"We're not deciding that anorexia is wrong. It just IS wrong."
November 25, 2008 7:40 AM Subscribe

Pro-Anorexia Group presence ballooning on Facebook.

Anti-Pro-Ana groups try to shut them down. Anti-anti-pro-anas complain about it, or say that antagonism will just fuel the disease.
Is it a Free Speech issue? Not in France.
Should facebook ban them? Or is the increased spotlight the first step to getting healthy?
The latest in a series of mainstreaming by this movement.

posted by Potomac Avenue (159 comments total) 10 users marked this as a favorite

how exactly is this different from the alarm they were on Livejournal?
posted by parmanparman at 7:42 AM on November 25, 2008 [4 favorites]

Ballooning?
posted by exogenous at 7:47 AM on November 25, 2008 [39 favorites]

I feel like although this is new, it's still really a double because we've all had this conversation here a couple of times and I think the general consensus has been:
1. anorexia is bad; 2. social groups do flourish; 3. we should support people who are anorexic; 4. some people simply cannot be reached.
posted by parmanparman at 7:51 AM on November 25, 2008 [2 favorites]

Ballooning?

Are they really ballooning or is it just that they feel like they are getting bigger?
posted by Pollomacho at 7:54 AM on November 25, 2008 [17 favorites]

Oh man, I've been looking for a new vertical for my facebook app company. Just think of the data tracking and the viral marketing hooks you could do with a little PHP.
posted by Nelson at 7:58 AM on November 25, 2008

PreAnorexia group presence growing large on Facebook

PreAnorexia group presence gaining weight on Facebook

PreAnorexia group presence being a fucking lardass on Facebook
posted by nitsuj at 8:00 AM on November 25, 2008 [10 favorites]

Isn't it THE Facebook?
posted by Mister_A at 8:02 AM on November 25, 2008 [1 favorite]

parman: After reading the older threads, it seemed to me that this article's big news is that these Facebook groups are, unlike LJ or various forums, exposing real names and faces. There's a big difference between anonymously joining a shadow community online and claiming the community as part of your mainstream online lifestyle.
posted by Potomac Avenue at 8:03 AM on November 25, 2008

Wait, "anti-anti-pro-ana"?

Are we supposed to be reducing these down like fractions or something?

And what about the pro-anti-anti-pro-anti-ana people? What are they saying? I just don't get it. Internet arguments should not get this dysfractionated.
posted by Spatch at 8:07 AM on November 25, 2008 [1 favorite]

balloon-knot
posted by docpops at 8:07 AM on November 25, 2008

The 20th Century called. It wants its moral panics back.
posted by Non Prosequitur at 8:09 AM on November 25, 2008 [5 favorites]

This thread isn't going to end well, but at least it will be thin.
posted by DU at 8:10 AM on November 25, 2008 [3 favorites]

Just wondering.. Isn't anorexia kinda like smoking? It's life threatening and stupid , but ultimately it's YOUR choice to do to yourself?
I"m not trying to be sarcastic. Is it because it preys on ignorant girls who want to be skinny? Otherwise it seems like it could be a person's right to starve themselves into a skeleton.
posted by Liquidwolf at 8:11 AM on November 25, 2008 [1 favorite]

Isn't anorexia kinda like smoking? It's life threatening and stupid , but ultimately it's YOUR choice to do to yourself?

No.
posted by Sys Rq at 8:13 AM on November 25, 2008 [13 favorites]

Yes.
posted by Durn Bronzefist at 8:15 AM on November 25, 2008 [1 favorite]

No. Yes.

I think I understand now.
posted by Liquidwolf at 8:19 AM on November 25, 2008 [16 favorites]

It's a mental illness. People don't starve themselves to death just because.
posted by showbiz_liz at 8:20 AM on November 25, 2008 [1 favorite]

Just wondering.. Isn't anorexia kinda like smoking? It's life threatening and stupid , but ultimately it's YOUR choice to do to yourself?
I"m not trying to be sarcastic. Is it because it preys on ignorant girls who want to be skinny? Otherwise it seems like it could be a person's right to starve themselves into a skeleton.

Instead of "just wondering" try "just reading" or "just researching".
posted by srboisvert at 8:20 AM on November 25, 2008 [15 favorites]

The predatory aspect of these sites is what makes them so appalling. For some of the people who apparently find starvation alluring there may not be any sense in trying to reach out to them, but the idea that they propagate their ideology in a forum where my kids may eventually wind up is as nauseating and predatory as a pedophile typing away in a chatroom pretending to be a ten-year old little league shortstop.

Fuck them and their narcissism.
posted by docpops at 8:21 AM on November 25, 2008 [4 favorites]

Otherwise it seems like it could be a person's right to starve themselves into a skeleton.

