Websites promoting eating disorders are on the increase and so are the number of Maltese, predominantly teenage girls, who are logging into pro-ana and pro-mia forums, chat rooms, websites and online communities.

But what, exactly, is a pro-ana or a pro-mia website? They nurture a culture of fostering and encouraging teenagers with eating disorders to get thinner and thinner – whether their vehicle is starving themselves (pro-ana/anorexia) or by vomiting up what they have consumed (pro-mia/bulemia)

The sites – completely unrestricted in the maze and tangle which the internet has become – do not acknowledge that these people are suffering from mental illness which could (and very often does) lead to serious health complications and in extreme cases death, if not treated timely and professionally.

The proliferation of these sites is attributed to the rise of social networking websites and blog use. We asked Dr Dorothy Scicluna, a clinical psychologist and psychotherapist specialised in eating disorders, on whether Maltese eating disorder sufferers make use of pro-ana sites. Dr Scicluna said that they do, but the usage cannot be gauged properly because we have no accurate statistics available. “We try and educate our clients about the negative effects of these websites on their recovery,” she explained. Dr Scicluna forms part of Eating Disorders Malta, a small initiative focusing on delivering group psychotherapy for eating disorders.

A quick search on the internet shows that in recent years, pro-ana and pro-mia web sites have proliferated with majority of users being young females, although there are sites which encourage eating disorders in men and boys. Many of these sites encourage doctors and families to treat and respect eating disorders as a ‘lifestyle choice’. Such sites are not illegal, though the message they disseminate is controversial, to say the least.

“It is important to remember that pro-ana websites are devised by unfortunately sick patients and also that eating disorders in themselves are psychiatric conditions”, said Dr Scicluna.

Eating disorders are a development of the late twentieth century. The terms bulimia nervosa and anorexia nervosa were not developed until the 1960s, and even then they were considered a rarity. Dr Scicluna told this newspaper that newer disorders are being diagnosed, such that a new international eating disorder diagnoses shall be out by 2012. Pro-ana and pro-mia movements are not even mentioned on the most recent textbooks on eating disorders.

Pro-ana is the promotion of anorexia nervosa, an eating disorder characterised by an extremely low body weight and a tweaked body image. Anorexics sometimes refer to it and personify it as a girl called ‘Ana’. A similar, but lesser used term is pro-mia, or ‘Mia’ referring to Bulimia, another eating disorder characterised by food regurgitation.

These sites feature pictures and videos of extremely skinny girls engaging in behaviour related to eating disorders, almost normalising their actions. They also offer controversial tips on crash dieting, extreme low calorie recipes, fasting and forced vomiting, calling those who fail to follow these tips lazy and weak. Some websites have password protected fora and chatrooms where anorexics meet and discuss their accomplishments, or even compete with each other at losing weight.

The communities surrounding such sites are rather cliquish and openly suspicious of newcomers fearing the risk of uncovering the secretive identity of regular users. Hostility is often expressed towards those who show disapproval towards eating disorders, including spouses, relatives and friends of members who appear on-site to post threats and warnings. Casual dieters who join these fora, believing that inducing eating disorders to lose weight more effectively are often called ‘wannabes’ or ‘wannarexics’ by the users. It really has become a sub-culture in itself.

Pro-ana individuals often wear beaded red bracelets to socially identify themselves discreetly. Pro-mia bracelets are blue or purple. Such bracelets can easily be ordered online and received by post.

Members of pro-ana and pro-mia sites encourage ‘thinspiration’ where members exchange pictures, footage, music, poetry and other material that portrays young women proudly showing or speaking about their protruding bones. The use of metaphors and other connotations portraying being abnormally thin as angelic and almost spiritual, is widespread on pro-ana websites.

Hotlines and websites for reporting of pro-ana websites are sprouting all over the Western world, trying to counter the promotion of pro-ana lifestyles by providing help to anorexics seeking assistance and also raising awareness on eating disorders. Most of these hotlines are run by voluntary organisations working in the field of eating disorders.

Attempts to stop the profileration of pro-ana websites fail as website creators find intelligent ways and means to bypass regular channels of information dissemination. It is also interesting to point out that these sites are not illegal. The only way to spearhead the eating disorders’ phenomenon is through well thought awareness campaigns in schools and hangouts for the young.

The ones most at risk are teen girls, exposed to raw information on eating disorders which is readily available, without having the family or friend base to discuss or ask advice on what they unknowingly exposed themselves to. Eating disorders are not even mentioned in Malta’s Personal and Social Development (PSD) curriculum that is used by PSD teachers in secondary schools, although to be fair some teachers do touch the topic if the need arises. Many parents are not even aware of the websites’ existence, hence the need for further awareness. We hope this article will help kick-start that process.

The saddest thing of all is that as any man will tell you, a fuller figure is much more attractive than the bags of bones these unfortunate girls become.

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