[Paleopsych] NYT: Web Sites Celebrate a Deadly Thinness

[Premise Checker]

Web Sites Celebrate a Deadly Thinness
New York Times, 5.6.7
http://www.nytimes.com/2005/06/07/health/nutrition/07eat.html

[The article lists no sites, but googling pro-ana brings up a great many, the 
first of which is http://www.plagueangel.net/grotto/id5.html and is called 
"Pro-Ana Links." Likewise, articles descrying hate sites don't give you a 
sample, but googling <"hate sites"> links to a lot of lists. I have not looked 
for child pornography sites, though, and wonder if I could be proscecuted for 
visiting sites using a text-only browser.]

    By [3]ERIC NAGOURNEY

    Before the Web site's pages begin to load, a box pops up the screen.

    "Caution," it reads. "This site contains pro-eating disorder images
    and information. If you do not have an eating disorder or are in
    recovery, do not enter this site."

    Click O.K., and a new box appears.

    "Seriously. You enter this site of your own volition, and I am not
    responsible for the decisions you make based on the information you
    see here."

    Click. A third box.

    "So don't send me hate mail. It's your fault if you don't like what
    you see."

    However sincerely intended, the warnings, posted on one of a growing
    number of Web sites that promote eating disorders like anorexia and
    bulimia, may serve more as a lure, especially for curious teenagers.
    And a recent study by researchers from the Stanford School of Medicine
    has found that the Web sites are commonly visited by adolescents who
    have eating disorders.

    Such sites are the public face of a movement that goes beyond the
    denial that often accompanies addictive behaviors like alcoholism and
    gambling, into something more like defiance.

    Many of the sites dispute that anorexia and bulimia are diseases,
    portraying them instead as philosophies of life. They offer tips on
    how to lose weight - by purging, among other methods - and how to hide
    eating disorders from family members or friends.

    In the new study, presented at a meeting of the Pediatric Academic
    Societies, the researchers said it was unclear whether the Web sites
    played a role in drawing people into eating disorders or in making
    recovery more difficult, in part because the study sample was fairly
    small. A larger study is planned.

    But the researchers found that adolescents who reported visiting
    so-called pro-ana, for anorexia nervosa, or pro-mia, for bulimia
    nervosa, Web sites spent more time in hospitals and less time on
    school work than those who said they did not visit the sites. For
    reasons that are unclear, the study also found that even when
    adolescents visited pro-eating-disorder and pro-recovery sites, they
    still fared worse than those who visited neither kind of site.

    Pro-eating-disorder Web sites can be very attractive, experts say.
    Many are well designed and well written, and they appeal to an
    adolescent sense of rebellion.

    "The belief that centers the pro-ana movement is the belief that
    eating disorders are a lifestyle choice and not a disease," said one
    of the study's authors, Dr. Rebecka Peebles, a specialist in
    adolescent medicine at Stanford's Lucile Packard Children's Hospital.

    Consider the page that greets visitors when they finally get past the
    warning boxes. "Quod me nutrit, me destruit," it declares. What
    nourishes me destroys me.

    The site goes on to give tips on how to conceal an eating disorder,
    including wearing baggy clothes, pretending to eat and hiding the
    health problems the disorders can bring on.

    The author of the site, in a "disclaimer," says she is not promoting
    eating disorders.

    "These sites," she writes "do not exist to say: 'I'm anorexic! Aren't
    I cool? Don't you want to be like me?' " The goal, she says, is to
    offer support: "This is a place where people can come to say, 'This is
    part of who I am. These are people who understand.' "

    Jenny Wilson, a Stanford medical student and the author of the study,
    is skeptical of efforts to attach a philosophy to eating disorders.

    Instead, she sees the Web sites as efforts by people with eating
    disorders to convince themselves that they have control over their
    lives. "I think it's an expression of the disease more than anything,"
    Ms. Wilson said.

    Many of the Web sites show a kind of ambivalence, the researchers
    said. They defend people's right to be anorexic or bulimic, but they
    spend a lot of time talking about the difficulties of having eating
    disorders.

    Dr. Peebles of Stanford said that for some people, the sites might
    serve as no more than a support community, and not as a source of
    encouragement to continue destructive behavior. "They can express
    their innermost eating-disordered thoughts in a sortof anonymous way
    where they won't be judged," she said.

    Still, when the researchers spoke to adolescents who had visited the
    sites, more than 60 percent reported trying weight-loss techniques
    they had learned there. (About a quarter of the adolescents who
    visited Web sites intended to help people with eating disorders
    recover also said they had found tips on ways to keep their weight
    down.)

    For the study, the researchers sent surveys to the parents of 678
    people, ages 10 to 22, who had been treated for eating disorders at
    Stanford. They also asked the parents to give separate surveys to
    their children.

    In all, 64 patients and 92 parents responded.

    And while the forms were anonymous, the researchers were able to link
    the responses of the patients with those of their families, to compare
    answers.

    The study found that 39 percent of the patients had visited
    pro-eating-disorder Web sites, 38 percent pro-recovery sites and 27
    percent both types of sites.

    Despite the differences in reported hospital stays, the researchers
    found that those who spent time on the pro-eating-disorder sites
    provided basically the same information when asked about health
    changes as those who did not. Their weight was not much different from
    their ideal body weight, the researchers said, and they were no more
    likely to have changes in their menstrual cycles or to have symptoms
    of osteoporosis.

    When the researchers tried to see how familiar parents were with the
    Web sites, they found that the parents whose children visited the
    sites were more likely to know about them and to be concerned about
    what their children were learning on the Web.

    But 39 percent of those parents said they did not know whether their
    children visited pro-eating-disorder sites. And 15 percent wrongly
    reported that their children did not use them.

    Some large Web servers like Yahoo, responding to complaints, have
    removed sites that promote eating disorders.

    But the sites remain easy to find. And some experts wonder whether
    they are doing a better job of getting their message out than do the
    sites intended to promote recovery from eating problems.

    Dr. Richard Kreipe, chief of adolescent medicine at the University of
    Rochester Medical Center, said he was struck by how attractive the
    pro-eating-disorder sites tended to be. Still, he said, it is hard to
    prove whether the sites actually make the problem worse.

    The issue, Dr. Kreipe said, is probably not whether the sites can draw
    the average teenager into an eating disorder but whether they may
    influence someone with an inherited predisposition to develop the
    disease - especially an adolescent who is feeling isolated.

    "The kid who's probably most vulnerable to this is the kid who's least
    connected to other people," he said.