It is also a person's right to scoop out their own eyes with a melon-baller. Yeah, they can do it. It's why they do it that's the problem. It's called mental illness. And that ain't no choice.
posted by Sys Rq at 8:22 AM on November 25, 2008 [20 favorites]

People don't starve themselves to death just because.

Anorexics don't have death as a goal, if I understand the intent.
posted by docpops at 8:22 AM on November 25, 2008 [1 favorite]

Instead of "just wondering" try "just reading" or "just researching".

Sorry professor, I thought this was a discussion.
posted by Liquidwolf at 8:23 AM on November 25, 2008 [7 favorites]

Liquid: Even if one was to claim that anorexia was a valid, if stupidly dangerous, life choice rather than a treatable mental illness (which is the usual medical diagnosis) the question, as you said, is whether websites than encourage people to discuss how it works are dangerous themselves because they "prey on" impressionable kids.

Would facebook allow a user group for preteens to encourage each-other to smoke? (This analogy will self-destruct in 30 seconds...)
posted by Potomac Avenue at 8:31 AM on November 25, 2008

If you have ever had the symptoms, you would know that pro ana/mia sites are quite comforting. The attention one gets when anorexic CAN be a way for the anorexic to feel successful and thus begin attempts at recovery, but what is crucial is the "thinspo". Anorexics need the thinspiration, and they need to be told that they look like their thinspiration. It is comforting because the validation needed to survive comes from the illness itself.
posted by johannahdeschanel at 8:32 AM on November 25, 2008

Wow. Has Metafilter initiated a zero-empathy policy, or is there a butt load of idiots in this thread.

Anorexia is a mental disease. Like a lot of mental diseases, it's devastating for all involved. This includes those who have the disease, and the families and friends that have to deal with the fallout.

If you think it's not a serious thing, then you know nothing. Anorexia Nervosa has the highest death rate of any of the well documented mental diseases. It's not equivalent to smoking, and if you're going to make jokes about it, then I'll be expecting you to turn up to equivalant threads about depression, schizophrenia, etc.
posted by seanyboy at 8:35 AM on November 25, 2008 [23 favorites]

Wow. Has Metafilter initiated a zero-empathy policy, or is there a butt load of idiots in this thread.

It at some point becomes difficult in this life to continue tearing one's self up over what others do to themselves.
posted by xmutex at 8:40 AM on November 25, 2008 [11 favorites]

Fuck them and their narcissism.

I worked with anorexic women in college, and while it's very easy to unscrupulously incriminate young women who starve themselves for being frivolous and even dangerous to their peers, it must be emphasized that yes, anorexia is a disease.

Healthy people, no matter how badly they want to be skinny, can rarely starve themselves, especially not to the point of collapse, hospitalization and death. This bears repeating: healthy people do not starve themselves to death. It is literally counterintuitive, on the most basic of biological levels, to starve your body to a skeletal condition if you have the resources to assuage hunger. Most (no, not all) neurologically typical people will break down and scarf a loaf of bread when they're at the brink of starvation, so the ability to abstain from self-nourishment generally attests to some seriously, potentially fatally off-balance neurological symptoms.

Younger and younger girls are going on diets, and this bespeaks some deeply messed up cultural values that they're metabolizing, but to conflate their poor body images with neurological disorders is not only unfair, it's placing the blame on the shoulders of sick people when that blame belongs squarely on cultural empires that worship thinness as an aesthetic.
posted by zoomorphic at 8:42 AM on November 25, 2008 [24 favorites]

My eyes, my choice, Sys Rq.
posted by stinkycheese at 8:45 AM on November 25, 2008

This might be a good time for people who exercise prudent skepticism in other threads dealing with mental illness to do so here. Something is not a "mental disease" because it is serious, because it can lead to death, because it affects a large number of people.

As for targeting children, yes, the tobacco industry does that, and with millions of dollars and concerted effort. Is choosing to give yourself cancer a sane choice? Do you know how widespread lung cancer is? All of that is beside the point that Liquidwolf was making, but do go on. I expect some name calling next, just to round things out.

This bears repeating: healthy people do not starve themselves to death.

Unhealthy does not necessarily = diseased, but I don't actually expect open discussion of this topic so I'll bow out.
posted by Durn Bronzefist at 8:45 AM on November 25, 2008 [4 favorites]

What's the skinny with Facebook these days?
posted by gman at 8:46 AM on November 25, 2008 [1 favorite]

Part of the problem lies with the inadequacy of the term "Mental Disease". Snarkers here see choice and agency, both of which are indubitably part and parcel of an objective description of anorexic behavior. Others correctly class it with the most serious of disorders. Mental illness is not somatic illness, and it includes the whole "person", and their agency, will, etc. Given our current descriptive terms, the snark/empathy dichotomy will persist and persist and persist. Goddam.
posted by fcummins at 8:47 AM on November 25, 2008 [9 favorites]

Developing anorexia is not a choice, but rather an illness. It would be hard for someone without the predisposition to the disorder (either by genetics or personality traits) to 'make' themselves anorexic.

