What Really Goes On Inside Pro-Ana Communities? (Maybe They Are Not So Bad After All)

Ambivalence is a great word to describe how many eating disorder patients feel about recovery. Many people that follow my Science of Eating Disorders tumblr run thinspo blogs. But, they follow me, and many probably follow fyoured, which offers pro-recovery advice. Many people might want to recover someday, but they feel they can’t let go of the behaviours now. They are not denying their illness, or that recovery will happen, or that it really IS a disorder, but, right now, recovery is just not an option.

Bear with me for a moment. Suspend your judgements and gut-reactions to “proana/mia.”

Eating disorders are highly stigmatized. Most people don’t understand them. Physicians, nurses, and healthcare staff are often no better than the public. Treatment itself can have negative consequences. In a recent study, “more than half of all nurses and residents (58.2%) thought that ED patients were responsible for their disease “always” or “in most cases.””

This stigma, hostility, and ignorance leads people to form on-line communities where they can openly discuss their experiences and connect with others. This is not unique to anorexia, mental health, or health in general.

But problems occur when the discussions that on-line users seek to have because they cannot have them in real life become so censored and policed that open and honest discussions cease. Ambivalence is no longer tolerated (and it isn’t on many/most pro-recovery communities).

Hence the need for an alternative. A place where people can openly discuss their struggles. But just as media portrayals of eating disorders are often very problematic, media portrayals of pro-ana/mia are often, unsurprisingly, one-sided and misleading.

Thankfully, researchers have began trying to understand why these communities exist, what purposes they serve, and what really goes on inside.

In one particularly illuminating study by Brotsky & Giles (2007), one researcher (Brotsky) went undercover into 12 pro-ana websites, participating in 23 separate groups, and posed as ‘SB’ (a female in her 20’s with anorexia nervosa and a pro-ana sympathizer) in order to understand the “kind of psychological support offered by such websites” and the “beliefs of community members towards eating disorders and the processes of of treatment and recovery.”

I’ll summarize some key points of this paper. As you read through this post, remember that this is ONE study and these are the experiences of ONE researcher.


Many individuals believe that pro-anorexia communities are, by definition, anti-recovery. So, are they?

When SB announced that she was about to go into inpatient treatment for her eating disorder, the responses were “overwhelmingly encouraging, supportive, and hopeful”:

That’s a big step your taking. I don’t know about anyone else, but I’m proud of you. Good luck!

I’m here for ya no matter what!! Best wishes!

I hope everything goes well and you’re able to beat this. *Hugs* I’ll be sending support waves to you!

well you’ve been here listening to me go on and on and you related to me and kept talking. I’ve never ever had that. Someone who understood why i need it. Now you want to recover and you may need someone to hear you, when no one else is there. […] you have given it, and i appreciate it so much.

“Not one word of dissent” was uttered at SB’s decision to seek treatment. On that note, Borzekowsky et al (2006), in a review of 180 pro-ana websites, found that 38% included recovery-oriented advice and information, and 21% featured specific sections dedicated to recovery.


On this, SB found that little consistency between groups, websites, or even individuals within one sub-community.

It is disease, and disorder. But it is not a lifestyle. Whoever claims an Eating Disorder as a lifestyle, agh! It makes me want to cry.

Sorry, but you DO CHOOSE to continue having an ED. And yes, I CHOSE to stick my fingers down my throat when I became bulimic. I didn’t catch any anorexic/bulimia virus. Take some personal responsibility people.

It is true that seeking treatment is a choice, but engaging in behaviours isn’t really a choice. The game is rigged in favour of “choosing” symptoms: they become compulsive, offering a powerful (of course, maladaptive) anxiety reducing and numbing tools to deal with moods and emotions. It is not a choice in the sense that picking the shirt you’ll wear today is a choice. Either way, you’ll be okay. Not so with eating disorders, choose one and you might be faced with an onslaught of anxiety and self-hatred, which is difficult to deal with when you don’t have adequate support (it is difficult even when you do!).


While the authors carefully selected communities that were NOT focused on recovery and DID use terms like “pro-ana,” SB found that many sub-groups and communities were not at all friendly to ‘ana’:

The following is an excerpt from a chat:

“SB: that’s why i am trying to make conversation […] come on guys
# 305: Nobody wants to talk about ‘ana’ with you, fucktwat.
SB: why the hostility
# 315: go to a pro ana site and talk about how fucking grand it is to be anorexic
SB: this is also not a recovery site
# 305: It’s not a recovery site, but it’s not a pro-ana site. This chat sure as fuck isn’t a pro-ana chat.”

