A critical in–depth content–analysis of popular pro–anorexia websites
Santos, Odette dos
MetadataShow full item record
The internet has become a popular place for finding information and support about conditions that are felt to be misunderstood and unrecognized in health–care settings. Anorexia nervosa is such a condition as it is often accompanied by severe social disapproval and rejection by those who want the individual with anorexia to recover. Pro–anorexia websites take a positive and encouraging attitude towards eating disorders by explicitly encouraging extreme thinness, portraying anorexia nervosa as a conscious lifestyle choice and denying that it is a serious mental disorder that requires treatment. By visiting these websites, individuals with anorexia feel accepted and supported and their loneliness is alleviated. As the majority of the people who visit pro–anorexia websites are pre–pubertal and adolescent girls, it is valuable to examine the content of these websites as it is questionable whether these adolescents are able to evaluate the information critically. This study aimed to investigate the content of pro–anorexia websites and how accurately they portray the information about anorexia. A qualitative research approach in the form of a multiple critical case study design was employed. Purposive sampling in the form of critical case sampling was used since the five most popular pro–anorexia websites represented the central phenomenon. Electronic data obtained from public documents, namely the content of the five most popular pro–anorexia websites on the internet, was analyzed inductively. Specific popular search terms used when searching for pro–anorexia websites were selected on the basis of information obtained from the online Keyword–Discovery Search Term Suggestion Tool. The most frequently listed websites dealing specifically with pro–anorexia were analyzed in an attempt to copy the search behaviour of the general public who use the internet. The top five overlapping results after comparing the top ten results of each keyword search were accessed to search for pro–anorexia content. The written website content that adhered to the inclusion criteria of pro-anorexia content, which excluded message boards, live journals, forums, chat rooms or websites that only contain links to other pro–anorexia websites, was analyzed by means of thematic content analysis. The main themes provided the framework for the structure of the sub-themes with their supporting themes. The first main theme was Defining Content which refers to “what” it means to develop an anorexic persona and to live an anorexic identity. The sub-themes relating to Defining Content include: Ideal Self, Ideal Lifestyle and Transcendence Ideal. The second main theme was Instructive Content which refers to “how” one becomes the idealized thin ideal and conveys useful information on how to encourage and maintain anorexia nervosa. Instructive Content was further divided into the sub-themes Deceptive Strategies, Self–discipline Strategies and Weight–Loss Strategies. The content of pro–anorexia websites addresses the development and maintenance of an anorexic identity by redefining the integral feature of self–discipline in anorexia nervosa as an acceptable and necessary part of the anorexic identity. The content also appeals to the perfectionistic attitudes and low self–esteem of individuals who visit these websites by providing a thin ideal which promises the achievement of perfection that they can identify with. By personifying anorexia nervosa as a god–like entity to be served and obeyed at all costs, the pro–anorexia websites could provide those with anorexia nervosa with a sense of identity and “holiness” that transcends the personal self. Furthermore, the content also redefines the unhealthy symptoms and behaviours associated with anorexia nervosa as an accepted and justified ideal lifestyle. The themes also advocate typical anorexic behaviour by providing specific strategies for selfdiscipline and deception which advise one on how to hide one's weight loss and anorexic behaviour. Specific weight–loss strategies are also provided, describing how one can lose weight and maintain weight loss. Therefore the symptoms of anorexia nervosa are not advocated as harmful, dangerous or pathological according to the diagnostic criteria in the DSM–IV–TR. The necessity for censorship of the harmful content of pro–anorexia websites in terms of media laws was highlighted. Also indicated is the importance of the advocacy role that psychologists should play in contributing to developing policies that protect vulnerable individuals against the harmful content of proanorexia websites. Suggestions for further research include the strengthening of offline relationships with vulnerable individuals, in a therapeutic as well as family and social context, and the effect this has on their need to visit pro–anorexia websites.
- Health Sciences