However, the premise of these groups and sites is that while the women don't choose to develop the illness, they do choose to maintain it. Many do not have death as a goal, and do not try to 'recruit' others. I spent a year researching and observing these groups as a part of my senior psychology thesis, and I concluded that the lack of adequate, compassionate treatment for anorexia is spurring these groups. Control is a huge factor in an eating disorder, and almost all treatments and treatment centers for eating disorders rob patients of that control. They are forced to eat, forced to be weighed, forced to participate in treatment, etc. They are infantilised, often treated as petulant, wayward children instead of grown women capable of making their own decisions.

Over the years, mental health treatment in general has made great strides in terms of becoming more compassionate, more empowering, and incorporating patient/client choices into treatment. The focus has shifted from a medical, cure- and disease-centered model to a recovery based model that deals with management of the illness, and empowers people to examine their choices and learn to adapt to their environment and illness. Eating disorder treatment has largely fallen behind in this movement.

Furthermore, the excoriation of these pro-ana groups in public only reinforces these women's negative perceptions of treatment and of society as a whole. I've read many articles where so-called eating disorder 'experts' and 'specialists' have ridiculed the movement, and called the women who take part "stupid," "appalling," and "shameful." Would YOU want to turn to these people for help if you were a part of a pro-ana group?

These individuals and groups need to be treated with compassion. The eating disorder experts need to let go of their rigid, one-size-fits-all notions of treatment, and work to catch up with the rest of mental health professionals and treatments.
posted by catwoman429 at 8:51 AM on November 25, 2008 [20 favorites]

hurf durf nothing-eaters
posted by M.C. Lo-Carb! at 8:53 AM on November 25, 2008 [16 favorites]

xmutex:

Anorexics don't wilfully do this to themselves. There's a couple of comparisons to make here.

Firstly, nobody accuses schizophrenics of deliberately hearing voices. Anorexics suffer a different but more life threatening distortion of perception. In tests where people have to estimate how wide they are, anorexics regularly overcompensate by huge margins (normal people tend to overcompensate by 5-10%; anorexics overcompensate by three times this.)

Secondly, mental illnesses regularly come with weird compulsions. Telling someone with OCD to stop washing their hands isn't going to make them better. Assuming that the constant handwashing is a deliberate thing would be naive. You know this for OCD, but you don't seem to be able to grasp the compulsive nature of anorexia. (despite what has been said in this thread)

Anorexia kills a higher percentage of people than more recognised mental illnesses. If you're going to care about something and you've limited time, then this is the one to care about.

Also: Boyzone. amirite.
posted by seanyboy at 8:54 AM on November 25, 2008 [11 favorites]

johannadeschanel: It's interesting that you'd say that because most opponents of these sites say that the comfort one gets just leads to getting sicker.

Certainly being ashamed and feeling alone can't be helpful, but how can being told that what you're doing is fine and normal help you overcome the self-aggrandizing fantasies that are part and parcel the disease?

I just watched Bender's Game last night and when Bender goes to the hospital Frye picks up a pamphlet entitled "Mental Illness: It's OK to Feel Ashamed!"

In full disclosure I find these sites tread the thin edge of Free Speech after my experiences with them, wherein an ex who was only normally deranged developed full blown Ana after researching their forums for her profession. It was almost exactly as if she had been recruited into a cult. So while I believe that some may get better through these communities, most seem to just get worse and worse. In fact, the tips they get may allow them to continue to live with the disease for much much longer without getting too physically ill or even looking horribly thin.

fcummins: Great points.
posted by Potomac Avenue at 8:55 AM on November 25, 2008 [2 favorites]

Moral issues aside, the fact that certain groups like this have their own support networks is fascinating. Just dieting is a contest of will versus body -- with the body usually winning, as it hates losing weight and will kick and scream and make you feel sick and make you feel light-headed or panicked just to trick you to eat. These groups really show the amount of work it takes to be anorexic. It takes so much time and energy, and it's sort of fascinating to learn the tricks that anorexics use to overcome their bodies' needs. I want these girls (or, mostly girls) to get help and get well, but I can't help but have a perverse curiosity about the culture they have built for themselves.

And, for people who specialize in dealing with anorexics, I must assume these Web sites are a gold mine in finding out tactics, and well as the strange reasoning, that goes into making an anorexic. Some mental illnesses are not so forthcoming about how they work and why.
posted by Astro Zombie at 8:56 AM on November 25, 2008

I miss Pro-Scurvy.
posted by brownpau at 8:58 AM on November 25, 2008 [3 favorites]

Isn't it THE Facebook?