When pro-recovery sites become so stifled with rules and any mention of symptoms (outside of saying “I used symptoms”) is censored to protect others who might be triggered, some people who joined the communities in order to be open and honest about things they cannot be honest about in real life will choose to seek support elsewhere. It doesn’t mean they are “pro” eating disorders.


Here are just some examples of why:

first thing my mom said to me when she got back was, wow shorty, look how big youve gotten

i only weigh about 115 and the last time i went home my dad looked at me and said “you haven’t been working out” […] my dad called me a little piggy in front of 3 friends last year when we went out to eat grrr


The notion of support was highly prevalent across the community. Even where the “pro-ana” label and its associated ideas were explicitly rejected by site users, the purpose of the community was still perceived as support above all else. However the form that support takes on pro-ana sites is somewhat elusive. SB’s persona was very warmly responded to on some sites, and harshly abused on others, although the basic tenets of the  sub-communities’ beliefs did not appear radically different. Making the right first impression seemed to be the only serious predictor of the way that different sub-communities would react.

These communities can be very supportive, but like many anonymous communities on-line, they can also be very snarky and mean. Like elsewhere on the internet, and in real lifemuch of the discourse depends on a few key, popular individuals. It is the same in a high-school classroom, or a focus group. And like elsewhere, first-impressions matter. It is just amplified on-line due to the nature of the discussions (often very emotional), the individuals involved (often isolated, emotionally unstable, and generally unhappy), and the anonymity component.

On the idea that pro-ana lures others, Brotsky & Giles point out that:

… the rather severe formal ‘application’ procedure set up by some sites would seem to foster a degree of suspicion towards outsiders and intruders demonized routinely within the community as “fakes” and “wannabes”).

What about all the tips on how to purge, starve, and deceive others? (As if one can’t figure this out on their own, my eating disorder developed without ever going on any pro-anorexia sites, and it continued without it, too.)

Ultimately, it seems that the support on offer on pro-ana websites is—for all the scare stories about “purging tips” and users egging one another on with their latest BMIs—little more than sympathetic companionship in a safe, anonymous and largely sympathetic environment. The ferocity of the verbal assaults on SB when trying to muscle into a closed community suggests that these virtual social networks engender a high degree of loyalty and exclusivity that resembles that of tight-knit offline friendship groups, counter-cultural knots of teens sheltering in the corner of the schoolyard from the more conventional “popular” students.

Finally, Brostky & Giles conclude with the following:

Our belief is that it is difficult to claim that pro-ana sites encourage non-eating disordered people to become eating disordered, and so their direct effect on “vulnerable” individuals may have been overstated. The most potentially problematic aspect of the sites, however, is that they offer their users something of a social mirage: the sense of support, connection, and social interactions that they lack in their offline environment.

These connections might be real, helpful, and exist off-line, but they are generally not the same as having strong friend or family support.

Instead of censoring and banning, which doesn’t work (more in later posts), we should be doing more to educate individuals about how to help those with eating disorders. We should raise awareness, amongst the public and clinicians, about the complex etiology of eating disorders. We need to foster a supportive community in real life, and that means working toward ending wide-spread ignorance and stigma about eating disorders.

These communities will continue to exist as long as the public, but particularly friends, family members, and clinicians, continue to be hostile, judgemental, and often wilfully ignorant about eating disorders.

I am just getting started on this topic (so please keep this in mind in the comments). In future posts, I’ll discuss (1) the demographics of individuals who visit pro-ana/mia sites, (2) delve into the content of the sites, (3) discuss how bloggers and users feel about pro-ana/mia, (4) talk about the impact (and implications) of banning pro-ana/mia websites and content, and (5) talk about the negative aspects of pro-ana/mia sites. (Not necessarily in this order.)

Special thanks to:

Dr. Antonio Casilli for recommending this paper. Dr. Casilli is the Scientific Director of the ANAMIA project, “a French National Research Agency (ANR) study focussing on online pro-ED websites and their social determinants”. I highly recommend visiting their website at anamia.fr/en/.

AnaGirlEmpath for answering some of my questions on Twitter. I would also urge readers who want to understand a bit more about the history of pro-anorexia to watch AnaGirlEmpath’s 15 minute video on the topic. It is very informative and very interesting. She also has a few videos on ana-mia research (I have not watched other videos yet, so I’m not endorsing anything, so let’s keep that in mind, I’m just sharing.)


