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Gendering the Pro-Anorexia Paradox: Men in Pro-Ana Spaces

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 STUDY

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.

RESULTS

Online Behaviour

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.

Personal Experience

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.

IMPLICATIONS

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

Written by Andrea

Andrea is a PhD student focusing on individual, familial, and health care definitions and experiences of eating disorder recovery. She has an MSc. in Family Relations and Human Development and a a BA in Sociology. In her Masters research, she used qualitative and arts-based approaches (digital storytelling) to explore the experiences of young women in recovery from eating disorders. Andrea has recovered from EDNOS. She can be reached at andrea[@]scienceofeds[.]org.

Discussion

12 Responses to “Gendering the Pro-Anorexia Paradox: Men in Pro-Ana Spaces”

  1. I’m not sure if those who go on pro-ana websites/forums experience more stigma or simply feel more isolated than those who do not go on these websites?

    How did they identify pro-ana websites? What does “pro-ana” even mean anymore; I don’t know. I think outsiders miss that there’s often plenty on pro-ana communities (especially big ones) that is actually not literally PRO anorexia at all.

    I think these places enable a lot of people to be honest about their ambivalence, which is something that’s often not well-tolerated in uber pro-recovery places and in treatment.

    Posted by Tetyana | May 24, 2014, 8:43 PM
    • I’d be interested to see what websites/forums they surveyed. Why is that information not included in the methods section of the paper?

      Posted by Tetyana | May 24, 2014, 8:46 PM
      • The methods section was a little thin. I also would have liked to see which websites/forums were included; I wonder if they left them out thinking this was a better ethical choice to protect the identities of participants?

        Posted by Andrea | May 24, 2014, 8:59 PM
    • Yeah, good point; stigma and isolation are not necessarily the same thing, and not everyone who feels isolated would experience stigma… still, looking at men in particular I would say they likely experience both.

      They identified the sites by searching Google for “proana, pro-ana, pro ana, proanorexia, pro-anorexia, and pro anorexia” and then added “male, guy, and boy” to look for ones that might be targeted toward men. I don’t know why they didn’t include “men” as an added word, but there you go. The terminology certainly does seem to miss what some of the sites are about; then again, I’ve never spent any time looking at the sites really so I’m not sure the extent of what all is discussed there.

      I agree with the “honesty about ambivalence,” and I was happy to see that the authors recognized this… not something I’ve often seen in the literature, honestly.

      Posted by Andrea | May 24, 2014, 8:57 PM
  2. I haven’t read the paper yet, but like you comments. In my perception pro-ana content is not limited to sites dedicated to pro-ana anymore. There are pro-ana blogs, and pro-ana content and groups on any other social medium, such as Pinterest, Instagram, Twitter, and even Whatsapp… Pro-ana is everywhere and that makes it even harder to assess the consequences. It also means that pro-recovery (and I agree this dichotomy simplifies things…) content should be everywhere too. See http://www.proud2bme.org and http://www.proud2bme.nl as examples.

    Posted by Eric | May 25, 2014, 12:04 PM
    • Hi Eric!

      The issue I have (okay, I have lots, but one of them) is: Who is defining what is/isn’t pro-ana? People who spend time in pro-ana communities can’t seem to even agree on a definition sometimes. I wonder, do researchers (parents, some sufferers) label a community or individuals as “pro-ana” when those communities or individuals wouldn’t self-identify as “pro-ana”?

      What *is* pro-ana? Is it just thinspo? Is it a space that promotes anorexia nervosa as a “lifestyle”? Is it a space that tolerates ambivalence toward recovery? Is it a space that doesn’t shy away from numbers and explicit descriptions of symptoms (as opposed to the glossy “engaging in symptoms”)? Is it a space where people in recovery (or who ultimately want recovery) can co-exist with those who (while they may want it at some point in the future) are currently in relapse? Is it a space where people engage in tips? And what *is* a tip? Does anyone actually think that telling someone to drink low-calorie liquids to get rid of feeling hungry is a “tip”? It is not exactly rocket science. What about things like not brushing your teeth immediately after purging. Is that a tip that promotes behaviour or is it just harm reduction?

      Is “pro-ana” just a word that stuck to identify communities that aren’t exactly pro-recovery in that somethingfishy kinda way? I think that’s true sometimes. Othertimes it is definitely way more than that.

      I think it would be interesting if someone were to compare the negative effects of spending time on pro-ana boards vs. the negative effects of spending time in a treatment facility.

      Posted by Tetyana | May 25, 2014, 12:53 PM
      • Excellent point… who does define pro-ana? People have such strong reactions to it, but I think “it” is not one thing; it’s many different things. Agreed that there is also a blurring between tips and harm reduction; there have been similar discussions about drug harm reduction (you know, the standard “does giving someone clean needles/providing a safe injection site encourage drug use” kind of thing which still provoke strong reactions from some but harm reduction approaches for drug use are becoming increasingly accepted).

        I would also be interested in the similarities and differences between pro-ana and treatment contexts, and perhaps add to that pro-recovery spaces. All of these (and likely other fora as well) can certainly provide “tips,” “harm reduction,” “recovery support,” etc….

        Posted by Andrea | May 25, 2014, 4:29 PM
        • Speaking of drugs, there’s a lot of that stuff on Tumblr too; stuff that I think that most people would consider glorifying drug use/addiction. I wonder what people’s reactions are to that (I legitimately don’t really know). I’m sure fewer people are upset over an image of a needle than of an emaciated model but both can trigger people…

          Posted by Tetyana | May 25, 2014, 10:11 PM
    • Thanks Eric. I agree that content labeled “pro-ana” is likely found elsewhere; similarly, I think that content some might label “pro-recovery” is found in unpredictable places- notably, there was recently an eating disorder recovery related post on a popular food blog, Cake Spy. I think other online social spaces can serve either (and many more) purposes. I also think that messages designed to be “pro-ana” or “pro-recovery” can take unexpected forms… searching the hashtag #eatingdisorderrecovery on Instagram, for example, reveals some potentially questionable material that I personally would not see as very “recovery” oriented. And yet, if it’s helpful for someone, who am I to say it isn’t recovery? These are things I grapple with. I think, as you say, that it is hard to dichotomize and that to do so makes very complex experiences and orientations toward recovery far over simplified.

      Posted by Andrea | May 25, 2014, 4:24 PM
      • On Tumblr, people (or a group of people, really) have recently started using the #actuallyanorexia and #actuallyed tags to get away from posts they didn’t like/didn’t feel reflected the actual reality of struggling with an ED (posts that were more pro-ana-ish). It is interesting how these things evolve.

        Posted by Tetyana | May 25, 2014, 10:05 PM

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