Pro-Ana is a term used for online forums and chat rooms regarding eating disorders, particularly anorexia. The term began to appear on the web in 2001. Pro-Ana forums exist to this day as a way for individuals with eating disorders, most commonly anorexia nervosa, to share support, anecdotes, advice, and a venue to discuss a socially stigmatized psychological disorder. There are three types of Pro-Ana communities: Lifestyle Communities, Thinspo Communities, and Support Communities. The users of lifestyle communities are commonly within their eating disorders and not seeking to change their behavior, so these communities are sources of sharing eating habits and ways to prolong their disorders. Communities that focus on thinspo, also referred to as "thinspiration" (a portmanteau of the words thin and inspiration), share photographs, phrases, and other content that has the intent of motivating, triggering, or inspiring users with anorexia to continue within their lifestyle, rather than seeking treatment or recovery. Support communities are used to provide emotional support through sharing anecdotes and hosting discussions, and often regularly state that their community is not encouraging or promoting anorexia. Several individuals also use the term "Pro-Ana" to spread awareness about the illness and provide support to those in need. Ethical concerns include claims that Pro-Ana communities cause anorexia to spread and age regulations for Pro-Ana communities and other similar sites.
Types of Pro-Ana Communities
There are three major varieties of Pro-Ana communities populating the internet. Some sites are a combination of these types, however these types categorize essentially all communities in the pro-ana internet.
The first type of Pro-Ana site is one that is a place of convergence for those who have not been diagnosed with an eating disorder by a medical professional, and additionally for those who may not be seeking treatment for their eating disorder. Some pages in this category feature moral codes for a Pro-Ana lifestyle, including tips for staying thin, extreme dieting, calorie restriction, ways to conceal their habits from family and/or friends, and various tools for viewing the world in a way that is consistent with anorexia. These types of sites often personify the disordered eating, framing it as a sort of companion in the daily lives of members.
Some sites even refer to anorexia, the disease, as a sort of character named "Ana." Sometimes Ana takes the form of an angel, a woman with a very thin body type, or sometimes Ana remains more of a mental reminder to people on these sites.
Thinspo communities are typically focused on sharing images of anorexic-perceived "ideal bodies." These images often emphasize the presence of bones under skin and very thin (primarily) women including high fashion models. Additionally, fitspiration or "fitspo" falls under this category as well. These images often emphasize svelte, athletic, toned muscle bodies, again the vast majority being women. Furthermore, in these communities, users share their goal weights, discuss their daily calorie intakes, and provide information about how they are living day to day with their eating disorder.
The third category represents the most commonly found Pro-Ana community on the web today. These groups offer support and raise awareness and tolerance for eating disorders. Since anorexia nervosa is a shame-based behavior in many cases, the anonymity of the internet provides a safe platform for many users to be more candid in regards to their eating habits, and often makes users more inclined to seek help and support.
Although these websites (the most prominent of which is www.PrettyThin.com), provide support for those suffering from disordered eating, they do not include tips on purging, fasting, or hiding food, and do not include “thinspo” threads.
Ethics of Pro-Ana
Pro-Ana forums were initially used as a way for many sufferers of anorexia (mostly young women) to converge and seek help from other affected persons. Backlash was caused by a lack of medical reliability in the dieting suggestions that were posted, leading to a fear of negative health consequences for community members. Further criticism of Pro-ana forums regards the type of support offered by community members, namely for encouraging and further perpetuating other members' disorders and poor eating habits. Nevertheless, supporters argued that the sites raised awareness for those afflicted with the disorder and were vehicles to further rights and tolerance for sufferers. Those who oppose the forums argue that they exist to ‘recruit’ others into disordered eating patterns, or seducing them into anorexia with false information.
The vocal minority who strongly opposed Pro-Ana websites saturated the mainstream media with examples of casual dieters who contracted eating disorders after visiting these types of forums. According to an article in Cambridge Common, a blog originating from Harvard students, “The very notion that the internet will give you an eating disorder is lewd to begin with. It’s not a computer virus that will infect you too.” However, once word spread that individuals fell to anorexia nervosa after having visited Pro-Ana forums, even long-time users began to defect from the sites, and after a short time almost all of them were disbanded or left virtually empty.
