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Tribal Starvation (6/22/01)

 

Ede, C. (2001, June 22). TRIBAL starvation. The Age.

 

 

"Jane" never felt fully accepted into the "club".

 

Despite being diagnosed with anorexia-bulimia three years ago, and having lived with the disorder for almost a decade, she knew her peers thought she was not a "real" sufferer because she wasn't sick enough.

 

"I had thought about attending a group with other people with my condition but didn't feel I would be eligible, that I wouldn't be accepted by the other girls because they didn't see me as anorexic enough," says the 25-year-old social worker from Melbourne's south-east.

 

"People thought they were better than everyone else if they had been hospitalised and had tubes down their throats. And with bulimia, there was the feeling that if you didn't spew up a couple of times a day, you weren't really bulimic."

 

And yet, being diagnosed with an eating disorder was an empowering experience that made Jane feel "normal", like she was part of something greater.

 

Jane's story is a startling revelation that within the inner sanctum of eating disorders lies a maze of cults that have systems of hierarchy, secret practices and even language.

 

You are either part of a strange starvation tribe - or you are not.

 

Sufferers find comradeship and solace among each other, but remain highly competitive. Many liken their battle with the condition to taking part in the Olympic Games - with the ultimate prize, the gold medal, being death.

 

They swap information on how to "improve" their conditions through better dieting, share which foods are easier to vomit out of the system once eaten, how to lose weight easier and which exercises are most effective.

 

They can pick other sufferers by the way they dress, organise themselves, talk and even walk. It's an allegiance only available to those on the "inside", but even then, sufferers are typecast by the extent of their illness or the purity of their disorder.

 

THE new subculture has been documented by Adelaide University PhD student, Megan Warin, who spent three years meeting with anorexics in Australia, Canada and Scotland to discover how they dealt with the disorder in their everyday lives.

 

She found that contrary to the public perception of anorexia as a debilitating psychiatric illness, sufferers found it an empowering condition that opened up an entirely new way of relating to the world.

 

Almost four in every 10 women and one in 10 men suffer an eating disorder. While people of all ages suffer the debilitating condition, more young people are being diagnosed than ever before.

 

Warin says anorexia is shrouded in secrecy, with sufferers reluctant to talk about their condition and eager to ensure no one finds out about it. But within the secret "clubs", they can open up and share with people who understand.

 

"People used the term cult, or club, or membership, to talk about the power of this thing called anorexia. It's really quite an isolating thing to come together, it develops bonds between people."

 

Warin says anorexics brag about how they cheat the "system" - hospitals, counsellors and people who want to help - and stop it from taking away such a profound part of their life.

 

"There's a certain power that is associated with anorexia. People call it a friend, or lover. There's an element of seduction and it's very difficult to give up because they rely on it. It's a buddy."

 

Warin says the hierarchy among anorexics, and all eating disorders, is related to the high level of competition among sufferers. The hierarchy levels are classed as A, B and C - anorexia, bulimia and compulsive eating - with anorexia being top of the grade.

 

But even within each group there are sublevels, with the elite of the anorexics calling themselves the "purists", who do not binge or purge, but simply abstain from food altogether.

 

"To be pure is the best, and to some people they described it like being in the Olympic Games, with the gold medal being death. I think they play with that very fine line - even though they say it's what they wish for, if an alternative was there they would probably take it," Warin says. "To some people, it's just a door out."

 

Warin says sufferers of eating disorders can also identify each other through bodily "markers", which they can spot just by looking at each other.

 

"They call it `the look in their eyes'. There's a difference between being skinny and having anorexia. It's about the way they hold their body, or what they do with their food."

 

Sally Walker, the president of the Eating Disorders Foundation of Victoria, says anorexics strive to have the "perfect" body, and so naturally tend to be competitive.

 

She says the foundation is aware of the hierarchy system among anorexics, and the pressure they put on each other, and themselves, to become "purists".

 

"There's a view that if you have an eating disorder, you have to do it perfectly. There's certainly a distinct look. Physically they can look a certain way, they wear extra layers of clothing and have a dullness in their hair."

 

For that very reason, Walker says the foundation does not run closed support groups. Rather than counselling the sufferers, such environments may simply exacerbate their problems.

 

In 1999-2000, the foundation's telephone support and counselling information and referral service received 4678 calls, 1073 of which were people affected by anorexia, 900 were bulimic and about 140 were affected by an eating disorder such as bingeing, or a mixture of anorexia and bulimia.

 

Jane, from Melbourne, says she overcame her illness in the past few years through therapy, and can now see how irrational she was in trying to "improve" her condition.

 

"A couple of years ago I saw a girl in a women's magazine who had overcome anorexia, and I remember thinking to myself, `she looks disgusting', and believed that she had failed as an anorexic," Jane says. "I was so repulsed by it, but now I think it's so wonderful.

 

"I think when your body is literally starving, your mind is starving as well and your way of thinking is not focused or clear," she says.

 

"I knew I was going to die and decided I wanted to live. I just made the choice to take myself to therapy and it helped me. It was hard work and it's still hard work. Every day I make the decision to live my life in the way I wanted, and nourish myself rather than punish myself."

 

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Self article (8/01)

 

New anorexia outrage, The. (2001, August). Self

 

 

THE NEW ANOREXIA OUTRAGE

 

Starving for companionship and unhealthy diet advice, women are flocking to websites that promote eating disorders. Self Reports.

 

"I'm looking for someone to help. I have tried over and over again to purge, but I just can't do it. Any suggestions to make it easier? Please post a reply. The sooner the better!" - Bliss

 

"Drink a glass of vinegar, or two. Drink it fast or your throat will hurt a lot. Then you'll feel like throwing up and will actually do so. But please be careful because it will sorta 'burn' your mouth, throat, and stomach. Hope I helped" - Sarah

 

"Have you tried drinking lots of water? It will make the food come up much easier and will stop it from sticking in your throat. Also, try eating things such as milk shakes and ice cream - they come up really easy" - Annonymous

 

No, this isn't some script from the latest after-school TV special on eating disorders - it's an exact transcript of an online chat that took place recently on a Yahoo! forum called Pro Anorexia. Experts have noticed an alarming number of websites and forums like this one, whose users not only reject the idea or recovery from eating disorders but also actively abet each others unhealthy quest for thinness. These pro-anorexia sites and forums - with names such as Anorexia for Life and Food is Evil - serve as a support network for women who want to refine the techniques that help them stay skeletal.

