Anyone who works with adolescents with eating disorders needs to know that the young people have access to a wide range of Internet websites that promote anorexia and bulimia as acceptable and even desirable life styles, say researchers who surveyed the Internet viewing habits of individuals diagnosed with eating disorders.

They found that pro-eating-disorder site usage was prevalent among teenagers, especially in the 13-to-19-years age range, a time at which many adolescents turn to the Internet for information about health. Half of the information-seekers are looking for ways to lose weight, and one-quarter are seeking information about eating disorders.

Web sites that respond to this search for information often promote eating disorders as a life-style choice, but some discuss it as an illness. In either case, the researchers found, the sites tend to share similar content, including “thinspiration” (images of thin women), poetry, weight-loss advice, methods for avoiding detection by family and health care providers, forums, merchandise, and links to related sites.

How much influence these sites have on adolescent behavior is not well known,  though some studies have shown them to be more supportive than face-to-face therapy. In any case, the researchers said, we need to know more about the sites themselves and how they are being used.

Among their findings:

• Use of the sites is prevalent among teenagers, but parents often have very little knowledge of their children’s viewing;
• Adolescents don’t need to be directed to the sites; most find them by chance;
• Many teens report learning about new weight loss or purging techniques from the sites, and many then use the new methods;
• Use of pro-eating disorders web sites was associated with longer disease duration and less time devoted to school-related activity.

The researchers, who were supported by the Pediatric Research Fund at Stanford University School of Medicine, say their study was intended as “a preliminary foray into the world of pro-ED web sites” and was designed to understand better the profiles of their adolescent users and to probe associations between their use and outcomes. The study, which required parental consent, was handicapped by a low response rate: the researchers note that “patients with ED are a notoriously difficult population to capture because of the nature of the illness.”

The full text of the article “Surfing for Thinness: A Pilot Study of Pro-Eating Disorder Web Site Usage in Adolescents with Eating Disorders” is published in the December 2006 issue of the journal Pediatrics. Correspondence should be addressed to rpeebles@stanford.edu.

See also:
January 2003. HHCS. Identifying and Treating Eating Disorders.