Brotsky, S.R., & Giles, D. (2007). Inside the “pro-ana” community: a covert online participant observation. Eating disorders, 15 (2), 93-109 PMID: 17454069

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Tetyana is the creator and manager of the blog. She has an Honours BSc in Neuroscience and an MSc in Medical Science. She can be reached at tetyana[at]scienceofeds[dot]org.


  1. One of the most striking things I have read about anorexics is that the competitiveness to be the thinnest means that they are always supportive of others’ attempts at recovery.

    • Well, that just sounds silly. I don’t see how that can ever be the case. But, that competitiveness exists in inpatient and residential units as well (as I’ve blogged about before). It is not unique to on-line communities, though it may well be worse on-line.

      I think my main point with this post, focusing on this *one* article, is that these communities often serve the needs of individuals who are ambivalent about recovery. That’s really the take home message. It would be absurd to argue they are wholly positive or wholly negative. I’ll cover more of the negative aspects in future posts.

      • OK, I found it: the quote is by Marya Hornbacher in ‘Wasted’:
        “People on eating-disorder units are notoriously supportive of one another’s recovery. Less competition.”

        The point I was trying to make, but probably didn’t, is that it seems that people suffering from eating disorders would have no reason to want to encourage others to be ill (via pro-ana/mia sites or otherwise). Either they are in recovery themselves and care about the recovery of others, or they are not and are motivated by competitiveness?

        • Oh I see (re: your point).

          I don’t think the competitiveness aspect is so explicit. I think (and perhaps I’m wrong, but this is from what I’ve personally experienced) it is more internal. I didn’t experience the competitive aspects *too much* (or maybe I don’t remember any more, I think it is something that’s more prevalent early on in the disorder) but it wasn’t that I didn’t care for people’s recovery, or was motivated by competitiveness, but there were times I wanted to be the thinnest, and that, by nature, was competitive.

          Vandereycken (2011) talked about this in his paper, I blogged about it here (http://www.scienceofeds.org/2012/08/22/can-eating-disorders-be-contagious/).

          I think readers (see Fiona’s and Cathy’s comments below) would probably be more helpful than I am because I honestly don’t remember how competition played into my anorexia when I was younger. Certainly it is not something that exists on the same level (if at all) in bulimia/bingeing purging.

    • I’ve found people with ED to be competitive about anything really. Even gaining weight. It’s not so much competition as it seems to be deep feelings of inferiority, failure, etc. But everyone that I’ve met with ED who has been supportive of other’s recovery has been sincere and thinking of the person’s well being and that they possibly might find a way out of this hell. Not about being thinner than them. We know there will always be people much, much thinner. And not only that, but ED will never let you be thin enough anyway.

      • Thanks for your comment. I agree. I think the competition is often an internal thing that happens inside one’s brain. It is part of the disorder, but I don’t think it means people are generally mean or want others to ‘fail’ in one aspect or another. I think it is generally directed inward (“I am so fat,” “I fail at recovery and at being sick” (boy I felt that one a lot), and that kind of stuff, like “My ED is not real because I weight more than this person”.)

      • I agree. I am horribly competitive (with ED stuff and with … most things!) and it’s not a quality I particularly like, but I can remember being in treatment as a younger peson and being competitive about things like weight gain, how well I did art therapy etc. I’ve done a lot of work on it actually. Anyway, I have never been insincere when encouraging people in recovery. Even when I’ve been my most ambivalent, I would never wish someone out of this hell just so I could be sicker, thinner, whatever. The ED competition is, for me really internal. I’ve also never felt that someone who is “proana” or whatever was wishing me well in treatment/in recovery just to get “ahead in the game” or anything.

    • Such competition is not universal amongst people with anorexia nervosa. If there is anyone I have envied it is those who have managed to gain weight and live a full life. I have always viewed the thinness of anorexia nervosa as an unwanted side-effect and am baffled as to why anyone would wish to compete to be ‘the thinnest’.

      Tetyana knows this, because she and I have discussed it at length. The reason why I raise it again is that I believe it’s important NOT to stereotype people with the same diagnosis.

      • Haha, we have, we have. I still think you are generally in the minority. Though, as individuals get older, I think they generally follow that trend of thinking, particularly if they have other resources of support in their life.