 

A site called My Goddess Ana (for anorexia) features shocking photos of svelte models and actresses like Calista Flockhart and Lara Flynn Boyle. In some, their ribs and hips have been computer enhanced to make them appear thinner than they are in real life. The site is run by a 20 year old who calls herself Xtremity and has been reveling in her eating disorder for nine years. "Along the way, I have picked up many tricks, tips, and motivations," she writes. "Hopefully you'll find them helpful!" Another site, Empress's World, is hosted by a 20 year old New York City dancer who's been in therapy for anorexia and bulimia, but who writes online that her illnesses are part of her identity and that she has no intention of getting better. (SELF tried repeatedly to contact the two women behind these websites, but neither returned email messages.)

 

Whether intentionally or inadvertently, many of the sites help budding anorexics and bulimics improve their methods. Even though the site Fat Like Me cautions that bingeing and purging is 'dangerous,' it also says if you're going to do it, "Rinse with baking soda dissolved in water after purging. This helps neutralize acid and spares your teeth and mouth somewhat."

 

Anorexia, which claims one of the highest death rates of any mental illness, has traditionally been known as a silent killer: Victims hide their bodies under baggy clothes and conceal their eating habits. But the anonymity of the Web is changing all that. "Unfortunately, the Internet is a great tool for having your disease validated. People can connect to others in the cyberspace darkness without feeling judged," says Ellen Davis, PhD., clinical director of the Renfrew Center, an eating disorders clinic in Philadelphia. "But women with eating disorders are so vulnerable that exposure to these sites is extremely dangerous." Judy Sargent, 33, author of The Long Road Back (North Star) and a recovering anorexic, agrees. "When I weighed 65 pounds, I totally alienated my friends. I wouldn't leave my house," says Sargent, who was hospitalized 26 times and nearly died. "that's why these sites are popular. Anorexics can hide their bodies and still form relationships and have a bond - starving themselves to death."

 

Case in point: "Chaos," 22, a Boston student who's 5 feet 9 and once weighed 82 pounds. Some 30,000 people have responded since she launched her pro-anorexia site last January. "I've come to find that there are plenty of people like me who want to talk about it and exchange ideas," she says.

 

To their credit, many of the venues post advisories to women in recovery to warn them of the pro-anorexia content, but the sites hold an irresistible appeal for those struggling to kick the habit. Pamela Ross-Perras, 30, a mother from Ohio diagnosed as a purging anorexic, tells SELF she runs to the computer to view images of stick-thin models whenever she's in a "weakened" state. "Usually, it's when I've been active in my eating disorder," she explains. "the sites inspire me to perpetuate my illness." Experts say it's too early to predict whether the women who troll the sites will be unusually resistant to treatment.

 

Although the First Amendment protects the websites, some eating disorder groups have tried without success to have them removed. "They have made it clear they have no interest in changing their message," notes Holly Hoff, program director for the National Eating Disorders Association in Seattle. Nor are Internet companies trying to ban them. A Yahoo! spokesperson says, "We're not responsible for the groups that pop up." (Yahoo! also hosts eating disorder recovery sites.)

 

Meanwhile, sites like the Anorexic and Bulimic Rec Room get more visitors every day. One of them, Anna K., writes, "Yesterday, I went 43 hours sic without food," she boasts. "I wasn't hungry at all - see, food calls to food. When you don't eat for 20-plus hours, you don't need food. Yes, I AM proud of my lack of need."

 

Those are chilling words to Sargent. "I've lost three friends to anorexia," she points out. "These sites don't tell you you're going go die if you don't get treatment. They don't tell you your friends are going to die if you don't help them.”

 

 

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Yahoo removes pro-ed sites (8/4/01)

 

Holahan, C. (2001, August 4). Yahoo removes pro-eating disorder internet sites. Boston Globe

 

 

Leaders of a national movement fighting eating disorders claimed victory yesterday after the popular Internet search engine Yahoo agreed to remove Web sites promoting anorexia and bulimia from its servers.

 

With names like "Stick Figures" and "Anorexic and Proud," pro-eating-disorder forums have exploded on the Internet during the past year, according to health care specialists. The forums, run by individuals who call their eating habits a lifestyle choice rather than a disorder, offer everything from tips on starving and purging to photos of celebrities doctored to look anorexic.

 

"These sites can be life-threatening to people with eating disorders," said Holly Hoff of the National Eating Disorder Association, based in Seattle. "It was a real challenge to get them removed because we're up against free speech."

 

Anorexics and bulimics can suffer from impaired brain function, bowel and kidney problems, depression, and heart failure, according to Dr. David Herzoz, a Harvard professor of psychiatry and president of the Harvard Eating Disorder Center. Anorexia has the highest death rate of any mental illness; many of these deaths are from suicide.

 

For the past six months, Hoff said, her organization, along with other health care groups, sent letters to Yahoo and other hosts urging removal of the forums. Hoff said they often received the same response: "We're not responsible for the content on our servers; it's protected by freedom of speech."

 

But three days ago, Yahoo became to first to relent.

 

Yahoo spokeswoman Dianna Lee said yesterday that she could not confirm when the company removed the sites, adding that user complains are reviewed within 24 hours and in "extreme" cases, sites that violate Yahoo's service agreement prohibiting "harmful, threatening, and abusive" messages are removed.

 

"We strive to promote a forum that promotes a wide range of free expression on the Internet," said Lee. "The Internet is a rapidly rowing medium and we as well as our users are struggling with its content."

 

That content included sites like Silent Chaos's Bathroom, a pro-anorexia Web ring developed by a 22-year-old Boston woman who claimed in a text posting on the sites that she had to move from Yahoo Geocities to another server after being shut down.

 

The site includes tips on not eating, purging, and hiding the disorder, including carrying around photos of anorexic-looking models to look at, taking specific diet pills, and ways to pretend to eat.

 

"I want to be anorexic but I can't keep control, any tips," writes Web user identified as Heather Gage in a posting from the site attached to the Web ring on the Silent Chaos site. She receives a reply from another user, Celeste: "When I started out it was hard for me too but I just slowly cut things out of my diet, every two days I would take away another food and now I'm down to apples and celery. Good luck."

