Raising Awareness vs. Promoting and Normalizing Pathology

Newsweek recently published an article titled Out of the Shadows regarding the proliferation of so-called “pro-ana” web sites:

A Web page labeled “Ana Boot Camp” recently offered its members a seemingly irresistible proposition: a 30-day regimen designed to help them drop some serious pounds, no exercise needed. The catch was that the group’s members were to vary their daily caloric intake from 500 (less than half the daily minimum requirement for women recommended by the American College of Sports Medicine) to zero. They were supposed to track their progress, fast to make up for the days they accidentally “overate” and support each other as they worked toward their common goal of radical weight loss.

Pro-anorexia, or “pro-ana,” Web sites (with more than one using the “Ana Boot Camp” name) have for years been a controversial Internet fixture, with users sharing extreme diet tips and posting pictures of emaciated girls under headlines such as “thinspiration.” But what was unusual about the site mentioned above (which is no longer available) was where it was hosted: the ubiquitous social networking site Facebook.com. The (largely female) users who frequent pro-ana sites have typically done so anonymously, posting under pseudonyms and using pictures of fashion models to represent themselves. Now, as the groups increasingly launch pages on Facebook, linking users’ real-life profiles to their eating disorders, the heated conversation around anorexia has become more public. Many pro-ana Facebookers say the groups provide an invaluable support system to help them cope with their disease, but psychologists worry that the growth of such groups could encourage eating disorders in others.

More recently, I came across an article by John Grohol in which he seems to argue that there is a positive side to such groups:

These groups are a little disturbing, especially as you read through the postings. But no more so than the dozens of self-harm sites online, or the sites devoted to helping people be more successful in suicide. Or a dozen other topics that if you learned you could join a group that was “pro” that, you’d be saying to yourself, “Really? Wow.”

That is, after all, the nature of the Internet. It allows for people with very diverse wants and needs to find one another and hook up with one another far more easily than has ever been possible previously in human culture. The fact that some of these wants and needs are outside of the mainstream norm is not at all surprising.

So what does all of this do for people? Isn’t allowing people to discuss their pro-ana needs just plain harmful and potentially dangerous? Not necessarily:

Marcia Herrin, a Dartmouth professor who has written several books on eating disorders, finds the public nature of the discussions of anorexia on Facebook encouraging, because it shows that teens are less afraid of confronting eating disorders.

The more “out in the open” these kinds of concerns become, the more society learns and can answer the kinds of information (or mis-information) they promote. If more teens feel comfortable talking about eating disorders, then perhaps more will also feel comfortable asking for help when they notice themselves or a close friend who might be going down that road. And while in an ideal world, we’d prefer a teen or child not have to go down that road to learn for themselves, sometimes experience is the only teacher that can make a difference.

I think Grohol is confusing two very different things here.

I would argue that the answer to Grohol’s question, “Isn’t allowing people to discuss their pro-ana needs just plain harmful and potentially dangerous?”, is an emphatic “Yes!”.

There is an enormous difference hetween raising awareness about anorexia and other eating disorders and pro-ana sites, just as there is between raising awareness about suicide and pro-suicide sites.

Raising awareness draws attention to, and potentially political and financial support for research into causes and treatment of, the disorder.

Pro-ana sites not only strive to normalize the behavior but encourage their members to ignore the risks in the pursuit of extreme “thinness”, aka “thinspiration”. How is this any different from the typical antipsychiatry site that promotes the view that illnesses such as schizophrenia do not exist beyond social rejection of the symptoms that characterize the illness?

For those caught up in (or formerly caught up in) the internet pro-ana scene, I would recommend having a look at We Bite Back, a forum community for support in recovery from this sinister online virtual cult world:

This is the site that comes after the madness. Before we came along, there was no place for people to go who found support on pro-ana forums, communities and email lists who didn’t want to do the ana thing anymore. Welcome to the first web site designed specifically for post-pro-anorexics.

We represent a worldwide virtual network of people proactively seeking recovery and happiness with the same dedication that proanas apply to seeking lower goal weights.

pro-ana sites, anorexia, bulimia, recovery, awareness, pathology, normalization

DMOZ still promoting pro-anorexia, pro-self-injury sites

I last posted on these DMOZ listings on May 2, 2006, almost a month ago (see DMOZ and web sites promoting anorexia and self-injury). I just checked back today – nothing has changed.

DMOZ, also knows as the Open Directory Project or ODP, is a large human-edited internet directory owned by Netscape which is in turn owned by America Online (AOL) which is in turn owned by Time Warner, Inc. Recently, Google purchased a share of AOL making them also part-owners of DMOZ.

DMOZ is endorsing and promoting web sites whose primary purpose is helping young people starve themselves into ill health or death, mutilate their bodies through self-injury, or kill themselves. The rationale for this seems to be that this is some sort of lifestyle choice. The defense of the practice, as with the previous DMOZ defense of endorsing and promoting pro-pedophilia web sites, is the banner of “free speech”.