The Monarch: "I have been blogging!"

Oh, this? Yeah, it's the exact same thing as when they were on LiveJournal, and when they had GeoCities websites before that. It's probably even some of or even mostly the same people. They just moved to the most popular platform like everyone else.
posted by DecemberBoy at 9:11 AM on November 25, 2008

Healthy people, no matter how badly they want to be skinny, can rarely starve themselves, especially not to the point of collapse, hospitalization and death. This bears repeating: healthy people do not starve themselves to death. It is literally counterintuitive, on the most basic of biological levels, to starve your body to a skeletal condition if you have the resources to assuage hunger.

Well there's no doubt that some anorexics are totally crazy. But not every girl who self-starves ends up skeletal, collapsing, hospitalized or dead.
posted by delmoi at 9:18 AM on November 25, 2008 [1 favorite]

Plunging yourself into debt buy clothes, makeup and pay for plastic surgery is a choice. Looking in a mirror and seeing a hugely distorted image of yourself so much that you starve yourself until you can't function and eventually die, is not a choice, its an illness.

I'm not so sure facebook should be banning these groups so much as trained counselors should be joining them and trying to convince these individuals to seek out help.
posted by captaincrouton at 9:18 AM on November 25, 2008 [2 favorites]

Secondly, mental illnesses regularly come with weird compulsions. Telling someone with OCD to stop washing their hands isn't going to make them better. Assuming that the constant handwashing is a deliberate thing would be naive. You know this for OCD, but you don't seem to be able to grasp the compulsive nature of anorexia. (despite what has been said in this thread)

Mental illness and choice are not mutually exclusive. Mental illness influences and limits your choices, it doesn't replace them and mentally ill people are (mostly) still more-or-less responsible for their actions. Telling someone with OCD to stop washing their hands might not be a very effective method of persuasion, but that doesn't mean that the person with OCD doesn't have a choice in the matter.

Back when I was mad (and on entirely the wrong medication), I damaged my wrist badly enough that I had to get it surgically repaired. That was a choice, and though it wasn't a great or very rational choice, it was definitely still my choice to damage myself. If it wasn't a choice and I wasn't responsible for it, then what about all the times I didn't hurt myself when I wanted to?

fficult choices are still choices. What about the anorexics who recover, or manage their illness well? Are you really saying that these people weren't able to make choices or that making healthy choices wasn't tough for them?
posted by xchmp at 9:22 AM on November 25, 2008 [6 favorites]

Catwoman nails it. Want to ensure that the most fatal mental health disorder won't get taken seriously amongst armchair nay-sayers and real psychologists? Make sure it affects primarily young women, since they're capricious little ditzes anyways.

If a bunch of middle-aged men suddenly became addicted to starvation thanks to neurological control issues, would we so cavalierly discount anorexia as narcissistic, and would men feel so isolated that they'd resort to secret, enabling pro-ana sites? No, we'd have official "Pro-Rex" resources that didn't discount the validity of the sufferers' conditions.

Look at Metafilter's fixation over Asperger's, a virtually 100% non-fatal condition that affects men more than women, and whose authenticity as a valid mental disorder is still hotly debated in many circles. We could just wipe our hands of Aspies for not knowing how to socialize with finesse, but this has been one of the most accepting general communities for the neurologically atypical. Could anorexic young women get a tenth of the compassion that we give so generously to Aspie guys?
posted by zoomorphic at 9:24 AM on November 25, 2008 [57 favorites]

In full disclosure I find these sites tread the thin edge of Free Speech after my experiences with them, wherein an ex who was only normally deranged developed full blown Ana after researching their forums for her profession. It was almost exactly as if she had been recruited into a cult. So while I believe that some may get better through these communities, most seem to just get worse and worse. In fact, the tips they get may allow them to continue to live with the disease for much much longer without getting too physically ill or even looking horribly thin.

This is very true. Anorexics band together, competing with each other, encouraging each other, and giving each other tips on how to get thinner. If I had a daughter with an eating disorder, I would keep her as far away from other anorexics as I could. I have also read that educating kids about anorexic doesn't work as a preventative tactic, though educating parents does.

And of course I support free speech, but as everyone knows, free speech has its limits. I'm not going to state categorically that all pro-ana groups on Facebook should be shut down... but I think the possibility should be examined.
posted by orange swan at 9:25 AM on November 25, 2008 [1 favorite]

Are there pro-suicide groups on facebook? I would assume Facebook has policies against this sort of thing. For their own selfish legal reasons, if nothing else.
posted by naju at 9:28 AM on November 25, 2008

My empathy for anorexics ends at the point where prosetlyzation begins.
posted by Pope Guilty at 9:30 AM on November 25, 2008 [3 favorites]

xchmp: That's fair comment.

also, fcummins said "Mental illness is not somatic illness, and it includes the whole "person", and their agency, will, etc.". I wish I had said that.