 

The ease which sites can move from server to server is a problem, said Hoff. Currently, dozens of forums promoting eating disorders turn up at other Web hosting sites, though they are no long among Yahoo's "clubs."

 

A search on Microsoft Network communities brings up the Stick Figures Web community.

 

The site, which boasts more than 42,000 hits, or site visits, since the end of January, features an altered picture of Angelina Jolie with the actress's face digitally shaded and elongated to appear starved and sickly. Next to the image is the slogan, "Anorexia is a lifestyle not a disorder."

 

"These sites infuriate me because people who have the disorder don't really choose," said 22-year-old Kimberly Leerssen, a recovering anorexic from Alabama. Leerssen, who at 5 feet 7 inches tall once weighed 90 pounds knows how devastating the disorder can be.

 

"I've lost friends, I've lost my health," said Leerssen. "It's a struggle every day to get through this."

 

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People article (11/19/01)

 

Web worry: Experts target sites that encourage anorexia. (2001, November 19) People, pp. 102.

 

Notes: Sidebar in article Beating the odds (file to be uploaded)

 

 

WEB WORRY Experts target sites that encourage anorexia

 

This past summer Vivian Hanson Meehan was shocked to learn that pro-anorexia web sites, with photos of emaciated women and advice on scoring a skeletal look, are proliferating on the Internet. Says Meehan, founder of the National Association of Anorexia Nervosa and Associated Disorders (ANAD): The sites "reinforce the anorexics' belief that what they are doing isn't dangerous."

 

Sadly, there's a large audience for that message. One site, started in August, recorded more than 16,000 hits in just two months. And despite ANAD's successful efforts to get Internet providers to shut down sites, it estimates that hundreds are still in operation, often disguised as diet pages. There vulnerable teenagers can find such "thinspirational" phrases as "Hunger hurts but starving works," and tips on how to purge in the shower.

 

Why would someone start such a web site? "A lot of people see themselves in me," one creator told PEOPLE via e-mail. "It makes them feel normal."

 

That is what worries eating-disorder experts. "These sites describe 'war stories' written by people who wear anorexia like a badge of courage," says Dr. Angela Guarda, director of the eating-disorders program at Johns Hopkins Hospital. Which is why, Meehan says, keeping the sites off the Internet "will be a continuing battle."

 

COLOR PHOTO Pro-anorexia Web sites "are so grotesque," Meehan says.

 

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NY Times (6/23/02)

 

Morris, B. R. (2002, June 23). A disturbing growth industry: Web sites that espouse anorexia. The New York Times.

 

 

A Disturbing Growth Industry: Web Sites That Espouse Anorexia

 

SHE's 17, a high-achieving student in a prestigious high school. For the last two weeks, she has exercised strenuously while subsisting on 500 calories a day. She's anorexic and knows it.

 

Like many others with serious diseases, the girl, who discussed her situation through e-mail messages on condition of anonymity, has come to rely on the Internet for information, support and advice. But with a difference: the girl goes online to get help in staying anorexic, surfing for advice on how to keep starving while hiding her condition from her parents. And there is a lot of advice on dozens of Web sites that proclaim themselves to be "pro-ana."

 

Web sites that are pro-ana, or pro-anorexia, and pro-mia — pro-bulimia — appear to be growing, despite efforts by groups led by former sufferers and eating disorder organizations to push them off mainstream venues like Yahoo and AOL. The young women who congregate on the sites have their own lexicon: tips they share are called "thinspiration," for instance. Their online names reflect their desires, like "WannaBpurrrfect," "00anagoddess00" and "PurfectLeighThin." Pro-ana-site Webmasters and site visitors say that, for them, anorexia is anything but a life-threatening disease. "People don't understand that anorexia is a choice, a DIET, a lifestyle that has nothing to do with `emotional instability,' etc.," the anorexic schoolgirl wrote in an e-mail message to this writer.

 

To health professionals, pro-anorexia and pro-bulimia Web sites represent the inversion of the Web's potential to help sick people. "Imagine a site that told women how to make themselves likely to get breast cancer," said Dr. Diane Mickley, the director of the Wilkins Center for Eating Disorders in Greenwich, Conn. "That is the analogy that puts these sites in perspective."

 

Anorexia and bulimia afflict 12 million to 13 million Americans, 90 percent of whom are women and have the highest mortality rate of any psychiatric disease: between 6 and 15 percent of patients are estimated to die from the disease.

 

CHAT rooms for people with eating disorders, run by professionals, predate the pro-anorexia sites, said Dr. Ira Sacker, the director of adolescent medicine at the Brookdale University Hospital and Medical Center in Brooklyn. The explosion of pro-anorexia sites has surprised experts on eating disorders. "We didn't see it coming," said Dr. Sacker, a former compulsive overeater who has been treating patients with eating disorders for 27 years. He said the Web sites created a cultlike atmosphere that "almost fits neatly into the eating disorder mentality itself."

 

Before, anorexics were hard pressed to find a community. "In truth, anorexia is really rare. You don't walk down the street and say, `I have something in common with those four girls standing on the corner,' " said Dr. Marcia Herrin, the author of "The Parent's Guide to Childhood Eating Disorders." "The Web sites justify and validate the community, the peer support makes it feel O.K., especially if a girl with an eating disorder is surrounded by people who are horrified by her."

 

Some anorexics call their disorder a religion. As with any religion, there are "commandments." Here is a sample from one site: "Being thin is the most important thing in life. You will feel guilty every time you eat." And from another: "Being thin and not eating are signs of true willpower and success."

 

The sites contain pictures of perilously thin women, including images of professional models, and snapshots (called "triggers") of anorexics displaying their protruding rib cages. The paper-thin flesh stretched against all those bones, health professionals and Webmasters say, is meant to inspire viewers to stick to starvation. Typically, the sites also feature poetry, calorie charts and, often, the Webmaster's personal diary. One site has an online store that sells hats and T-shirts with the words "Ana's Fight Club" on them. But most popular features on the sites are the forums, where girls swap e-mail addresses and tips about which diet pills work best, for instance. Popular Web-to-real-world activities are group fasts.

