We all know eating disorders are dangerous. We would have had to have been living under a rock for the past twenty years to have missed all the cautionary tales, tabloid headlines, and made-for-TV movies that have dramatized the dangers and trappings of such psychological illnesses as anorexia nervosa and bulimia. But a disturbing new trend has come about in the eating disorder community in recent years — and ‘community’ is, in fact, the operative word.
With the advent of internet chat rooms in the late 1990’s came a new means for technologically-savvy sufferers to commiserate in their illnesses. And today, in the age of Twitter, Facebook, and YouTube, gone are the days when eating disorders were synonymous with isolation; conversely, those with eating disorders — especially young sufferers — now have formed a sort of sob-society online, wherein they are finding encouragement to proceed in their illnesses, often to the point of no return.
When I was a teen suffering with anorexia in the 1990’s, I gradually withdrew from my friends and family, seeking solitude as a refuge from the prying questions and intrusive concern of outsiders. As is almost always the case with these illnesses, my disorder became the most important thing in my world, and I came to a point where I would have done anything at all to protect it — even if that meant my world growing strangely small. And while I found a dysfunctional sort of comfort in the bell jar of my anorexic world, I had an undercurrent of awareness that my life had fallen away from normal. I didn’t necessarily want things to be right — but at least I knew that something was wrong.
Many of today’s young anoretics are unified in their exclusive world, and they all seem to know the secret handshake. “Pro-ana” is a modern term describing a sect of eating disorder sufferers who seek to embrace anorexia and bulimia as lifestyle choices rather than life-threatening illnesses requiring treatment.
In pro-ana circles, the illnesses are no longer referred to in clinical terms, but rather by familiar, almost friendly-sounding nicknames: “ana” for anorexia and “mia” for bulimia. The lingo also includes such neo-slang terms as “thinspiration” or “thinspo”, which is any sort of material — photos, song lyrics, books, video — that inspires sufferers to lose weight; “food porn”, which are images intended to allow a sufferer to enjoy the food vicariously by poring over the images and imagining eating the foods portrayed; and “wannarexics”, which are usually young girls (and sometimes guys) who are deemed by the group to be illegitimate posers — those seeking to pop into the chat room for diet tips and tricks who do not intend to make the disease their lifestyle, or who are not already chronic sufferers.
I spent a week lurking in these pro-ana chat rooms and groups, and was disturbed by the cameraderie that was so evident among the girls in the group. They know one another by screen names such as TinyDancer, LovelyBones, and LilStickFigure17. Their posts to one another are almost sickeningly sweet as they encourage one another one their group fasts, cleansing programs, and in their attempts to thwart the efforts of their therapists and parents or boyfriends to “make them fat.” There seems to exist a terrible “us-versus-them” mentality in the groups, wherein mental health professionals are the enemy, bent on invading their utopia.
These girls believe they can live this way. They believe that their systems are sustainable. They convince themselves — and one another — that the decision to live on, say, 250 calories per day, is a hallmark of self-control and willpower, and that those who would seek to correct their self-destructive behavior are merely jealous.
So how then do we hope to reach a generation of psychologically-fragile young women who have found comfort and community in such deadly territory? What can we offer them that their counterfeit online relationships cannot? And how do we go about doing so before it is too late?
Anorexia nervosa holds the highest mortality rate of all psychological illnesses, and is the third most common chronic illness among adolescents. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anoretics die within 10 years after contracting the disease; 18-20% of anoretics will be dead after 20 years and only 30 – 40% ever fully recover. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of all causes of death for females 15 – 24 years old.
The threat of death is real. The allure of sickness is enigmatic. The number of statistics is growing. What can we do? Have we any options? Is there an answer?
If there is any key piece to the puzzle, it is awareness. We must be aware of our teens’ online lives. They have done their homework, seeking out the forums and learning the protocol. We need to do the same. We cannot look the other way and hope the phase passes. These stakes are too high. Statistics show that early intervention affords an anoretic the greatest chance of recovery.
Got a teen or tween in your life? Sister, daughter, student, friend? Keep your eyes open. Watch for warning signs. Mentor her. Love her. Encourage her. Help her to discover her unique talents before she becomes fully convinced that starving is an art. Engage her. As much as is possible, keep her in the moment, in this three-dimensional world where people express affection without the use of emoticons. Form a support network around her (if the person is a minor, insist she see a counselor with expertise in eating disorders), so that she will not go in search of her own in a world where up is down and food is foe and illness is honor. Awareness may not equal prevention in all cases, but it is a step in the right direction, and we cannot afford to be ignorant.
Our world is changing, and if we want to make a difference, we’ve got to keep up. Mental illness, like everything else, has gone high-tech.