"Eating disorders affect between 1 and 4 percent of young adult women" and are on the increase, diagnoses having "risen more than 50% since the 1970s," according to the authors of "Pro-anorexia Communities and Online Interaction: Bringing the Pro-ana Body Online." But, before this important study, rare coverage in the news media did little besides increase speculation that these communities are "spreading rapidly," normalizing eating disorders, recruiting new sufferers, and have "an immediate negative impact on the young people who view them," as authors Natalie Boero and C.J. Pascoe write in the journal Body & Image.
Now we have much more detail, and insights that go way beyond consideration of a single group or pathology, for example…
* How "online embodiment" happens – or "how people negotiate their material bodies" in a "disembodied space" and "an increasingly online world," as the authors put it
* How much community (from family to broader forms) informs, or forms, identity – to what extent it always has and now that we have the online kind
* How a community figures out if online presentation matches offline reality (the authenticity question)
* The positive and negative politics of online community – how people express themselves and relate to one another online without the physical representation of the offline world
* How individual meets collective in online communities, and whether individual interests give way to collective ones more readily online than offline
* What social capital looks like in different kinds of communities and how it's used for individual and community gain
* Whether power is demonstrated differently in online communities and how it is
* Where traditional and online media representations of body image intersect.
Boero and Pascoe found and, for more than a year, studied MySpace's 14 most populous, publicly accessible pro-ana online discussion groups (made up of 3,354 participants and 2,156 of their discussion threads). [None of the groups still exist, "as they violate MySpace policy and have been closed down, migrated to other sites, or have become 'private' groups under new and more ambiguous names," the authors add, and this was in 2005-'06, when MySpace was the US's largest social network site.] What they found "challenges many dominant psychological and medicalized conceptions of eating disorders," they write.
So here are just some of the insights I found in their thoughtful research:
* What the communities look like: They "take many forms – a bulletin board, a static website, a blog, groups on social network sites or email groups." They're "non-recovery-oriented, offer weight-loss tips, generate support, and provides non-judgmental community that does not take a negative attitude toward eating disorders."
* Crafting body, crafting community: What used to be seen almost strictly as "an individual psychopathology" now seems – at least for sufferers who participate in online groups – to be "a collective project of crafting" two things: their physical bodies and the community (including its norms and goals for participants and itself). Possibly a third thing: identity, at both individual and collective levels.
* A social disorder too now? The researchers say these online communities "bring together people who rarely talk about their disorder face to face in non-therapeutic setting" – "there is no offline corollary to these online groups." In the article's notes, they write that, "of the 20 participants we interviewed, almost all of them stated that they had not spoken socially (apart from on a treatment program) about their eating disorders before going online." The authors see "the online and offline body" as both constituted by and constitutive of these online communities.
* "Authenticity," the ever-present question. Because eating disorders are about "embodied practices" and these communities are disembodied spaces, "participants constantly grapple with authenticity," the authors write. Interestingly, whether members have been diagnosed "is beside the point." The focus is creation and maintenance of community through interaction, which is how authenticity is determined….
* Rituals: "Bringing the body online," as the authors put it, is done through various rituals (that seem to be much more disturbing to outsiders): e.g., "weigh-ins, posting photographs, food reports, [fasts,] and other group activities." By joining in those activities, participants develop "authenticity" (or "enact online embodiment"), the social capital of pro-ana sites – and use that capital to grow their authority and challenge others', "usually through labeling them a 'wannarexic'." So we see that these communities are self-"policing," using social norms.
* Community-management "tools." To grow their authority and help "police group boundaries and norms," participants use "tools of authenticity" such as knowledge (e.g., medical), aggression, and experience (e.g., side effects they experience, hospitalization [why reporters' own exposure to this activity, if their reporting goes that deep, can lead to unsurprising but also unhelpful sensationalist reporting]). The three forms of aggression are "self-aggression" (putting oneself down), "motivating aggression" (using insults in a non-malicious way to "inspire" each other to "succeed"), and the malicious kind against "haters" of people with eating disorders as well as "wannarexics." [It's hard not to make associations with bullying; here, too, the aggressor can be in denial about her own vulnerability, but what may be different is that targets participate willingly.]
* Two of the roles played: pro-ana anorexic vs. "wannarexic." "The pro-ana anorexic does not seek to hide her body or her disorder, often acts aggressively, actively searches out membership in a pro-ana community, and shows ambivalence about both anorexia and recovery," Boero and Pascoe write (adding that 90-95% of anorexia and bulimia sufferers are female). A "wannarexic" is what nobody wants to be in this context – the newbie, "dieter," "inauthentic" dabbler who doesn't have "the dedication and control [that are held up to be] at the core of a pro-ana identity." "Wannabaiting" is the aggressive behavior that targets "wannarexics."
* Element of performance. The authors' terms for how participants gain acceptance are "performativity" and "body enactment." But it's important for observers to keep in mind that, online, just as offline, "what people say they are doing and plan to do with their bodies and what they actually are doing are often different things" (the authors' words, emphasis mine). So performance is closely tied to authenticity in these communities, but we see elements of performance and seeking of authenticity in general online socializing too.
* Probably not for "recruiting": The authors point out that aggressive behavior like wannabaiting "contradicts the common-sense notion that these sites are recruiting grounds for eating disorders. Rather, we found that members actively try to limit the number and quality of new members so as to create more elite and authentic groups."
* "Lifestyle" vs. disorder. "Members of these groups take pains to differentiate a pro-ana lifestyle from anorexia, offering a distinction between the disorder and a new way of conceptualizing the creation of community around stigmatized bodies and spaces." This reminds me of the potentially harmful silos and echo chambers of social media that Eli Pariser describes in this TED Talk.
* About control: "Participants often explain their behaviors in ways that are more positive and agentic than medical discourses which tend to focus on anorexia as pathology," the authors write. "This reframing provides participants a sense of control, accomplishment and attractiveness." So participants don't seem to associate attractiveness only with physical appearance, interestingly. [I'm seeing a correlation between the attraction to control in eating disorders and other forms of self-harm.]
* So does community perpetuate the problem? The authors write that "visiting these sites correlates with a delay in seeking treatment," but "the link between these sites and increased levels of eating disorders is not inevitable."
* Consider the context too: "Focusing on these sites is … a way to deflect attention from larger cultural messages around eating and body size found in mainstream media outlets which are not so different from the ones promulgated on these sites," Boero and Pascoe write.
Insights raise more questions, of course. One is, whether the collective embodiment and goal-setting represented in these communities have any relation to other collective self-destructive rituals, such as suicide pacts. Another is, whether the fears reflected in the early news reports are based on the sense of urgency that arises from making associations with pre-Internet self-destructive behaviors in groups.
Clearly, we need to understand how community influences identity in everybody's experience – or better, how community, physical body, self-expression, and identity are related. That's what Boero and Pascoe seem to be after. Citing the seminal article "Doing Gender," by scholars Candace West and Don Zimmerman, these researchers write that "much as the gendered self emerges through interactions with others, so does the embodied self." So creating and participating in community may've always been as much about establishing and expressing identity as it is about a sense of belonging – just even more so now, in the age of online community. Something for parents and educators to think about!
Why am I relating all this? First because of the important questions it raises. Second because I think that a blend of what the Internet now exposes and thoughtful investigations like this can lead us more quickly than ever to effective handling of what urgently needs care as well as to the collective self-knowledge that moves civilization forward.
* Blog post about the study from another sociologist, Deborah Lupton
* My 2008 post about French legislation against online promotion of eating disorders (linking to previous posts on the subject) and PBS Frontline in 2009 on France's struggle with obesity