 

Anorexia is an isolating disease; the Web provides instant friendship, and that is why the forums receive the traffic that they do. "I thought that maybe since we have the same goals, u could e-mail me and we could help each other," wrote one girl, who said she wants to lose 10 pounds because "I want them to be talking about how thin I am."

 

SUSAN BATTAGLIA, 34, a recovering anorexic from Brooklyn, weighed 65 pounds at her lowest weight. Ms. Battaglia acknowledged the allure of the sites for current anorexics. "They know somewhere inside of them that it's not the right way to be," she said. "These Web sites give you validation, that it's O.K.."

 

Last year, the National Association of Anorexia Nervosa and Associated Disorders, in Highland Park, Ill., lobbied large Web servers like Yahoo and MSN to remove the pro-ana sites. Now, the sites mostly pop up on private Web servers. Since the movement has gone underground, so to speak, Web addresses are traded on the bulletin boards. But sites that list them are easy to find through search engines.

 

Banning the sites will not solve the problem, argued Jen Datka, a recent New York University graduate who spent the last year studying the phenomenon for her honors thesis in anthropology. "Deleting pro-ana sites and message boards does nothing but punish the girls who participate in them," Ms. Datka wrote in an e-mail message.

 

It makes them even more appealing. "I'm sure that the fact that they are banned helps fuel their allure," Dr. Sacker said.

 

Now there is an online petition circulating through the pro-ana Web site community to "allow pro-anorexia pages" as well as an online "ribbon campaign" to support the movement. The petition was started by Shannon Bonnet, a recovered anorexic and bulimic who runs a personal Web site, www.makaylashealingplace.com, which has resources for eating disorder sufferers and their loved ones. Ms. Bonnet, who is not pro-anorexic, argues that if there are disclaimers on the sites and links to eating disorder organizations, the sites should have a right to exist. She said she hoped her campaign would promote understanding. "Maybe there is hope that the pro-anorexia community won't have to hide in the shadows and fear treatment and help," she said.

 

Lately, the anorexic 17-year-old, who currently weighs 118 pounds, has been counting calories with online pals. This month, she planned to drop her daily intake to 200 calories. In July, her daily intake will be 100 calories, she said. The girl is, in a word, starving.

 

And, she admits, her "parents would freak if they knew."

 

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NY Times Magazine article! (9/9/02)

 

Udovitch, M. (2002, September 5). A secret society of the starving. The New York Times Magazine

 

 

A Secret Society of the Starving

 

Claire is 18. She is a pretty teenager, with long strawberry-blond hair, and she is almost abnormally self-possessed for a girl from a small town who has suddenly been descended upon by a big-city reporter who is there to talk to her, in secret, about her secret life. She is sitting on the track that runs around the field of her high school's football stadium, wearing running shorts and a T-shirt and shivering a little because even though we are in Florida -- in the kind of town where, according to Claire, during "season" when you see yet another car with New York plates, you just feel like running it down -- there's an evening chill.

 

Claire's is also the kind of town where how the local high school does in sports matters. Claire herself plays two sports. Practice and team fund-raisers are a regular part of her life, along with the typical small-town-Florida teenage occupations -- going to "some hick party," hanging out with friends in the parking lot of the Taco Bell, bowling, going to the beach.

 

Another regular part of her life, also a common teenage occupation, is anorexia -- refusal to eat enough to maintain a minimally healthy weight. So she is possibly shivering because she hasn't consumed enough calories for her body to keep itself warm. Claire first got into eating disorders when she was 14 or 15 and a bulimic friend introduced her to them. But she was already kind of on the lookout for something: "I was gonna do it on my own, basically. Just because, like, exercise can only take you so far, you know? And I don't know, I just started to wonder if there was another way. Because they made it seem like, 'You do drugs, you die; be anorexic and you're gonna die in a year.' I knew that they kind of overplayed it and tried to frighten you away. So I always thought it can't be that bad for you."

 

Bulimia -- binge eating followed by purging through vomiting or laxatives -- didn't suit her, however, so after a little while she moved onto anorexia. But she is not, by her own lights, anorexic. And her name isn't Claire. She is, in her terms, "an ana" or "pro-ana" (shortened from pro-anorexia), and Claire is a variation of Clairegirl, the name she uses on the Web sites that are the fulcrum of the pro-ana community, which also includes people who are pro-mia (for bulimia) or simply pro-E.D., for eating disorder.

 

About one in 200 American women suffers from anorexia; two or three in 100 suffer from bulimia. Arguably, these disorders have the highest fatality rates of any mental illness, through suicide as well as the obvious health problems. But because they are not threatening to the passer-by, as psychotic disorders are, or likely to render people unemployable or criminal, as alcoholism and addiction are, and perhaps also because they are disorders that primarily afflict girls and women, they are not a proportionately imperative social priority.

 

They have been, however, topics of almost prurient media fascination for more than 20 years -- regularly the subject of articles in magazines that have a sizable young female readership. In these forums, eating disorders are generally depicted as fundamentally body-image disorders, very extreme versions of the non-eating-disordered woman's desire to be thin, which just happen, rivetingly, to carry the risk of the ultimate consequence. "So many women who don't have the disorder say to me: 'Well, what's the big deal? It's like a diet gone bad,'" says Ellen Davis, the clinical director of the Renfrew Center of Philadelphia, an eating-disorder treatment facility. "And it is so different from that. Women with the vulnerability, they really fall into an abyss, and they can't get out. And it's not about, 'O.K., I want to lose the 10 pounds and go on with my life.' It's, 'This has consumed my entire existence.'"

 

And now there's pro-ana, in many ways an almost too lucid clarification of what it really feels like to be eating disordered. "Pain of mind is worse than pain of body" reads the legend on one Web site's live-journal page, above a picture of the Web mistress's arm, so heavily scored with what look like razor cuts that there is more open wound than flesh. "I'm already disturbed," reads the home page of another. "Please don't come in." The wish to conform to a certain external ideal for the external ideal's sake is certainly a component of anorexia and bulimia. But as they are experienced by the people who suffer from them, it is just that: a component, a stepping-off point into the abyss.

