When someone says “pro-ana,” what comes to mind? Likely, given the strong reactions pro-anorexia websites provoke, you may be able to conjure up an image of what would take place in such a forum. Thoughts of “thinspiration,” emaciated and waif-like images, and starving tips likely spring to mind, alongside considerations of the dangers of a community that would encourage behaviors that can be very harmful to health.
I’d venture to say that it is unlikely that you have pictured a man participating in these sites. Given that we know that men get eating disorders too, and that they may feel alienated in their struggles, is it surprising that some might seek out online communities, including pro-ana?
As Tetyana noted in previous posts on pro-ana (here and here), these sites can serve a harm reduction purpose and/or provide a space for sufferers to openly and honestly share their struggles and seek support from a community of understanding others. Is it possible that men, who may feel even more stigmatized than women with eating disorders (see this post, too), use these sites to seek solace during an isolating experience?
Until recently, research exploring both the positive and negative functions of these sites has focused almost solely on females. Woolridge, Mok & Chiu (2014) noted this gap in the literature, and sought to better understand how men use pro-ana websites.
The authors conducted a content analysis on a sample of 12 pro-anorexia forums, including both open (9 of the sites) and password protected (3 of the sites). Within these sites, they selected 689 posts by men for analysis.
The researchers determined “male participation” using information the participant presented in their posts, including screen name, picture, or bio. As the authors note, it is possible that some men post under a female name to avoid stigma and judgment; however, given the difficulty of determining gender in this setting, they worked with what they had, so to speak.
Two researchers coded the data independently and then compared their codes to ensure rigor; the authors note that they reached agreement much of the time (92%).
I’m curious about the authors’ choice to include both password-protected and non-password protected sites. I wonder whether there are significant differences between sites that require membership and those that do not? Is it possible that users feel their information is more private on the password-protected site, and therefore disclose more information?
I am not familiar enough with the pro-ana literature to know whether others have noted differences in this area. The authors do note that site participants do not expect to have their information analyzed for research; they argue that the benefits outweigh the risks.
While I agree that the study reveals important and interesting findings, I would have enjoyed a bit more of an exploration of ethical implications, including whether password-protected forums can be considered “public domain.” But then, I’m a bit of an ethics nerd.
THE MAIN RESULTS
In line with findings on the function of pro-ana participation for women (e.g. Mulveen & Hepworth, 2006; Yeshua-Katz & Martins, 2013), the authors identify that men commonly used these sites as a form of social support. Participants sought this support both for maintaining the eating disorder and for recovery, though seeking recovery support was discussed less often than seeking support for struggles associated with being a man with an eating disorder.
For example, one participant said:
It was incredibly difficult for me to go through high school trying to hide an ED. By not eating it even attracted more attention than if a girl would not have. Now, whenever I tell someone close to me about my eating habits I get crucified and told “oh no, only girls have eating disorders” followed by a long list of discrimination. [This site] is a safe haven for all people, regardless of anything, a place without bias and a place where we are free to be our selves. no one is a minority, we are all people. If I hadn’t found this site I don’t know if I would have gotten out of high school alive.
Male posters in particular seemed to support each other in what they described as a difficult and isolating experience, saying things like:
You’re definitely not alone. I’m here quite often and I see a few dudes scattered here and there. We gotta [sic] stick together!
The authors noted that posts on the forums offered support and understanding regardless of whether the goals of the poster were maintaining the eating disorder or aiming for recovery. They describe this paradoxical function, where participants might find a place where they feel they can belong while also finding practical information, like ways to reduce hunger. On the topic of thinspiration, some men on the forums sought out male-specific images, noting that these were quite hard to find.
Beyond looking at the online interactions of men in pro-ana forums, the authors also used the data set to explore the personal experiences of the men engaged in these websites. Again, the idea of feeling alienated was raised; men on the forums described loneliness and isolation, in line with literature exploring the experience of being a man with an eating disorder in general (e.g., Levine, 2012).
This isolation was exacerbated by feelings of shame around suffering from a “feminine” issue, as described by one poster:
“I’m shy posting on sites like this because it is mostly girls. I have nothing against girls but there seems to be a certain antagonistic feeling towards males, it often is. Really I’m just lonely here and everywhere else too.”
Participants’ posts also reflected how ambiguous the experience of having an eating disorder can be; while in some ways the eating disorder can serve a very practical and even empowering function, individuals with eating disorders often recognize the health dangers related to engaging in symptoms (e.g., Warin, 2004).
I appreciated the authors’ consideration of this ambiguity, particularly their description of the difficulty associated with focusing on weight restoration in treatment. They describe how a focus on weight gain can make sufferers feel alienated, potentially leading to a rejection of treatment. The pro-ana space acted as a place where participants could explore their experiences without fearing judgment from clinicians who may hold what is perceived as a singular goal: weight restoration.
Much like other studies on the positive and negative elements of pro-ana sites, the authors note that there are a number of dangers linked to participation in these sites. They cite Bardone-Cone & Cass (2007) who found that participation in pro-ana sites negatively impacted participants’ self-esteem, self-ratings on appearance and attractiveness, and perceptions of weight.
They go on to acknowledge that this setting may simultaneously provide a space for men to connect with others who understand their experiences and who do not pass judgment on them for suffering from a “female issue.” Reflecting again on the ambiguity of the eating disorder experience for sufferers, they demonstrate how pro-ana spaces highlight the tensions between the various purposes an eating disorder can serve for individuals.
With respect to this last point, I was pleased to see this article take seriously the multiple meanings an eating disorder can hold. It is important to avoid glossing over the subjective experience in favor of a sole focus on weight restoration in eating disorder treatment, and it is nice to see this increasingly reflected in the literature.
The article also highlights the neither wholly negative nor wholly positive function of pro-ana sites, with a focus on a group who may experience more stigma around their behaviours. I would be interested to see whether pro-ana site users are made up of individuals who have experienced more stigma around their eating disorders for whatever reason, be it gender, culture, socioeconomic status, body size, or any other identity category.
Wooldridge, T., Mok, C., & Chiu, S. (2014). Content analysis of male participation in pro-eating disorder web sites. Eating Disorders, 22 (2), 97-110 PMID: 24359281