My point was (I think) that anorexia shouldn't be defined as "not an illness" simply because the people who suffer from it could eat properly if they wanted to. Obviously, the concious mind is a complex thing and choice, responsibility and control play important roles during all stages of this disease.

To be honest, this isn't something I know a huge deal about. I just know enough to know that it's a serious thing that people treat too lightly.
posted by seanyboy at 9:31 AM on November 25, 2008

Thin may have a taste all its own; I'm willing to bet that it's nothing like this roast beef and pepperjack cheese sandwich I'm scarfing down right now.
posted by adipocere at 9:32 AM on November 25, 2008

Zoomorphic: Indeed, the problem with prescribing compassion is that, much like with the disease of alcoholism or drug-addiction, the more compassionate you are the more the sick person will abuse it and lie to you.

(And to be fair Aspies are way more irritating IRL than they are on internets).

Catwoman and others: Is it compassion to allow these kinds of online communities to exist, or enablement?
posted by Potomac Avenue at 9:34 AM on November 25, 2008 [1 favorite]

(Oops, I should've read the article. Yes, they do have firm policies against this.)

Anyway, this debate reads like something from the 1970's.
posted by naju at 9:35 AM on November 25, 2008

I don't buy that anorexia is on the same level as schizophrenia at all. I think it's patently ridiculous to assert such a thing. If you can show me some evidence of such a thing, I'd be all ears. By and large we've seemed to turn the idea of mental illness into a catch-all to avoid personal responsibility for any of our actions.
posted by xmutex at 9:36 AM on November 25, 2008 [13 favorites]

wtf mefi? maybe $5 is to low...
posted by Jeremy at 9:37 AM on November 25, 2008 [3 favorites]

"Could anorexic young women get a tenth of the compassion that we give so generously to Aspie guys?"

Yes.
posted by aerotive at 9:37 AM on November 25, 2008

In tests where people have to estimate how wide they are, anorexics regularly overcompensate by huge margins (normal people tend to overcompensate by 5-10%; anorexics overcompensate by three times this.)

This part of anorexia I get. The part I don't get is how they also have difficulty realizing that joining groups supporting their life-threatening mental condition is a bad thing. Is it common that people afflicted with these sorts of conditions become simultaneously blinded to the fact that the condition is a problem? Is it a failure of rationalization, or of self-assessment?
posted by 0xFCAF at 9:38 AM on November 25, 2008

Look at Metafilter's fixation over Asperger's,

You mean the standard reaction of "no you don't have Aperger's"?
posted by smackfu at 9:38 AM on November 25, 2008

The difference is very few people secretly suspect they might have anorexia. Online, everybody sort of thinks they have Asperger's.
posted by Astro Zombie at 9:43 AM on November 25, 2008 [2 favorites]

adds anorexia to increasingly lengthy list of topics that do not go well on MetaFilter
posted by fixedgear at 9:48 AM on November 25, 2008 [1 favorite]

By and large we've seemed to turn the idea of mental illness into a catch-all to avoid personal responsibility for any of our actions.

Can you feel that? 'Cause I'm favoriting you that hard.

I do believe anorexia is a real mental disorder (I'm not as sold on Asperger's, and most certainly for every 10 that claim to have it 1 actually might), but your larger point is spot on.
posted by DecemberBoy at 9:49 AM on November 25, 2008 [1 favorite]

xmutex: If you had anything to contribute here other than opinion, I'd probably try and do just that.

You're not going to change your mind and it's not my job to teach you about the world.
However - Might I suggest you spend a bit of time working out (in this thread) who are those who might actually know more about this subject than you and LISTENING to them.
posted by seanyboy at 9:52 AM on November 25, 2008

(I'm assuming this "boyzone" comment was meant seriously and have started a MeTa on the subject. Um, sorry, but at least I'm not derailing the thread.)
posted by grobstein at 9:54 AM on November 25, 2008

The most pernicious mental illness in modern society is the persistent belief that uninformed, uneducated opinions are just as valid as informed, educated ones, seanyboy.
posted by Astro Zombie at 9:55 AM on November 25, 2008 [26 favorites]

By and large we've seemed to turn the idea of mental illness into a catch-all to avoid personal responsibility for any of our actions.

And in other Daily Mail news - Kids seem to be out of control these days, single mothers deliberately get pregnant and you used to be able to leave your front door unlocked. Get Off My Lawn.
posted by seanyboy at 9:55 AM on November 25, 2008 [6 favorites]

I think anorexia is more like a substance abuse disorder than it is like "organic" mental illness (schizophrenia, for instance). There is probably a genetic predisposition, but environmental factors must be in place for the disorder to manifest clinically. And, like alcoholism or other substance abuse disorders, I contend that anorexics must take responsibility for their behavior, and cope with the demons that drive them to that behavior, in order to heal. Anorexia, like schizophrenia, is a real and dangerous disorder, but the natural history of the disorder, and the appropriate treatments for it, are very different.