 

As the girls (and in smaller numbers, boys) who frequent the pro-E.D. sites know, being an ana is a state of mind -- part addiction, part obsession and part seesawing sense of self-worth, not necessarily correlating to what you actually weigh. "Body image is a major deal, but it's about not being good enough," says Jill M. Pollack, the executive director of the Center for the Study of Anorexia and Bulimia, "and they're trying to fix everything from the outside." Clairegirl, like many of the girls who include their stats -- height, weight and goal weight -- when posting on such sites, would not receive a diagnosis of anorexia, because she is not 15 percent under normal weight for her height and age.

 

But she does have self-devised rules and restrictions regarding eating, which, if she does not meet them, make her feel that she has erred -- "I kind of believe it is a virtue, almost," she says of pro-ana. "Like if you do wrong and you eat, then you sin." If she does not meet her goals, it makes her dislike herself, makes her feel anxiety and a sense of danger. If she does meet them, she feels "clean." She has a goal weight, lower than the weight she is now. She plays sports for two hours a day after school and tries to exercise at least another hour after she gets home. She also has a touch of obsessive-compulsive disorder regarding non-food-related things -- cleaning, laundry, the numeral three. ("Both anorexia and bulimia are highly O.C.D.," says Pollack. "Highly.")

 

And she does spend between one and three hours a day online, in the world of pro-ana. Asked what she likes best about the sites, Claire says: "Just really, like at the end of the day, it would be really nice if you could share with the whole world how you felt, you know? Because truthfully, you just don't feel comfortable, you can't tell the truth. Then, like, if I don't eat lunch or something, people will get on my case about it, and I can't just come out and tell them I don't eat, or something like that. But at the end of the day, I can go online and talk to them there, and they know exactly what I'm going through and how I feel. And I don't have to worry about them judging me for how I feel."

 

Pro-ana, the basic premise of which is that an eating disorder is not a disorder but a lifestyle choice, is very much an ideology of the early 21st century, one that could not exist absent the anonymity and accessibility of the Internet, without which the only place large numbers of anorexics and bulimics would find themselves together would be at inpatient treatment. "Primarily, the sites reinforce the secretiveness and the 'specialness' of the disorder," Davis says. "When young women get into the grips of this disease, their thoughts become very distorted, and part of it is they believe they're unique and special. The sites are a way for them to connect with other girls and to basically talk about how special they are. And they become very isolated. Women with eating disorders really thrive in a lot of ways on being very disconnected. At the same time, of course, they have a yearning to be connected."

 

Perfectionism, attention to detail and a sense of superiority combine to make the pro-ana sites the most meticulous and clinically fluent self-representations of a mental disorder you could hope to find, almost checklists of diagnostic criteria expressed in poignantly human terms. Starving yourself, just on the basis of its sheer difficulty, is a high-dedication ailment -- to choose to be an ana, if choice it is, is to choose a way of life, a hobby and a credo. And on the Web, which is both very public and completely faceless, the aspects of the disorder that are about attention-getting and secret-keeping are a resolved paradox. "I kind of want people to understand," Clairegirl says, "but I also like having this little hidden thing that only I know about, like -- this little secret that's all yours."

 

Pro-ana has its roots in various newsgroups and lists deep inside various Internet service providers. Now there are numerous well-known-to-those-who-know sites, plus who knows how many dozens more that are just the lone teenager's Web page, with names that put them beyond the scope of search engines. And based on the two-week sign-up of 973 members to a recent message-board adjunct to one of the older and more established sites, the pro-ana community probably numbers in the thousands, with girls using names like Wannabeboney, Neverthinenuf, DiETpEpSi UhHuh! and Afraidtolookinthemirror posting things like: "I can't take it anymore! I'm fasting! I'm going out, getting all diet soda, sugar-free gum, sugar-free candy and having myself a 14-day fast. Then we'll see who is the skinny girl in the family!"

 

That ana and mia are childlike nicknames, names that might be the names of friends (one Web site that is now defunct was even called, with girlish fondness, "My Friend Ana"), is indicative. The pro-ana community is largely made up of girls or young women, most of whom are between the ages of 13 and 25. And it is a close community, close in the manner of close friendships of girls and young women. The members of a few sites send each other bracelets, like friendship bracelets, as symbols of solidarity and support. And like any ideology subscribed to by many individuals, pro-ana is not a monolithic system of belief.

 

At its most militant, the ideology is something along the lines of, as the opening page of one site puts it: "Volitional, proactive anorexia is not a disease or a disorder...There are no victims here. It is a lifestyle that begins and ends with a particular faculty human beings seem in drastically short supply of today: the will...Contrary to popular misconception, anorectics possess the most iron-cored, indomitable wills of all. Our way is not that of the weak...If we ever completely tapped that potential in our midst...we could change the world. Completely. Maybe we could even rule it."

 

Mostly, though, the philosophical underpinnings of pro-ana thought are not quite so Nietzschean. The "Thin Commandments" on one site, which appear under a picture of Bugs Bunny smiling his toothy open-mouthed smile, leaning against a mailbox and holding a carrot with one bite taken out of it, include: "If thou aren't thin, thou aren't attractive"; "Being thin is more important than being healthy"; "Thou shall not eat without feeling guilty"; "Thou shall not eat fattening food without punishing thyself afterward"; and "Being thin and not eating are signs of true willpower and success."

 

The "Ana Creed" from the same site begins: "I believe in Control, the only force mighty enough to bring order into the chaos that is my world. I believe that I am the most vile, worthless and useless person ever to have existed on this planet."

 

In fact, to those truly "in the disorder" -- a phrase one anonymous ana used to describe it, just as an anonymous alcoholic might describe being in A.A. as being "in the rooms" -- pro-ana is something of a misnomer. It suggests the promotion of something, rather than its defense, for reasons either sad or militant. That it is generally understood otherwise and even exploited ("Anorexia: Not just for suicidal teenage white girls anymore" read the home page of Anorexic Nation, now a disabled site, the real purpose of which was to push diet drugs) is a source of both resentment and secret satisfaction to the true pro-ana community. Its adherents might be vile and worthless, but they are the elite.

