July 6, 2010
SPH study examines pro-anorexia, pro-bulimia websites
A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health examines the content and messages presented by websites that appear to support or encourage eating disorders.
These websites use images, text and interactive applications to further knowledge, attitudes and behaviors to achieve dangerously low body weights. The study is the largest and most rigorous analysis to date of pro–eating disorder websites, and was published online June 17 in advance of print in the American Journal of Public Health.
The Internet offers messages and communities that sanction anorexia, bulimia and other eating disorders. Previous studies have shown that the adolescents exposed to such pro–eating disorder websites have higher levels of body dissatisfaction compared to adolescents who have not been exposed. In addition, young people who have visited these sites are known to engage in more and intense eating-disordered behaviors.
“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 Dina L.G. Borzekowski, lead author of the study and an associate professor in the Bloomberg School’s Department of Health, Behavior and Society. “Other sites seemed less harmful; they offered links to support recovery from these disorders and gave users venues for artistic expression.”
For the study, Borzekowski and colleagues conducted a systemic content analysis of 180 active pro-anorexia and pro-bulimia websites. This involved creating a valid and generalizable sample and a reliable coding scheme. In addition to objectively counting site logistics and features, researchers devised a perceived-harm scale for the analyzed sites. According to the study, more than 91 percent of the websites were open to the public, and more than 79 percent had interactive features, such as calorie and body-mass index calculators. 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. About 83 percent provided overt suggestions on eating-disordered behaviors, including ways to engage in extreme exercise, go on a several-day fast, purge after meals and hide rapid weight loss from concerned family and friends.
On the other hand, 38 percent of the sites included recovery-oriented information or links. Nearly half (42 percent) provided the maintainers and users a place where they could post artwork and poetry.
“Knowing the messages that vulnerable populations encounter is critical,” Borzekowski said. “To better understand how media messages can potentially harm, first we must be aware of what messages are out there.”
Co-authors of the study are Summer Schenk, Jenny Wilson and Rebecka Peebles. At the time of the study, Schenk was completing her MPH at the Bloomberg School. Wilson and Peebles are from the Stanford University School of Medicine.