Another thing to keep in mind when discussing mental illness is that substance abuse and eating disorders are often comorbidities accompanying other mental illnesses, like bipolar disorder, depression, borderline personality, or schizophrenia. In cases where patients have substance abuse issues and underlying mental illness, bipolar disorder for instance, the substance abuse must be brought under control before you can really effectively treat the bipolar disorder. I am not sure the same is true with an anorexic bipolar patient, but I suspect it is.
posted by Mister_A at 9:59 AM on November 25, 2008 [6 favorites]

I specifically and intimately know two people who became anorexics after they identified that influential personalities in their social groups were anorexic.

It was like a club. They had their coded language, symbolic images, rallying cries, gathering places, and, if they worked very hard, the obvious physical state. They coached each other. They were like AA sponsors - talking each other out of yoghurt cups and pieces of toast. One of the sets would weep for the poor souls who gained or had loved ones initiated medical intervention.

This was extremely eye-opening for me. I'd only ever known "solitary" anorexics (& bulemics) before those individuals. They had no shame, and were, in fact, defiant about their "choice".

And anyone who didn't know their situation would be hard-pressed not to compliment them on their figures and fashion sense, as this was where they expressed their creativity and pride in their "accomplishment"...at least until it goes too far - since the body really does have limits - and it all starts looking skeletal and sickly.

They didn't care, though. They all had this broken view of what a body should look like and they'd reinforce themselves and each other. I saw it as merciless and madness, but they felt like this was the kind of support and control they wanted in their lives and nothing could shake them from the assertion. Nothing.

I can see both sides of their issue. I even empathise with them, to be honest. But I've seen this...fixation spread and nearly destroy people who were already dealing with heavy burdens. And I'm a lucky one. Other people I know have loved ones who did destroy themselves with it. I don't think it should be so easy for them to form communities which validate their dangerously imperfect understanding of physicality and especially not when it can be communicated to people who didn't start out with it.

Bringing up other things like smoking and even over-eating can lead to interesting conversations, but I don't think those conversations quite fit the focus of this post, which is about anorexia. If you start that broader conversation somewhere, though, I'd like to know about it.
posted by batmonkey at 10:03 AM on November 25, 2008 [12 favorites]

Might I direct you to this thread?

More on topic, however, it seems to me that the proliferation of these kinds of support groups, regardless of venue, indicates how close to the surface of mainstream this issue is.

And that is, because we venerate thinnness? What about the clear sociopathy that we idealize in people like Donald Trump or "Chainsaw Al"?

The difference between madness and genius is success. The difference between Kate Moss and my own beautiful, thin daughter is several hundred thousand dollars a year.
posted by Xoebe at 10:03 AM on November 25, 2008

I'm sure Facebook's love of dishing all young women "targeted ads" about weight loss drugs, skinny superfoods, and celebrity diets is not contributing to this problem at all.
posted by almostmanda at 10:06 AM on November 25, 2008 [15 favorites]

Mister_A: I think anorexia is more like a substance abuse disorder than it is like "organic" mental illness (schizophrenia, for instance). There is probably a genetic predisposition, but environmental factors must be in place for the disorder to manifest clinically.

Pardon, isn't this true of just about any current model of mental illness these days?
posted by KirkJobSluder at 10:06 AM on November 25, 2008

The focus on whether the actions of an anorexic are "choices" is not really productive. It is easy to define "choice" so narrowly that all compulsions become a choice, as if an anorexic choosing to starve herself is the same as choosing what color your new car should be. A more fruitful discussion would focus on the causes of this irrational behavior and the way in which treatment and medication may alleviate the causes, allowing the anorexic to begin to see past the compulsions and delusions. Leave the questions of the moral agency of anorexics to the philosophers (or by all means discuss them, but leave the normative judgment out of it).
posted by Falconetti at 10:10 AM on November 25, 2008 [4 favorites]

Look at Metafilter's fixation over Asperger's, a virtually 100% non-fatal condition that affects men more than women, and whose authenticity as a valid mental disorder is still hotly debated in many circles.

First of all, the way to get sympathy for Anorexia is not to bash other mental illnesses. It is a form of Autism Spectrum Disorder that is at epidemic levels.

Second, 100% non-fatal? You might want to check your facts.

Also here.

And here.
posted by cjets at 10:11 AM on November 25, 2008

There was a great TED talk that featured the growth of support groups on the internet both for good an bad, with a Pro-anorexia group as an example.

The internet is a weird, weird, weird place.
posted by blue_beetle at 10:12 AM on November 25, 2008

Isn't anorexia / bulimia a primarily a problem in developed countries?

