Anorexia nervosa is an illness. Everyone knows that. And there are support groups for people who are ill. Everyone knows that, too. What is not common knowledge is the fact that an increasing number of internet-based groups are being set up in support of anorexia itself. They come in the form of what are known as "pro-ana" websites. Here, those with eating disorders can learn new starvation tactics, while keeping up to date with how their anorexic and bulimic counterparts all over the world are getting on with theirs.
"I'm starting a four-week fast today," says one message posted on the e-mail board. "Does anyone want to join me?" This Web page boasts the title "Only popular with anorexia", and has 1,085 members. Fifty-five have joined up in the past three days. From here, there are links to other sites of a similar genre – "starvemesane" is one mailing list that offers hints and tips for weight loss, and the "Ana-detox" site promises to eliminate "almost all carbohydrates from your diet – which we know are EVIL!!!".
On these sites, there is a plethora of information plucked from various unnamed health books, as well as advice from individual experience. How to keep your appetite down. Which foods are good, which bad. Instructions for those who want to weigh less than 100lb (around seven stone). Tips from girls who worry if they consume over 300 calories per day. "Trigger" photos of skinny models to encourage endurance and remind dieters of their goal.
This is a no-go zone for those who want to "judge" or destroy the sanctuary of anorexic solidarity. "If you have an ED [eating disorder] and like it, this is the place to talk about it," says one site, championing the need for sufferers to be free to do what they want with their bodies. Yet amid the friendly advice, there is sometimes an awareness of its destructive potential. A few of the sites hold warnings, cautioning that if you are "recovering from anorexia and/or are easily triggered, this site may be detrimental to your health: please leave now".
Gill Todd is the Clinical Nurse Leader of Eating Disorders Unit in the South London and Maudsley NHS Trust. She suggests that this internet-based phenomenon takes the form of a moral stand. "Those with eating disorders feel that choice has been taken away from them. They think that others possess the choice whether to eat or not, while they are trapped. It's a faulty logic." These websites provide a means of taking control, and the need for control is a familiar trait of those with such illnesses.
Todd points out that people are free to abuse their bodies with alcohol, smoking or drugs, but eating disorders are classified as mental illness. Of all the psychiatric illnesses, anorexia makes up 20 per cent of fatalities and the choice to abuse one's body by food, or the lack of it, has become a legal issue. "The country takes a stand on this matter. The law does not consider that these people are rational, and will not allow them to kill themselves." Because those with extreme eating disorders are not in a position to consider an alternative, there is no room for adult-to-adult conversation. They will not negotiate, and cannot be drawn into a debate.
The pro-ana websites are a form of debate, but in a small world. It is, says Todd, a way of staving off doubt. To persist in a lifestyle that no one else agrees with would be difficult to maintain. Now those who suffer from anorexia can be in touch with thousands all around the world who share their vision.
Dr Dee Dawson, Medical Director of Rhodes Farm Clinic, says that this behaviour is not surprising. "Anorexics like to form a club. Before websites, they loved to write to each other and compare notes. Even Princess Diana used to write to the children in my care. It's like a massive group that they're proud to be in."
As far as Dr Dawson is concerned, the web sites are as bad as those that promote paedophilia. What she finds appalling is the normalisation of such abnormal behaviour. "There is a real danger that people will stumble upon the site who can be triggered into eating disorders. Lots of people would love to fast for weeks, but don't feel that they have the will-power. These sites provide encouragement, which is basically suicide."
For many anorexics, starvation is a symptom of psychological problems, but it can work both ways. Dawson points to research that shows that although the Irish hunger strikers were not concerned about their body shape, their starvation led to anorexia, which in turn became addictive. "People get hooked. These sites need to be stopped by the servers that allow them to function."
Dawson considers these web-pages so dangerous that she declined even to ask her patients their opinion. She didn't want them to find out that they existed.
The recovering anorexics on Gill Todd's ward find the idea of these sites terrifying. They found it difficult to believe that anorexics would construct something that was so dangerous by encouraging each other to starve. They protested that anorexics genuinely care what other people think about them, and that this was wilfully destructive. Yet the websites continue to attract more members, demonstrating what a powerful tool they can be in uniting people with a common interest – particularly if it's an illness frowned upon and misunderstood by society.
Eating Disorders Unit in the South London and Maudsley NHS Trust, 020-8776 4402
Rhodes Farm Clinic 24-hour helpline, freephone 020-8906 0885Reuse content