 

The usual elements of most sites are pretty much the same, although the presentation is variable enough to suggest Web mistresses ranging from young women with a fair amount of programming know-how and editorial judgment to angry little girls who want to assert their right to protect an unhealthy behavior in the face of parental opposition and who happen to know a little HTML. But there are usually "tips" and "techniques" -- on the face of it, the scariest aspect of pro-ana, but in reality, pretty much the same things that both dieters and anorexics have been figuring out on their own for decades. There are "thinspirational" quotes -- "You can never be too rich or too thin"; "Hunger hurts but starving works"; "Nothing tastes as good as thin feels"; "The thinner, the winner!" There are "thinspirational" photo galleries, usually pretty much the same group of very thin models, actresses and singers -- Jodie Kidd, Kate Moss, Calista Flockhart, Fiona Apple. And at pro-ana's saddest extreme, balancing the militance on the scales of the double-digit goal weight, there are warnings of such severity that they might as well be the beginning of the third canto of Dante's "Inferno": "I am the way into the city of woe. I am the way to a forsaken people. I am the way into eternal sorrow." The pro-ana version of which, from one site, is:

 

PLEASE NOTE: anorexia is NOT a diet. Bulimia is NOT a weight-loss plan. These are dangerous, potentially life-threatening DISORDERS that you cannot choose, catch or learn. If you do not already have an eating disorder, that's wonderful! If you're looking for a new diet, if you want to drop a few pounds to be slimmer or more popular or whatever, if you're generally content with yourself and just want to look a bit better in a bikini, GO AWAY. Find a Weight Watchers meeting. Better yet, eat moderate portions of healthy food and go for a walk.

 

However.

 

If you are half as emotionally scarred as I am, if you look in the mirror and truly loathe what you see, if your relationships with food and your body are already beyond "normal" parameters no matter what you weigh, then come inside. If you're already too far into this to quit, come in and have a look around. I won't tell you to give up what I need to keep hold of myself.

 

Most of the pro-ana sites also explicitly discourage people under 18 from entering, partly for moral and partly for self-interested reasons. Under pressure from the National Eating Disorders Association, a number of servers shut down the pro-ana sites they were hosting last fall. But obviously, pretty much anyone who wanted to find her way to these sites and into them could do so, irrespective of age. And could find there, as Clairegirl did, a kind of perverse support group, a place where a group of for the most part very unhappy and in some part very angry girls and women come together to support each other in sickness rather than in health.

 


 

Then there's chaos -- also her Web name -- who like her friend Futurebird (ditto) runs an established and well-respected pro-E.D. site. Chaos, whom I met in Manhattan although that's not where she lives, is a very smart, very winning, very attractive 23-year-old who has been either bulimic or anorexic since she was 10. Recently she's been bingeing and purging somewhere between 4 and 10 times a week. But when not bingeing, she also practices "restricting" -- she doesn't eat in front of people, or in public, or food that isn't sealed, or food that she hasn't prepared herself, or food that isn't one of her "safe" foods, which since they are a certain kind of candy and a certain kind of sugar-free gum, is practically all food. ("You're catching on quickly," she says, laughing, when this is remarked on.) Also recently, she has been having trouble making herself throw up. "I think my body's just not wanting to do it right now," she says. "You have the toothbrush trick, and usually I can just hit my stomach in the right spot, or my fingernails will gag me in the right spot. It just depends on what I've eaten. And if that doesn't work, laxis always do."

 

Chaos, like Clairegirl, is obsessive-compulsive about a certain number (which it would freak her out to see printed), and when she takes laxatives she either has to take that number of them, which is no longer enough to work, or that number plus 10, or that number plus 20, and so forth. The most she has ever taken is that number plus 60, and the total number she takes depends on the total number of calories she has consumed.

 

While it hardly needs to be pointed out that starving yourself is not good for you, bulimia is in its own inexorable if less direct way also a deadly disorder. Because of the severity of Chaos's bulimia, its longstanding nature and the other things she does -- taking ephedra or Xenadrine, two forms of, as she says, "legal speed," available at any health food or vitamin store; exercising in excess; fasting -- she stands a very real chance of dying any time.

 

As it is, she has been to the emergency room more than half a dozen times with "heart things." It would freak her out to see the details of her heart things in print. But the kinds of heart things a severe bulimic might experience range from palpitations to cardiac arrest. And although Chaos hasn't had her kidney function tested in the recent past, it probably isn't great. Her spleen might also be near the point of rupturing.

 

Chaos is by no means a young woman with nothing going for her. She has a full-time job and is a full-time college student, a double major. She can play a musical instrument and take good photographs. She writes beautifully, well enough to have won competitions.

 

But despite her many positive attributes, Chaos punishes herself physically on a regular basis, not only through bulimia but also through cutting -- hers is the live-journal page with the picture of the sliced-up arm. To be beheld is, to Chaos, so painful that after meeting me in person, she was still vomiting and crying with fear over the possible consequences of cooperating with this story a week later. "Some days," she says of her bulimia, "it's all I have."

 

One thing that she does not have is health insurance, so her treatment options are both limited and inadequate. So with everything she has going for her, with all her real-world dreams and aspirations, the palpitating heart of her emotional life is in the pro-E.D. community. As another girl I spoke with described herself as telling her doctors: "Show me a coping mechanism that works as well as this and I'll trade my eating disorder for it in a minute."

 

And while in some moods Chaos says she would do anything to be free of her eating disorders, in others she has more excuses not to be than the mere lack of health insurance: she has a job, she is in school, she doesn't deserve help. And what she has, on all days, is her Web site, a place where people who have only their eating disorders can congregate, along with the people who aspire to having eating disorders -- who for unknowable reasons of neurochemistry and personal experience identify with the self-lacerating worlds of anorexia and bulimia.

 

Futurebird, whom I also met in Manhattan, says that she has noticed a trend, repeating itself in new member after new member, of people who don't think they're anorexic enough to get treatment. And it's true, very much a function of the Internet -- its accessibility, its anonymity -- that the pro-ana sites seem to have amplified an almost-diagnostic category: the subclinical eating disorder, for the girl who's anorexic on the inside, the girl who hates herself so much that she forms a virtual attachment to a highly traumatized body of women, in a place where through posts and the adoption of certain behaviors, she can make her internal state external.

 


 

Futurebird and Chaos are sitting in a little plaza just to the south of Washington Square Park, with the sun behind them. Futurebird is a small African-American woman. As she notes, and as she has experienced when being taken to the hospital, it is a big help being African-American if you don't want people to think you have anorexia, which is generally and inaccurately considered to be solely an affliction of the white middle class. Futurebird has had an eating disorder since she was in junior high school and is now, at 22, looking for a way to become what you might call a maintenance anorexic -- eating a little bit more healthily, restricting to foods like fruits and whole-grain cereal and compensating for the extra calories with excessive exercising.