If it is then does it fit the definition of a mental illness?

Example: Schizophrenia exists within the population in Uganda but not anorexia.

keerist I'm having a hard time framing this question.
posted by pianomover at 10:17 AM on November 25, 2008 [1 favorite]

Ana's song.
posted by Eideteker at 10:20 AM on November 25, 2008

KirkJobSluder:

That's a really good question. One of the differences that I see with addiction-type disorders is that there is, at least at first, a choice to engage in a behavior, whether it be drinking, fasting, snorting coke, etc. Not so with other sorts of mental illnesses. However, the lines do become blurred in most cases, and it can be downright impossible to sort out which disorder begat which–are you depressed because you're an alcoholic, or the other way 'round? In the end it doesn't matter; you have to treat the whole patient, not just a constellation of symptoms and disorders, and when you're treating a patient with an eating disorder, you need to hold that person accountable for her (or, more rarely his) choices.
posted by Mister_A at 10:21 AM on November 25, 2008

Falconetti: A more fruitful discussion would focus on the causes of this irrational behavior and the way in which treatment and medication may alleviate the causes, allowing the anorexic to begin to see past the compulsions and delusions. Leave the questions of the moral agency of anorexics to the philosophers (or by all means discuss them, but leave the normative judgment out of it).

Bingo. If we have learned anything from psychology it's that moral shame seems to be a piss-poor motivation tactic, much less an effective treatment for mental illness.

cjets: First of all, the way to get sympathy for Anorexia is not to bash other mental illnesses. It is a form of Autism Spectrum Disorder that is at epidemic levels.

Certainly. A problem has come up though in that many people on the intertubes seem to have latched onto Autism Spectrum Disorders in the same way that pop psychology previously grabbed onto left/right-brain dominance as an explanation for more mundane behavioral choices.

pianomover: Isn't anorexia / bulimia a primarily a problem in developed countries?

If it is then does it fit the definition of a mental illness?

An interesting question. However most models of mental illness these days include both biological and environmental factors.
posted by KirkJobSluder at 10:26 AM on November 25, 2008

Being a former anorexic, it was about control and acceptance. I couldn't control anything in my life growin up thanks to super controlling parents so all I could do was control what I ate--or not. End end result was being skinny and "hot" and thus, accepted by guys because to me, female friendship was pointless.

Looking back, it wasn't worth seizures and obession.

If I only realized then that 38D cups on a 115lb girl was all I needed to have to be accepted. :)
posted by dasheekeejones at 10:36 AM on November 25, 2008 [3 favorites]

Metafilter : Zero empathy policy
posted by jeffburdges at 10:48 AM on November 25, 2008

It's the dittoheads in that thread with their farktastic fratboy aynrandian "Take Personal Responsibility" chant that piss me off. It's their answer to poverty, addiction, hangnails and now, I guess, mental illness as well.
posted by Rumple at 10:48 AM on November 25, 2008 [9 favorites]

It seems that anorexia exists as a societal problem and less one that's biological or enviromental.

I have no data to support this but it seems to be a problem mainly among white middle class and up women and I'm in no way trying to belittle the seriousness of anyone who is anorexic, but am curious as to why this particular group seems to be the predominant participants.
posted by pianomover at 10:50 AM on November 25, 2008 [1 favorite]

If someone created a group on Facebook encouraging alcoholics to celebrate booze, I think you'd see the same level of incredulity and waning of empathy, and rightly so.

Well, in my instance, you'd see me join such a group.

Booze!
posted by Astro Zombie at 10:51 AM on November 25, 2008

In fairness, Rumple, I agree with people who think others should take personal responsibility for their hangnails.
posted by Astro Zombie at 10:52 AM on November 25, 2008 [1 favorite]

johannahdeschanel wrote "Anorexics need the thinspiration, and they need to be told that they look like their thinspiration."

It is my understanding that your argument here is as follows: Anorexics need to be told that they are insanely thin, and they need insanely thin role models, otherwise they won't get better.

If I understand you correctly, I must say I don't think this makes any sense. Helping people recognize that they are at dangerously low body weights, yes - but holding up others with dangerously low body weights as inspiration? How does this help anyone? I honestly don't see any way that this could possibly be beneficial.
posted by caution live frogs at 10:53 AM on November 25, 2008

The part I don't get is how they also have difficulty realizing that joining groups supporting their life-threatening mental condition is a bad thing.

Why is this hard to understand? If you have a compulsion that incites disapproval from some and approval from others, which group will you gravitate towards? The sick irony of anorexia is that it feeds on shame (about body imperfection) but we try to treat it with shame (for taking the quest for perfection too far).