  2. yes! i’ve been involved in the “pro-ana” community since i’ve started with the disorder. the thing that i’ve picked up on are that there are really two very different communities. yes, one is very much invested in posting thinspo and perpetuating disorder techniques/tips. the other is very vested in the idea that we all have this issue, many of us lacking support in real life, and that we can come and talk about the disorder and our lives without the stigma that many of our actual relationships have about it. the latter has been the one that i’ve been involved with and was really my only support system through much of the disorder. at one point, my parents had found out about my involvement and believed that it was hindering my recovery, but then i never had a good relationship with my parents and the online presence was having the opposite effect and allowing me to be vulnerable and genuine in a way that i couldn’t be with my family.

    i’m not so much involved anymore (this is 5+ years later) but still regularly talk to a lot of people that i’ve met through the community. a lot of us have very similar home lives and personalities and deal with a lot of similar issues. our communication is not focused on perpetuating the disorder, but urging each other to cope and to attempt recovery while also realizing that doing so is very difficult. it’s a judgement free environment to be honest in when many of us lack that in any other sphere of our lives.

    • This is very informative, thanks Lauren!

      So, I have a question for you (and I have my opinions and answers, but I’m interested in your thoughts). Why do you think the communities that are very involved in posting thinspo and perpetuating the ED exist, and what purpose do they serve to their users?

      I feel it is basically more of a harm-reduction approach as opposed to a constant, fully motivated, desire to recover?

      I agree with you on judgement free, definitely. I always felt much less judged and more comfortable in communities that are, on the whole, ambivalent or at least realistic toward recovery. They are not “pro” ED, but they are not heavily moderated (if at all) and people just write about the real stuff that happens in their lives. Certainly any progress is congratulated, but people can also post openly about their awful days/weeks/etc…

      I think one of the components that could be hindering recovery is the normalization of behaviours. I had to constantly remind myself that purging just wasn’t something people did on a regular basis. I would qualify “involuntarily” when I talked about the time I got sea-sick and threw up. Only after realizing how absurd that must sound to people without eating disorders.

      That’s definitely a dangerous component of it, but again, on-line communities aren’t alone in this, it occurs any time you are around people with eating disorders, it might happen faster on-line. But again, the solution isn’t to ban, it is to help individuals be less judgemental in real life.

  3. I would wager there are not a *lot* of studies out there that look in depth to pro-ana sites and how they help or hinder people with eating disorders. It seems to be quite a taboo topic. I’m agreeing with what I’m reading.

    I always used to find these sites abhorrent, my feelings were similar to “how can they want something that makes my life hell” and “you would not want to have cancer”. But that was before I realised they are sick too, just as sick, and the sites do serve a purpose. Because it IS very isolated trying to live with an ED. It IS very much an illness where we are heaped on with shame. And (ironically when we are taught so much about how our own thinking can be black/white all/nothing) the community, including the treatment professionals, often seem to have a very black/white view of recovery/not in recovery. You either WANT to be, or you are pro-ana, or non-compliant. I think this black/white standard is even more pronounced than the extremes between you are either in recovery or you are in relapse, whereas in reality, it takes such a long journey of small steps with setbacks along the way. I wonder why there is such an unrealistic set of standards for people battling eating disorders in this way. It certainly fuels the need for pro-ana sites.

    I agree that they have their place in the community. I have ventured onto some – found them not my place, because when I was more in need of someone to talk to about my own ED, I didn’t have access to the internet, and now, I feel like I’ve heard it all before and just find reading these sites tedious and repetitive. Also, highly distressing – what distresses me most is actually NOT the amount of people who are ambivalent towards recovery, but the continually hearing the same things over and over about where the system where they are has failed to help them, where they have been treated badly by others, where they have lost hope for ever getting the help they need, or where they have been made to feel like they are ‘bad’ and ‘naughty’ and treated like delinquents. And scariest of all to me, those who have been ‘given up on’ by the system and left to pretty much live utter hell until they die.

    In all but a few places I’ve ventured where the whole site has been pretty depraved and I would wager not even created by someone with an ED, the members have been pretty supportive and there have been dedicated ‘recovery’ sections/threads. There have always been a lot of people who have been going in and out of recovering or attempts to do so and been using the site for support along their journey for the good times AND the bad times – which is something I guess pro-ana sites can offer that other sites don’t – if you are relapsing, it really is a bit of a taboo. They are all for you recovering and will hold your hand for that, but relapse and a lot of them drop you like a hot potato until you are ready to toe the recovery line again. And in trying to recover from an ED, we know that it never runs that smoothly. Well pretty much never. It’s an up and down path most of the time.

