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Anorexic lifestyle thrives as Internet subculture

Not to be glib, but I have developed a recent — and admittedly morbid — fascination for dieting Web sites which, among your typical suggestions for weight loss, include tips on hiding your weight-loss regimen from your parents. One page, titled “ana-by-choice,” offers a list of excuses for not eating: “doctor says I have an ulcer,” for example, or, “I bit my tongue earlier and I think it’s still bleeding.”

The start of a new school year is upon us. Time to dust off the ol’ brain, release the frogs and start wearing shoes again. I don’t know about most of you, but having spent the last three months reading Sherlock Holmes mysteries and watching “The Twilight Zone,” I’m prepared for anything.The anonymous online editor also includes pages from her eating journal, charting the course of her own day-to-day struggle to slim down: “I didn’t eat breakfast or lunch yesterday,” she writes. “For dinner I had a cucumber and low-fat cottage cheese. It’s almost 8 p.m. and I haven’t eaten at all today. Hopefully I won’t eat at all.”

Anorexia has reached the World Wide Web, as it was bound to. Sooner or later everything reaches it. Indeed, we would expect eating disorders to find a comfy little niche on the Net, where a few keyboard strokes and a good search engine are all that is really needed to track down an astonishing accumulation of information. Naturally, Yahoo has an entire category devoted to anorexia nervosa.

Yahoo Health is quick to remind us anorexia nervosa affects roughly four in 100,000 people. Risk factors for the eating disorder include “being Caucasian, having an upper or middle economic background, being female, and having a goal-oriented family or personality.” The page also pointedly mentions several symptoms for anorexia: constipation, dental cavities, yellow skin and absent menstruation. Somewhat obliquely, the page also reminds us that anorexia is, fundamentally, self-starvation.

The page neglects to mention possible outcomes of anorexia, so, in the interests of offering a fair warning to readers, I shall do so. According to the National Association of Anorexia Nervosa and Associated Disorders, 6 percent of patients diagnosed with severe anorexia die of the disorder, while only 50 percent ever recover from it.

The cost of treatment can be extremely high, estimated at $30,000 per month for inpatient treatment and approximately $100,000 per year for outpatient treatment. Physical repercussions associated with anorexia include serious heart, liver and kidney damage, intestinal ulcers, possible ruptured stomach and tears of the esophagus. If these facts are news to anybody, I will be greatly surprised. The media has done a better-than-adequate job of covering the subject of eating disorders, particularly the profound physical decline brought about by the disease.

What the media doesn’t cover, however, is the subculture of anorexia. And, at least on the Internet, it is a thriving subculture. If we take a detour from Yahoo’s fairly responsible collection of links and instead click on a selection of links labeled “Pro-Anorexia,” we find another world altogether.

In all fairness, Yahoo itself lists only three sites, only one of which could genuinely be viewed as actually encouraging eating disorders (to track down other pro-ana Web pages, you must follow links, as many servers refuse to list them). Yahoo lists “The Thin Page,” which follows the belief that “people have the right to control their bodies and weight as they see fit. I am opposed to the censorship of pro-anorexia Web sites, and to forced treatment of anorexics who repeatedly and vehemently turn down help. I am opposed to friends, family and any other people who may attempt to forcibly take away our right to live as we please.”

The words “forced” and “forcibly,” it should be noted, are bolded on the original page.

“The Thin Page” begins with a Web log that chases down various dietary statistics and offers complex meditations on the subject of body image. On Aug. 21 of this year, as an example, the anonymous author of “The Thin Page” cited Focault’s “Madness and Civilization.” Our author writes, “I began to think about how similar his description of the way that the mentally ill are hidden in our culture from ‘normal people’ was to the degree of comfort people have with seeing clearly anorexic people, or even finding pro-anorexia pages on the Web.”

Most pro-ana Web pages avoid such navel-gazing, and there is grist on “The Thin Page” for a dozen or so senior theses on society and body image. “The Thin Page,” however, links to the previously mentioned “ana-by-choice,” and this is more typical of the genre. As is often the case, it is a page that opens with a warning in bold lettering: “You are solely responsible for the decisions you make. This site, its owners and its affiliates bear no liability for the choices you made/make nor for any harm that came to you as a result thereof. This site does not encourage that you develop an eating disorder.

“This is a site for those who ALREADY have an eating disorder and do not wish to go into recovery. Some material in here may be triggering. If you do not already have an eating disorder, better it is that you do not develop one now. You may wish to leave.”

The use of the word “triggering” is perplexing here. It’s full of jargon, suggesting that people new to the page already know a little bit about the language of eating disorders. “Triggers,” in this instance, refer to information or images that might encourage anorexia, such as photos of super-thin models that anorexics frequently carry in their purses or hang in their lockers, which they then refer to as a sort of totem against eating.

“The Thin Page” is plastered with such images: A section titled “Galleries” consists of page after page of skeletal runway models revealing sunken faces, protruding cheekbones and pipe cleaner-thin arms and legs (some of the images seem to have been printed to be especially narrow, thinning the models further).

And, along with the supermodel snapshots, there is dietary advice, a constant on these pages. A Web page entitled “Totally in Control,” for example, has a long list of suggestions for the struggling anorexic. These hints are so similar in content to suggestions found on other sites, even down to their very wording, that I suspect that pro-ana sites often simply lift each other’s contents in entirety. Indeed, sometimes it seems that there must be a pro-ana template out there someplace, so completely do these starving Webmasters reduplicate each other’s efforts.

Most unnervingly, they constantly list the same few arguments: We know we are anorexic, we choose to be anorexic, so why don’t you just leave us alone? A defiant message that constantly scrolls across the top of the “Totally in Control” page reads, “It’s my life and how I live it don’t affect nobody else but me.”

Despite her rebellious attitude, the author of “Totally in Control” seems anything but in control, as demonstrated by her self-castigating journal. These journals are also common to the sites, usually combining a diet inventory with shamefaced admissions of binges. The language used in these journals is often quite troubling, such as the author of “Totally in Control” mentioning that “I don’t think I’ve lost very much, though, because I’ve been a bad girl.” One Web page, entitled “ana’s underground grotto,” includes a section for poetry, and it is here that various pro-ana writers wrestle most honestly with their eating disorder.

The authors of these Web pages make constant, vague comments about the dangers of anorexia — they recognize it as an eating disorder, but insist it is their right to refuse treatment. But here they address the subject most compellingly. “My wrists are nothing but bone and skin,” one writes, “My arms long and lean. Only a little bit left, only a little more to go.”

Another, chillingly, opens a poem with these words: “I hate this. To eat is to die, and to starve is to live.”

Max Sparber’s column appears alternate Tuesdays. He can be reached at [email protected].

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