This article is written by  Helen Butcher and she’s asked me to share it here to help bring awareness for this terrible illness, and the harm this can do to both sexes.

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Pro-Ana’ Movement – What On Earth Is Going On?

In a former life, I worked in mental health services. It was a job which wrenched my heart on a regular basis, and frequently made me very angry with the incompetency of society in general (and health service managers in particular [1]) when it came to mental health. But I never got frustrated with the patients themselves. Until, that is, I came across the ‘Pro-Ana’ phenomenon.

‘Pro-Ana’, if you’re not familiar with the term, is short for ‘Pro-Anorexia’. ‘Ana’, for some of the movement’s adherents, is a kind of goddess – a deified personification of weight loss and beauty. Her devotees willingly sacrifice their meals, their sanity, and (sadly) their lives in her service. The ‘Pro-Ana’ community offers its members ‘thinspiration’ over the internet, including extreme tips on calorie elimination, and advice on how to hide one’s eating disorder from friends and family.

This is where it gets weird. ‘Pro-Ana’ individuals are frequently all too well aware of the fact that they’re ill. They KNOW that they have an eating disorder, they KNOW that it’s making them miserable, and they KNOW that they are putting their health in extreme danger. This isn’t something unique to pro-anas. Many people with eating disorders know that something is wrong but nonetheless shy away from getting anorexia or bulimia treatment [2]. Pro anas, however, wear their disease as a badge of honor [3]. They are proud of their illness, and will do all that they can to advance it. Pictures are posted on forums of jutting clavicles, stick-thin thighs, hollow cheeks, and drumskin bellies. These pictures are in turn torn to pieces by the frequently vicious community, who pick out imagined imperfections and exhort the posters to go to even more dangerous dietary extremes.

Which brings me back to my frustrations.

I could kind of understand the Pro-Ana movement. If I worked at it, I could frame it as a method of coping for mentally ill people – a way of presenting their illness to themselves in a manner which meant that they did not have to feel weak and humiliated by it. While I did not necessarily approve of the method, I understood the motive, and could assimilate it into my non-judgemental view of their illness as a symptom. Indeed, some ostensibly Pro-Ana sites do come from more of a ‘moral support’ angle than an ‘encouraging anorexia’ angle – and that’s kind of laudable when done properly [4]. Where I fell down, however, was on the treatment meted out to other sufferers within the community. Eating disorders are dangerous enough on their own. Many of the eating disorder patients I saw had horrendous trouble drowning out the repetitive thought-cycles in their own heads, which poured scorn and loathing upon them. To have this internal chorus reinforced by the sufferer’s contemporaries on the internet put a lot of my patients in very real danger of death.

I remember one patient in particular – let’s call her ‘Sally’. At the age of sixteen, when Sally should have been studying for her GCSEs, she was instead going back and forth between mental health units, hospital, and her family home. She had anorexia, and – as is so often, sadly, the case – it had not become apparent to her loved ones until her extreme weight loss became noticeable. Generally, by this point the disease has quite a hold upon the patient. This was certainly the case with Sally. However, while in our mental health unit, Sally displayed a willingness to recover which was unusual in anorexia patients. She made determined efforts to eat, and participated to her fullest capacity in our therapies. This gave us a lot of hope. With this kind of attitude, there was no reason why she could not make a full recovery and live a long and happy life. Yet every time she was discharged, she was hospitalised and then sent back to us within months.

What on earth was going on?

Basically, every time Sally was discharged, she’d head straight online. She was seeking support from those who were experiencing the same kind of thing as she was – perhaps tips on how to get healthy. But what she found was her own disease, given voice and writ large across the internet. Her efforts to defeat anorexia were screamed down with extreme vitriol, her body derided as fat and unattractive, her whole life picked apart by the community she thought would help her. Yet she kept on going back. Someone that deep into self-loathing will do anything to gain a sense of ‘tribe’ – even if their chosen ‘tribe’ is almost literally destroying them from the inside out.

Needless to say, I was horrified at the extent of the damage fellow sufferers can willfully inflict upon one another [5].

Sally’s story has a reasonably happy ending. Once her parents discovered what was going on, they began to monitor her internet usage closely, and sent her to a therapist who specialises in helping young adults have a healthier relationship with social media. Sally is on the road to recovery – although it’s likely to be a long journey for her, and the years of anorexia have taken an undoubted toll on her health.

For the hundreds of eating disorder sufferers who get lured into these Pro-Ana forums, however, it may well be a very different story. And that troubles me. It troubles me greatly.

[1] Daniel Boffey, “Leaked report reveals scale of crisis in England’s mental health services”, The Guardian, Feb 2016

[2] Bulimia, “Bulimia Treatment”

[3] Sarah Rainey, “Secretly Starving”, The Telegraph, 2013

[4] Mandie Williams, “Unpopular Opinion: Pro-Ana Websites Were A Positive Influence In Helping Me Recover From My Eating Disorder”, XOJane, Apr 2014

[5] Geraldine McKelvie, “Revealed: Scots student tells how he starved himself to the brink of death after being bullied by anorexia trolls”, Daily Record, Aug 2013