    Ambivalence towards recovery isn’t a ‘bad’ thing we do/feel. It’s part of having an ED. So many ED’s are ego-syntonic. And for many of us, they have literally saved our lives in times where we had no other way to stay alive, to cope. Sure they are deadly, but they have a purpose and so it’s very hard to let go of them if that’s what they have done for you. They also often coexist with depression, OCD, anxiety, etc – they can be ways of coping with these, extensions of these… living with one of these but not the ED can be a scary thought. I feel the ED gave a lot of the things I suffered from – especially depression – a purpose. It gave ME a purpose to keep on getting up each day. It gave me hope that I was doing something to ‘fix’ the problems that had made my life such a hell – even though that was a highly irrational thought that I now can see through, I will never forget that feeling of comfort and hope that it gave me and I have never stopped craving it. So of course, when life without ED is hard, and recovering from ED is hard too, I will feel ambivalent, and wish I could stay with what feels okay.

    Sorry for such a long comment! I could keep going on but I have to go away and think some more first to avoid repeating myself/repeating things you have already said. I really appreciate this post and your preparedness to go where most people won’t go in your writing about EDs.

    • Fantastic comment Fiona! I think you hit so many important points!

      When I stumbled upon pro-ana sites, just a glimpse would be a great motivator to go and get something to eat, because if you look through them, they are not happy. It is clear that it is not a lifestyle, it is a place for people to get support where they can’t in real life. But I’d see it, and realize, no way, I do NOT want to feel guilty for eating those extra hundred calories (I already did, anyway). But, recovery sites were often stifling. As you say, very little tolerance for relapses, it is true. I mean, people might protest it, and that’s fine. Absolutely every site, community, or subgroup is different, the dynamics are different (and why wouldn’t they be, different people, after all) and they don’t stay constant, but this is my general feel.

      “And (ironically when we are taught so much about how our own thinking can be black/white all/nothing) the community, including the treatment professionals, often seem to have a very black/white view of recovery/not in recovery. You either WANT to be, or you are pro-ana, or non-compliant.”

      “Also, highly distressing – what distresses me most is actually NOT the amount of people who are ambivalent towards recovery, but the continually hearing the same things over and over about where the system where they are has failed to help them, where they have been treated badly by others, where they have lost hope for ever getting the help they need, or where they have been made to feel like they are ‘bad’ and ‘naughty’ and treated like delinquents. And scariest of all to me, those who have been ‘given up on’ by the system and left to pretty much live utter hell until they die.”

      Yes, oh god yes. This 100000% times. Absolutely, spot on.

      It is actually heartbreaking to see this happen continuously. (Especially for me, living in Canada where health care is, in my opinion, much better in terms of access. Definitely not perfect, but I’ve never had to go through what people in the US do.)

      I felt ambivalent about recovery a lot of the time. Not when I first got sick at 14 (and I was never in denial, I fought, literally, to get treatment against the wishes of one parent). I was very motivated to recover.

      Then I relapsed accidentally (I kept losing weight week after week, but wanted desperately to maintain), and then regained it, but then, started really bingeing and then really purging in University and I was ambivalent for most of my time. I wanted to be recovered, but, I felt I couldn’t put my life on hold, and frankly, the eating disorder helped me deal with life. I felt renewed motivation after moving in with my partner, because my level of sickness would certainly break apart our relationship in no-time. And I felt it wasn’t fair for him to be with someone that was so sick.

      “Sure they are deadly, but they have a purpose and so it’s very hard to let go of them if that’s what they have done for you.”


      I’ve also seen communities that are basically recovery oriented but not the typical pro-recovery communities that censor so much of everything except the most mundane (and put everything under a “trigger warning cut”). They are the judgement free zones where it is okay to be ambivalent, to keep trying to recover, but sometimes slip, or mostly slip and sometimes try to do better. As Lauren suggested, I think these communities can be very helpful & useful for many individuals. But I do think many parents, professionals, or lay people, if they were to look at the content, might jump to label them as pro-ana/mia, probably out of fear or worry?

      (And not to minimize their concerns for their children or clients. Of course they should be concerned, but not about the use as much as the eating disorder itself. I think the best response wouldn’t be to tell them to stop going, or to blame the communities for their child’s/client’s ED or recent relapse, but to offer open, honest, non-judgemental support. After all, chances are, they are there because they can’t find support elsewhere.)

  4. Tetyana,

    I am really glad you are writing about pro-ana. I think it is an important topic that is covered too much by mainstream media and not enough by eating disorder publications and organizations.

    Do you know of any good studies that estimate the percentage of people who visit pro-ana websites?

    Pro-ana seems to be a huge topic in the media when eating disorders are discussed, as if everyone with an eating disorder visits them. I am curious if we have any idea of how many people actually visit the websites on a regular basis.

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