The Corpus Callosum

Eating Disorder Websites May be Harmful

According to a study published in the medical journal, Pediatrics,
girls and young women who visit eating disorder oriented websites may
be harmed by the activity.  The funny thing is, is does not
matter if the sites encourage eating disorder behavior, or discourage
it.  Persons who visit such sites are more likely to end up in
the hospital for treatment of their disorder, and are more likely to
have along duration of active illness.  Furthermore, they are
likely to spend less time on schoolwork.

Although it is not possible to say that the use of such sites
exacerbated the disorders, persons who do access the sites report that
they learn new techniques for dieting and attempted weight loss.
 Some of these techniques are pathological.  

Surfing for Thinness: A Pilot
Study of Pro–Eating Disorder Web Site Usage in Adolescents
With Eating Disorders

PEDIATRICS Vol. 118 No. 6 December 2006, pp. e1635-e1643

Jenny L. Wilson, BA, Rebecka Peebles, MD, Kristina K.
Hardy, PhD, and Iris F. Litt, MD

OBJECTIVE. Pro–eating disorder Web sites
are communities of individuals who engage in disordered eating and use
the Internet to discuss their activities. Pro-recovery sites, which are
less numerous, express a recovery-oriented perspective. This pilot
study investigated the awareness and usage of pro–eating
disorder Web sites among adolescents with eating disorders and their
parents and explored associations with health and quality of life.

PATIENTS AND METHODS. This was a cross-sectional study of 698 families
of patients (aged 10–22 years) diagnosed with an eating
disorder at Stanford between 1997 and 2004. Anonymous surveys were
mailed and offered in clinic. Survey content included questions about
disease severity, health outcomes, Web site usage, and parental
knowledge of eating disorder Web site usage.

RESULTS. Surveys were returned by 182 individuals: 76 patients and 106
parents. Parents frequently (52.8%) were aware of pro–eating
disorder sites, but an equal number did not know whether their child
visited these sites, and only 27.6% had discussed them with their
child. Most (62.5%) parents, however, did not know about pro-recovery
sites. Forty-one percent of patients visited pro-recovery sites, 35.5%
visited pro–eating disorder sites, 25.0% visited both, and
48.7% visited neither. While visiting pro–eating disorder
sites, 96.0% reported learning new weight loss or purging techniques.
However, 46.4% of pro-recovery site visitors also learned new
techniques. Pro–eating disorder site users did not differ
from nonusers in health outcomes but reported spending less time on
school or schoolwork and had a longer duration of illness. Users of
both pro–eating disorder and pro-recovery sites were
hospitalized more than users of neither site.

CONCLUSIONS. Pro–eating disorder site usage was prevalent
among adolescents with eating disorders, yet parents had little
knowledge of this. Although use of these sites was not associated with
other health outcomes, usage may have a negative impact on quality of
life and result in adolescents’ learning about and adopting
disordered eating behaviors.

This is not really surprising.  Probably it is not a causal
thing.  Persons who are in more distress, and who have less
support from actual humans (for whatever reason) seem more likely to
use the Internet to seek help.  This these are risk factors
for more serious conditions.  Also, without a professional
moderator, it is very easy for persons with eating disorders to become
competitive with each other.  That competitiveness leads to a
sense of urgency, which increases the motivation for weight loss at any

Further reading: David Earl Johnson, MSW, LICSW, has a nice review of
the subject on his blog, Dare
to Dream
.  Shelly Batts, writing on Retrospectable,
recently had an interesting post, followed by a long discussion in the
comments.  A news report of the Pediatrics study can be found
at Daily
News Central
.  Another review can be found
at Newsweek.
 They mention the following comment:

In November, the Academy for Eating Disorders
suggested a mandatory warning statement: “Warning: anorexia nervosa is
a potentially deadly illness. The site you are about to enter provides
material that may be detrimental to your health.”

That would be a responsible thing to do, but it is hard to see how it
could be enforced.  


  1. #1 Rob Knop
    December 11, 2006

    My wife volunteers for the Eating Disorder Coalition of Tennessee. We have a friend who works there who is a former Miss Indiana (I think), and who was the second runner up that year for Miss America. And who, as nobody will be surprised, struggled with eating disorders.

    The EDCT has a speakers’ bureau, where they train people (mostly health professionals) in giving talks on the matter. Our friend talks about how once upon a time, she was on the “former beauty queen recovering from an eating disorder” lecture circuit, where she’d go and tell young women and girls how bad it had gotten and how she got out of it. But, she said, the effect was that girls in the audience would listen more closely to the techniques and self-deceptions she used to further her eating disorder. She came to realize over time that untrained people giving self-revelatory talks about their own struggle is not the right way to approach the problem.

    Even when you’re pro-recovery, it can be tricky to do it right.


  2. #2 Joseph j7uy5
    December 11, 2006

    Exactly so. It is similar to the situation I’ve seen in some substance abuse recovery centers, where it is easy for groups to go off on countertherapeutic tangents about their “war stories” of their drinking episodes. Although they are not consciously trying to undermine anyone’s treatment, it does have that effect. What’s more, though, is the competitiveness that you sometimes see in persons with eating disorders. That is a difficult thing to manage, because it becomes such a central part of a person’s identity.

  3. #3 Kapitano
    December 16, 2006

    Not exactly the same thing, but there’s also “ex-gay” groups – organisations like NARTH and Exodus International which try to make gay men straight through electroshock aversion, bible study and psychotherapy.

    I spent a few months infiltrating them once for a research project, and I’ve never heard so many lip-smacking descriptions of “same sex sin” from self-hating christians. If you want to hear men wallow in lurid detailed descriptions of sodomy together, listen to groups trying to give it up.

  4. #4 Kristine Tippen
    January 27, 2009

    This is a new site aimed toward providing community support while promoting recovery from an eating disorder. Please check it out and add your thoughts!

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