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Hopkins researchers examine sites glorifying eating disorders

Juli Babbitt, a 26-year-old recovering anorexic living in Columbia, often found herself visiting a website featuring pictures of rail-thin models with protruding rib bones, and providing purging techniques, at the height of her eating disorder.

"I remember visiting [the website] numerous times as a way to keep my head focused on staying thin," she said. "It wasn't until during my treatment that I realized how damaging these websites are. The promotion of anorexia as a lifestyle choice instead of a mental disorder is incredibly dangerous to individuals who suffer from eating disorders."

Such sites feature images of rail-thin celebrities, such as the Olsen twins and Lindsay Lohan, tips on how to conceal eating disorders from parents and tricks to lose weight in unhealthy ways. Some sites also feature song lyrics and poetry glorifying eating disorders.

A new study by the Johns Hopkins University's Bloomberg School of Public Health that examines the content and messages of 180 sites promoting eating disorders known as "pro-ana" and "pro-mia, as well as "thinspiration sites," is the first step to understand what role they play in developing eating disorders. The lead author of the study, Dina L.G. Borzekowski, an associate professor in the Bloomberg School's Department of Health, Behavior and Society, is in the final phases of completing another study that explores the effects of pro-eating disorder websites on young people.

Borzekowski said that parents should be concerned about the sites because there are thousands of these sites, which are virtually impossible to police because of their seemingly harmless content that might include poetry, essays, and art.

"Some of the reviewed sites present very dangerous ideas and disturbing material that serve to inform and motivate users to continue behaviors in line with disordered eating and exercise behaviors," said Borzekowski, who specializes in the study of children, media and health. "Other sites seemed less harmful; they offered links to support recovery from these disorders and gave users venues for artistic expression."

The study, which appeared in last month American Journal of Public Health, found that more than 90 percent of the websites were open to anyone and almost 80 percent had interactive features, such calorie and body-mass index calculators. The data were taken from sites in the spring of 2007.

Kate Glorioso is infuriated when she thinks about people teaching others how to perfect the eating disorders that have wasted 20 years of her life and have resulted in her going to three treatment programs.

"I think girls or even boys who are toying around with the idea are going to get all these ideas." said Glorioso, a 33-year-old Rodgers Forge resident, about sites that glorify anorexia and bulimia. "I think it will make them spiral downwards."

The Hopkins study has been released at a time when there seem to be mixed messages in the media about body image.

A couple of years ago, the modeling industry grabbed headlines when several fashion shows wouldn't book models deemed "too skinny." Last year, the actresses of the TV show "90210" came under fire for appearing too emaciated in episodes. And while full-figured actors now appear in successful mainstream shows and movies such as "Glee", "Huge" and "Hairspray," celebrities such as Kelly Clarkson and Jordin Sparks of "American Idol" fame, "Precious" star Gabourey Sidibe, actress Jennifer Love Hewitt and television personality Tyra Banks have also battled online critics who have commented about their fuller figures.

"I think that we need to quit focusing on weight," said Sharon Peterson, head of the Eating Disorder Network of Central Maryland. "We are supposed to be all different sizes."

People visiting these "pro-sites" are usually searching for some group to which they can belong, said Peterson, whose organization provides a variety of support groups and resources for those struggling with eating disorders.

"Our society praises and glamorizes people who are thinner," said Peterson. "It is looked upon as a positive thing. People who get tied up in these websites … that is what it is all about."

Borzekowski, who estimates that there are thousands of pro-eating disorder websites, declined to identify what sites her study used. She said the sites are readily available with a simple Google search.

"Some of the images on these sites are quite disturbing," she said.

Eighty-four percent of the sites surveyed offered pro-anorexia content, while 64 percent provided pro-bulimia content. "Thinspiration" material appeared on 85 percent of the sites; this included photographs of extremely thin models and celebrities, according to the study.

"Knowing the messages that vulnerable populations encounter is critical," said Borzekowski. "To better understand how media messages can potentially harm, first we must be aware of what messages are out there."

About 83 percent of the sites used in the study provided overt suggestions on eating disorder behaviors, including ways to engage in extreme exercise, go on a several-day fast, purge after meals and hide rapid weight loss from family and friends.

Thirty-eight percent of the sites included recovery-oriented information or links. Forty-two percent encouraged users to post artwork and poetry.

"The internet is a place where people can convene in anonymity," Borzekowski said. "While there hasn't been a study about how long the sites have been around, they have been around since the Internet was started. They have gotten more sophisticated."

People who go as far as starting these sites are in the greatest need of help for their disorder, according to Peterson.

"They are the sickest of the sick," Peterson said. "They are usually very, very ill."

Peterson, who struggled with bulimia during the 1980s, has clients who range in age from 7 to their 80s. Her clients include men, as well as all ethnic and socioeconomic groups.

"It is looked at as a younger person's disease, but it reaches all ages," she said. "In poorer countries, there have been recent studies that show that eating disorders are more widely spread with minorities and poorer people."

Glorioso, who is working as a nanny this summer with hopes of being employed as a teacher in the fall, has been in treatment for anorexia and bulimia three times, most recently last year. She said she is finally standing on her own two feet.

"Yes, I am thin," she said. "But I'm not purging. I feel more in control of my life."

When she thinks about her struggles, Glorioso is baffled by the pro-eating disorder sites.

"Hearing about these sites [angers] me," she said. "It is irritating and sad. Is this all that they have to do? Part of me wants to go on and see what it's like, but I'm trying to move on. I'm trying to separate from that."

Babbitt also wants nothing to do with the sites.

"As someone recovering from anorexia, I believe it to be in my best interest to avoid such sites because they encourage obsessiveness and they minimize the seriousness of the life-threatening disorder," Babbitt said. "I think the body image that this type of media promotes is one that is impossible to achieve. The masses get enough of this image in everyday fashion advertisements and magazines, which is also a problem. I believe that pro-ana material is unnecessary and ultimately dangerous."

john-john.williams@baltsun.com


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