 

Like Chaos, she is opposed, in principle, to eating disorders in general and says that she hates anorexia with a blind and burning hatred. Although she also says she thinks she's fat, which she so emphatically is not that in the interest of not sounding illogical and irrational, she almost immediately amends this to: she's not as thin as she'd like to be.

 

Both she and Chaos would vigorously dispute the assertion that the sites can give anyone an eating disorder. You certainly can't give anyone without the vulnerability to it an eating disorder. But many adolescent girls teeter on the edge of vulnerability. And the sites certainly might give those girls the suggestion to...hey, what the hell, give it a try.

 

"What I'd like people to understand," Futurebird says, "is that it is very difficult for people who have an eating disorder to ask for help. What a lot of people are able to do is to say, well, I can't go to a recovery site and ask for help. I can't go to a doctor or a friend and ask for help. I can't tell anyone. But I can go to this site because it's going to quote-unquote make me worse. And instead what I hope they find is people who share their experience and that they're able to just simply talk. And I've actually tested this. I've posted the same thing that I've posted on my site on some recovery sites, and I've read the reactions, and in a lot of ways it's more helpful."

 

In what ways?

 

"The main difference is that if you post -- if someone's feeling really bad, like, I'm so fat, et cetera, on a recovery site, they'll say, that's not recovery talk. You have to speak recovery-speak."

 

"Fat is not a feeling," Chaos says, in tones that indicate she is echoing a recovery truism.

 

"And they'll use this language of recovery," Futurebird continues. "Which does work at some point in the negative thinking patterns that you have. But one tiny thing that I wish they would do is validate that the feeling does exist. To say, yes, I understand that you might feel that way. And you get not as much of that. A lot of times people just need to know that they aren't reacting in a completely crazy way."

 

The problem is that by and large, the people posting on these sites are reacting in a completely crazy way. There are many, many more discussions answering questions like, "What do you guys do about starvation headaches?" than there are questions like, "I am feeling really down; can you help me?" And in no case, in answering the former question, does anyone say, "Um...stop starving yourself." A site like Futurebird's, or like the message board of Chaos's, are designed with the best intentions. But as everybody knows, that is what the way into the city of woe, the way to a forsaken people and the way into eternal sorrow are paved with.

 


 

What Clairegirl, sitting shivering on the running track, would say today is that when she reaches her current goal weight, she will stay there. But she can't ever really see herself giving ana up altogether. "I don't think I could ever stop, like, wanting to not eat. Like, I could keep myself from eating below 300 calories a day. But I could never see myself eating more than 1,000," she says, wrapping her arms around her knees. "I consider myself to be one of the extreme dieters. Like, I could never want to be -- I mean, it would be so awesome to be able to say a double-digit number as your weight, but it would look sick, you know?" (Clairegirl is 5 feet 7 inches.)

 

And what about the people on the pro-ana sites who are not so happy, who describe the disorder as a living hell, who are in very bad shape? "Those girls have been going at it a lot longer than me. But you can't ever really say that ana isn't a form of self-hatred, even though I try to say that. If I was truthfully happy with myself, then I would allow myself to eat. But I don't. And it's kind of like a strive for perfection, and for making myself better. So I can't honestly say there's no..."

 

She trails off, and gazes up, as if the answer were written in the night sky, waiting to be decoded. "Like, you can't say that every ana loves herself and that she doesn't think anything is wrong with her at all," she says. "Or else she wouldn't be ana in the first place."

 

 

Mim Udovitch is a contributing editor at Rolling Stone.

 

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Attempt to ban pro-sites at UConn (9/13/02)

 

Pinsonneault, J. (2002, September 13). College campuses must combat eating disorders [Editorial]. The Daily Campus.

 

 

(The Daily Campus) (U-WIRE) STORRS, Conn. -- Fact: At any given time in the United States, approximately half a million people suffer from eating disorders. Fact: 6 to 10 percent of eating disorder cases are fatal. Fact: 80 percent of the female population has dieted in some way by the age of 18. Are you listening yet?

 

Somewhere along the line, it seems that in our society, the phrase "eating disorder" began to carry with it a dirty, selfish, unmentionable connotation. This is unfortunate because the reality is that eating disorders are sicknesses. A sickness that is growing rapidly, especially across college campuses.

 

I'll bet you didn't know that approximately 20 percent of college women engage in anorexic or bulimic eating behaviors or that one in ten individuals with an eating disorder is male. Those are some pretty sobering statistics. Take a good look around you the next time you are walking around this campus, sitting in the dining hall or waiting for a class to start. Notice the body shapes, especially of women. As a woman, it is somewhat depressing. I consider myself to be in fairly decent shape. I work out on a regular basis, practice healthy eating habits and well until I moved to Storrs last August, was for the most part content with my body. The average American woman is 5'4" tall and 142lbs. Well, here at UConn, an "average American woman" according to those standards would look obese. This is NOT ok.

 

We can ignore this growing problem, brush it under the carpet as if it never existed, continue to treat eating disorders as something to be ashamed of or we can attempt to fight this issue head on. The facts are right here, in black and white: Eating disorders are spreading like wild fire and their main targets are college campuses, such as our very own. What then is our university doing to help those suffering from these sicknesses, as well as the student population?

 

Not a whole hell of a lot, to be honest. UConn has recently implemented a program called SHAPE, Students Helping Achieve Positive Esteem.

 

The group focuses on health risks, causes and symptoms of "disordered eating." On SHAPE's present agenda are the tasks of blocking the access of pro-anorexia/bulimia web sites through the university, as well as ridding the CO-OP of magazines promoting negative body images.

 

While I find SHAPE's intentions admirable, unfortunately, I also believe them to be rather unrealistic. Blocking certain web sites promoting anorexic and bulimic eating behaviors is something I would completely endorse. However, cleansing the Co-Op of all magazines in which unhealthy body images are displayed is quite ridiculous. Who will make that judgment call? Who decides what is a healthy or unhealthy body image? Practically all magazines boast a beautiful, thin and near perfect celebrity on their covers; what would be left if these were all deemed unacceptable?

