Bandura's social cognitive theory proposes that modeled behaviors are more likely to be imitated when message receivers can relate to the model and perceive rewards with the communicated behavior. Peebles et al., unpublished data, 2010).īehavior change and communication theories justify concern about pro–eating disorder Web sites. 4, 6, 7 In addition, increased use of pro–eating disorder sites has been positively correlated with disordered eating behaviors and negatively correlated with disease-specific quality of life among adults (R. Adolescents exposed to pro–eating disorder Web sites have been shown to have higher levels of body dissatisfaction than adolescents not exposed to these sites, as well as decreased quality of life and longer durations of eating disorders. This content can be conveyed through text, images, audio, or video, and it encourages knowledge, attitudes, and behaviors to achieve terribly low body weights.Ī distinction must be made unlike Web sites that encourage healthy weights, moderate exercise, and recognized nutrition and diets, many pro–eating disorder sites recommend that their users try intense practices, such as vomiting and fasting, with an emphasis on achieving extremely thin or skeletal appearances. A pro–eating disorder Web site is a collection of Internet pages, all accessed through a domain name or IP address, that deliver content about eating disorder such as anorexia and bulimia. 2– 4 Similar to Web sites that promote other equally unhealthy behaviors such as self-injury and suicide, 5 pro–eating disorder Web sites (also identified as pro-Ana and pro-Mia Web sites) are of great concern. While health professionals investigate causes of and prevention strategies and treatments for eating disorders and their poor health consequences, 1 pro–eating disorder Web sites and communities have emerged wherein users can find material to support the progression and maintenance of eating disorders. Continued monitoring will offer a valuable foundation to build a better understanding of the effects of these sites on their users. Pro–eating disorder Web sites present graphic material to encourage, support, and motivate site users to continue their efforts with anorexia and bulimia. Common themes were success, control, perfection, and solidarity.Ĭonclusions. Thirty-eight percent of the sites included recovery-oriented information or links. Thinspiration material appeared on 85% of the sites, and 83% provided overt suggestions on how to engage in eating-disordered behaviors. Few sites focused on eating disorders as a lifestyle choice. A large majority (84%) offered pro-anorexia content, and 64% provided pro-bulimia content. Practically all (91%) of the Web sites were open to the public, and most (79%) had interactive features. We conducted a systematic content analysis of 180 active Web sites, noting site logistics, site accessories, “thinspiration” material (images and prose intended to inspire weight loss), tips and tricks, recovery, themes, and perceived harm. We examined the features of pro–eating disorder Web sites and the messages to which users may be exposed. The Internet offers Web sites that describe, endorse, and support eating disorders.
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