While it is difficult to prove that pro-ana sites encourage eating-disorders, researchers have voiced concerns about the social mirage, or illusion of support, that the sites create. ProAna community members can receive short term relief from the sites by gaining a sense of support, connection, and social interactions that they lack in their offline lives. Some worry that the physical, psychological, mental, and emotional consequences of managing an eating disorder require more committed relationships than those that are formed in online communities. 
Even third-category websites, such as www.PrettyThin.com, mentioned previously, have steep regulations placed on them in the wake of the media firestorm surrounding Pro-Ana sites in the early 2000s. Although the forum offers support and does not encourage unhealthy behavior or “thinspo”, and encourages healthy eating habits, looser control on calories, and moderate exercise as methods for weight control, there is still some censorship that occurs on the website. For instance, there are places for users to share their personal stories, as is consistent with the form of a rehabilitation program. However, users under the age of 18 cannot view these posts, and 18 years of age is a common age cutoff for many popular Pro-Ana forums. This, however, is inconsistent with the fact that anorexia nervosa is a common disorder in girls aged 13-18 .
Many new cases that seek help in the information age do so over the internet, and those cases who are in the most popular age group for new cases of anorexia can often not receive online support due to censorship, which is largely a backlash to type-one Pro-Ana forums, most of which no longer exist, and can be detrimental to the physical and psychological well-being of individuals who suffer from anorexia nervosa. Some common forum sites have sought to censor pro-ana supporters under the argument that freedom of expression is limited if the content causes harm to others. Others argue that censorship of ProAna sites would lead to relocation and further isolation of the community, making it increasingly difficult for physicians, families, and charities to reach out.
Support for Pro-Ana Websites
In 2014 the Italian Parliament proposed a bill targeting those who encourage eating disorders, primarily pro-ana and pro-mia websites.  The bill would either give jail time or large fines to those found guilty. Antonio Casilli, an associate professor at Telecommunication College of the Paris Institute of Technology, argued in a Medium blog post that while the bill has good intentions, it fails to understand and find a solution to the problem, which may result in a public health disaster.  In a study modeling a pro-ana forum by Casilli and colleagues, they found that pro-recovery discussions are more likely than radical anti-recovery discussions. 
French model and actress Isabelle Caro died in 2010 at the age of 28 from her anorexia, which she was reported to have suffered from since the age of 13. She was enormously involved in spreading information about the harm of the disease in its later stages, which include hair loss, the cessation of menstruation, organ failure, and eventually death. In her most prominent role, she posed nude for an Italian fashion house's campaign against anorexia, revealing her extreme state of physical deterioration (NSFW). Caro is credited as an important figure in spreading information of what the disease is actually like once it progresses beyond the stages shown in most "thinspo."
Kenneth Tong, a native of Hong Kong who achieved celebrity as a result of his participation in Big Brother UK, has announced plans to launch a diet based upon his theory of "managed anorexia." He claims that all people can achieve a size zero, that thinness is associated with success, and that it's "not okay" to be plus sized or fat In an interview with noted journalist Johann Hari, Tong displays an incredible misunderstanding of what anorexia is as well as the natural variation in size of the human body's skeletal system. He also confirms he has no medical training or medical advice on his diet plan, and Hari insinuates several times that he displays a sociopathic contempt for other people and should seek profession psychiatric help. His twitter page confirms his contempt for the non-wealthy as well as those sized larger than zero.
- Brotsky, S. Giles, D. "Inside the "Pro-ana" Community: A Covert Online Participation Observation". Routledge Taylor & Finance Group. 2007.
- "Eating Disorders" The Ohio State University Wexner Medical Center
- Casilli, Antonio. "An open letter to the Italian Parliament against the criminalization of 'pro-ana'" Medium, (19 August 2014. Retrieved 21 April 2017.)
- Casilli, Rouchier, and Tubaro. "How to Build Consensus in a Health-Oriented Online Community: Modeling a 'Pro-Ana' Forum"(25 January 2015. Retrieved 21 April 2017.)
- "Isabelle Caro Dead: Anorexic Model Dies at 28" Huffington Post,(Retrieved 21 April 2017.)
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