 

SHAPE is a new organization that as far as I can tell has a lot of potential. But the university can not possibly believe that by instituting a group such as SHAPE that it has solved the body image issues on this campus. It would be mistaken. So I dug a little deeper, searched for some other potential remedy on this campus.

 

As you may have guessed, I ended up with the university's Health Services. In addition to a very informative web page, Health Services also sponsors an "Eating Disorder Team." The team's mission is "to provide comprehensive, coordinating health care for students with eating disorders." On the list of services they provide are weekly support groups, counseling services and medical as well as nutritional evaluations for students suffering from the disorders.

 

This is a great asset to our campus. But what happens to students who either don't admit they have a problem or are too ashamed to ask for help?

 

What happens when they get lost in the cracks? On a large campus like our own, information on how, where and when someone can get help should really be made more accessible. Just the other day I was reading a commentary article about the "junk adds" forced on students shopping in the Co-Op. Wouldn't informational health pamphlets distributed in bags be better suited to the students of UConn than credit card applications?

 

The more the phrase "eating disorder" is used in everyday conversation the less of a negative connotation it continues to carry. These sicknesses no longer have to be the dirty little secret of those suffering from them behind closed doors, but rather it is our community's responsibility to take action. We, as a campus, have a problem, just as a number of other college campuses across the nation do. How we choose to handle this problem will make all the difference.

 

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Blog post: Argument by disease (10/24/01)

 

Gould, G. (2001, October 24). Argument by disease. [Originally] Retrieved April 2, 2004, from http://www.mit.edu:8001/people/ggould/minirant01/10-24-01.html

 

 

Greetings, traveler!

 

I recently found myself in the position of defending the "pro-anorexia" movement. The pro-anorexia movement, if you've not heard of it or encountered any of its many manifestations on the web, is a social/political movement that regards anorexia as a "lifestyle choice" (I've never been clear on what that phrase meant, even back when it was just a code-word for "gay"). They use phrases like "body art" and attempt to bring others around to their view that anorexia is just another aspect of body modification, like tattooing or ear-piercing. They maintain all sorts of web pages on the proper ways to not die of malnutrition, the appetite-suppressant effects of amphetamines, and things like this. I do not much like the pro-anorexia movement. It is, to borrow a phrase from Austin Powers, "not my bag." The inability to appreciate good food is a heinous enough disability (I have enough trouble with the notion of vegetarians who don't appreciate the beauty of steak au pauvre); that people compound that with concern over self-image is astonishing and repellant to me. But "De gustibus non disputandum est," as my grandmother used to say. As long as it's not my food that they scorn, I'll call it live-and-let-live, much as I am creeped out by the entire concept.

 

What I found myself defending them against, however, is a much more interesting point. It is what I call "argument by disease." It goes something like this: "How can anyone be for anorexia? It's a disease! Nobody can seriously be arguing for a disease -- what morons!" The general form of this argument is that it characterizes an action or point of view as "diseased" and then uses the stigma attaching to disease to dismiss the argument, frequently with an ad hominem implication that those who argue in favor of a disease are clearly either stupid, emotionally disturbed, or themselves diseased.

 

Looked at dispassionately, this is less an argument than an elaborate form of slander. But arguments are seldom examined dispassionately.

 

The worst thing of it is that this truly vile argument can be used for both sides of an argument, and as often as it serves some vicious cause it is used to serve some virtuous one. The argument technique in many ways pioneered by the definition of homosexuality as a disease is the same argument used to great effect through the choice of the medical term "homophobia" to describe a moral/political view. The implications and pejurations implied by disease terminology are equally twaddle in both cases, but just try to condemn one without being sucked into an implied political allegiance to the other!

 

I've seen much the same thing applied to a "diseased" cause which I support -- the suicide pro-choice movement, which says that suicide is not a diseased mental condition but a legitimate and potentially rational choice. A dozen years ago a number of suicide pro-choice folks were imprisoned ("involuntarily committed") in mental health facilities because their political views were deemed "diseased." Freedom of speech in this country does not extend to the "diseased."

 

(Indeed, I have no doubt that my FBI file begins not with these rants but with my support of a diseased cause those years ago.)

 

All that argument by disease really accomplishes is the neglect of the need to make an informed argument and the abdication of moral judgment in favor of the people who define disease. But disease is not a moral term. Medicine may tell us that anorexia or suicide or depression or homosexuality meets certain criteria of abnormality or impairment, but it cannot whether abnormal means bad. We are too used to thinking of diseases like malaria, whose cure is a technical challenge but morally unclouded. We have grown so used to thinking of diseases as medicine's villianous adversaries that we have forgotten that the moral judgment is not always so trivial.

 

Not everything that is called a disease is a disease. Not everything that is a disease is evil. To stand in favor of a thing called a disease is not wrong, and to point out that a thing is called a disease is not an argument. The argument from disease is facetious at best and at worst combines simple ignorant obedience to decisions of terminology made by others with a sort of hyper social-darwinian belief that disease is a matter of moral failing or else a tremendously patronizing application of pity to those who neither need nor want it.

 

So I'll defend the pro-anorexia movement as long as anorexia's label as disease is used as an argument against it. There are some fine arguments against the movement, from the safety of providing ignorant idiots on the internet with dangerous advice (if you can't name the essential amino acids, you have no business taking on any form of dieting that eliminates whole food groups), to the questionable nature of the medical and dietary advice provided (if dieting is causing muscular weakness, this is not an indication to go ahead), to simple questions of common sense (do not take medical advice from people who cannot spell. Like, duh.). But "anorexia is a disease" is not an argument, or even an intelligent attempt at an argument. It is the ultimate absence-of-argument, an irrelevant appeal to irrelevant authority.

 

To the extent that the argument from disease says anything, it is a bizarre two-level ad hominem attack -- the allegation that (1) to support argument X, one must be Y, and (2) to be Y makes one morally unfit to argue X. Step 1 proceeds from a misunderstanding of the nature of logical debate, frequently buttressed by an irrelevant appeal to authority. Step 2 can only be attributed to simple abusive argument and to a positively insupportable argument of construction. In total, it adds up to the appearance of a damning argument and the content of damnable lie.

 

Onward! --G

 

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