starting a four-week fast today. Anyone want to join me?" They contain advice on how to get through the pain of extreme hunger after eating a yoghurt a day, or how to hide extreme weight-loss from parents or doctors. Some use pictures of excessively thin models as "thinspiration" for self-starvation.

One million people in the UK suffer from eating disorders, commonest in teenage girls. More than one in 10 girls look at pro-eating disorder websites repeatedly, the Royal College of Psychiatrists says. In a paper today, the College calls on the Government to do more to protect vulnerable women. They say the UK Council for Child Internet Safety, set up last year, should specifically target pro-eating disorder websites in its monitoring and educational activities.

Professor Ulrike Schmidt, chair of the College's Eating Disorders Section, said: "This is not a rare problem; it affects a significant number of schoolchildren. Studies have shown that girls who looked at these sites had low self-esteem, felt bad about their bodies and were miserable. Patients in eating disorders units spend up to 20 hours a week looking at [the websites]. There is a vulnerable group of women who are being sucked into this."

The pro-eating disorder websites offer a forum for debate and help young girls stave off doubt about what they are doing. They offer a way of keeping in touch with thousands around the world who share their vision. Other countries have tried to control the websites by law. A Bill to ban them in France last year was ultimately lost. In Spain, the health ministry has closed sites accused of promoting self-starvation in girls and, in the Netherlands, moves have been made to add warnings to the sites. Professor Schmidt said the College was not proposing a ban on the websites, many of which were beyond UK jurisdiction. "These sites are probably set up by people who are themselves vulnerable. Criminalising the problem would not be helpful."

But she warned that the media had a responsibility not to sensationalise the issue in a way that could lead to increased use of the sites. The fashion industry was also responsible for fostering unhealthy body images among women. Concern over "size zero" models two years ago led the British Fashion Council to order all models to obtain medical certificates before being allowed to take to the catwalk, but the recommendation had not been implemented, Professor Schmidt said.

"London Fashion week can act as a showcase for underweight women," she said. "We are very concerned that the lack of medical checks for models at London Fashion Week, coupled with working in an environment where being underweight is considered the norm, prevents models with eating disorders from gaining insight into their condition."