Anorexia is not a lifestyle choice. It is a mental disorder. So is self-injury. So is suicidal ideation (at least in the overwhelming majority of cases, leaving out the issue of incurable terminal illness). Endorsing such web sites is akin to promoting web sites that promote depression or panic attacks or paranoid thinking as a lifestyle choice.

Have a look at some of the listings in these DMOZ categories – these are presented as a quick sample and not intended to represent an exhaustive list:

Where is the social value in sites like these? Who do they benefit? Where is the social responsibility in promoting and endorsing sites like these? Does anyone really believe that mixing in a few sites on the dangers of anorexia or self-injury justifies the listing of pro-anorexia and pro-self-injury sites in a public directory with the size and status of DMOZ?

ODP, DMOZ, eating disorders, anorexia, bulimia, self-injury, suicide, social responsibility, social irresponsibility

DMOZ and web sites promoting anorexia and self-injury

I have written previously about the AOL-owned directory known as DMOZ or ODP (Open Directory Project) endorsing and promoting via listings in their directory sites that are pro-pedophilia and/or provide forums and chat rooms where child molesters can congregate to rationalize and justify their sexual preferences (see AOL-owned DMOZ Directory promotes child pornography [February 14, 2006] and DMOZ still listing pro-pedophilia sites [April 15, 2006]).

Now, I come across a recent publication in the APA journal Developmental Psychology warning of the dangers of the proliferation of web sites promoting self-injury, anorexia, and other self-destructive behaviors among young people:

The study’s three authors, all from Cornell University, point out that although internet contacts “clearly provide essential social support for otherwise isolated adolescents, they may also normalize and encourage self-injurious behavior.”

The study’s lead author, Janis Whitlock, explained in an interview that the marginalized adolescents who hurt themselves often are the types who are drawn to anonymous social contacts provided by internet bulletin boards and chat rooms.

And in the world of self-injury, the number of those virtual communities has grown prodigiously over the past decade, according to Whitlock’s research. The first was established in 1998. Currently, 406 exist.

It isn’t clear how much can be done to prevent the growth of sites such as these but it would seem to me that at least some pressure could be applied to web hosting services to take down the sites when they are made aware of them and to search engines and directories such as DMOZ to cease promoting them by listing such sites in their indices and making them easier to find. I have argued previously that if webmasters, directory owners, and search engines fail to demonstrate social and moral responsibility in the choices they make they may well find that they have lost the choice to make those decisions themselves, relinquishing them to international police forces and the courts.

It shouldn’t surprise anyone by now to learn that a quick search in the DMOZ directory locates this category – Top: Society: Issues: Health: Body Image: Pro-Anorexia. What one finds there are several listings for exactly the sorts of sites Whitlock is warning about:

Ana’s Underground Grotto – Background information about anorexia and food, tips and tricks, quotes, links, pictures, essays, and poetry. Beautiful PerfectionThinspiration, tips, tricks, poetry, pictures, bracelets, forum, and chat.
Cerulean ButterflyTips, tricks, thinspiration, resources and support for anyone suffering from an eating disorder.
Chaotic SerenityPro-anorexia basics, sections on food, exercise and media, link list, and chat room.
Life with Ana – Skin Deep – Offers personal story, tips, tricks, fasting information, and chat room.
LiveJournal: Happy Anorexic – Community message board for anorexic or bulimic people.
LiveJournal: Pro_Anorexia – Community message board for pro-ed people.
LiveJournal: Proanorexia – Community message board for people with eating disorders.
LiveJournal: Thinspiring – Community message board for thinspiration such as pictures, poems or stories.
Mia Is A Faithful Friend – Information and links about anorexia and bulimia. Thinspirational photos, tricks and quotes, nutrition and exercise, and chat.
Pro Ana Suicide Society – Community message board covering various topics ranging from eating disorders (male and female) to music and other interests (requires registration).
The Red Bracelet ProjectThinspiration gallery, recipes, excercise programs, and information on different eating disorders.
The Thin FilesA listing of pro-ana sites.
Words Won’t Bring Me Down – Personal story, daily food journal, tips and tricks, calories in foods, and thinspirational photos.

Those opposed to restrictions on the content of such websites use the red herring of “free speech”, apparently not understanding that society has long recognized that one person’s rights end where they endanger the rights or well-being of another. Supporters of DMOZ in particular have tried to argue that they are not promoting such sites, merely indexing them, and that too is nonsense: A directory of the size and influence of DMOZ has a responsibility to act responsibly and listing sites like these is not by any stretch of the imagination a socially or morally responsible act.

ODP, DMOZ, AOL, anorexia, eating disorder, self-injury