Given a slightly different mental makeup and maybe a more dysfunctional family, I would probably be anorexic or bulimic. Thin women are worshipped, they are goddesses, in this culture. They make lots of money, they are movie stars, they are on TV, they are in the magazines. If you are a woman and you want power and recognition, you have a 1000% better chance if you're not fat, if in fact you're nearly skeletal.

All the hand-wringing is laughable; if you want to be worshipped, unless your genes are incredibly fortunate ones, you're going to have to starve yourself at some point. Deep down, the majority of women still prefer eating to being worshipped, but it's completely non-surprising that so many women decide to go for broke, and if the internet puts a tool for doing so in their hands, why wouldn't they use it?
posted by emjaybee at 10:54 AM on November 25, 2008 [5 favorites]

A problem has come up though in that many people on the intertubes seem to have latched onto Autism Spectrum Disorders in the same way that pop psychology previously grabbed onto left/right-brain dominance as an explanation for more mundane behavioral choices.

I'm not sure where you're going with this. I think that people on the intertubes are latching onto this is simply a reflection of society latching onto this. And ASD is all about behavioral choices. The best most effective treatment for ASD is ABA (Applied Behavorial Analysis) which attempts to modify a person's behavior. So I'm not sure how you classify any behavioral choice as mundane, unless the outcome of such choice is mundane (such as the choice of cereal in the morning).

Sorry for the derail. I would equate Anorexia with Autism in that they are both mental illnesses with potentially dire results. And anyone who chooses to "elevate" their disease at the cost of other diseases, is part of the problem, not the solution.

The cure for the disease may seem deceptively simple (just eat, damn it!) but if you've ever lived with an alcoholic or a child with ASD or, I'm sure, a young girl with Anorexia, that's a very painful deception to be sure.
posted by cjets at 10:54 AM on November 25, 2008

Cjets, I certainly wasn't bashing Asperger's, as child of a father with Asperger's and a mother who works with high-functioning autistic children, personal experiences I have spoken of in depth elsewhere on Metafilter. I was merely pointing out the disparity between how we react to those with Asperger's and those with anorexia, though they both qualify (controversially from many corners) as neurological disorders. And while in some cases Asperger's, like many isolating conditions or atypical neuroses or whatever you want to call it, can lead to suicide among depressives, its driving purpose is not to destroy the physical body while maintaining a psychological high.

Sorry, Zoomorphic. Didn't see this before I just posted. I appreciate the explanation. My son has ASD (possibly Asperger's) so I'm particularly sensitive to it.

And I would add that ASD and Asperger's do lead to many different types of maladaptive behavior because of their rejection, in many cases, by society. I do certainly agree with you on the severity of anorexia.
posted by cjets at 11:01 AM on November 25, 2008

The part I don't get is how they also have difficulty realizing that joining groups supporting their life-threatening mental condition is a bad thing.

Never known anyone who went to church?
posted by Pope Guilty at 11:01 AM on November 25, 2008 [4 favorites]

Anorexics have made bad life choices. Addicts are weak-willed people. People who commit suicide are selfish. Depressed people have nothing to be depressed about. Autistic kids are faking it. People on the Internet ooze sympathy and tolerance.
posted by giraffe at 11:03 AM on November 25, 2008 [10 favorites]

giraffe you are horrible!
posted by Mister_A at 11:06 AM on November 25, 2008

You think this is bad? The anti-anti-pro vs anti-pro cat declawing groups are at war on Bebo.
posted by PenDevil at 11:08 AM on November 25, 2008 [2 favorites]

"Facebook's the most personable," Rose says. "If you're on something like MySpace, that's famous for creepy old men. Facebook seems the safest."

Um.
posted by Halloween Jack at 11:08 AM on November 25, 2008

Oh, I forgot: poor people are lazy. And um, above-the-knee amputees need to walk it off.
posted by giraffe at 11:10 AM on November 25, 2008 [1 favorite]

Hmm. I feel an incoherent rant coming on.

I admit I've looked at pro-ana communities in the past. They are, by and large, hotbeds of misinformation. You'll see tons of tips and "facts" that are false at best (lists of fruits with "negative calories") and dangerous at worst (swallowing cotton balls? where to buy ephedra?). You'll also see tons of self-loathing mantras - although outright bullying other members is rare, things like the Thin Commandments are parroted incessantly as "motivation."

Should they be taken down? I couldn't tell you. I certainly don't think they're helpful.

A couple things worth mentioning: eating disorders can function somewhat like an addiction. Going for one day on 300 calories, if you're used to functioning on 2000, can feel like hell... but after three or four days you get high off the hunger, you get high off the number on the scale slipping downward, and a full stomach feels strange and painful. When people talk about eating disorders, they often use a false either/or standard: either you are healthy, or you are anorexic; either you are predisposed to obsessive dieting and exercise, or you are "normal" about food and weight. There's a whole continuum in between, and because disordered eating habits can be so addictive, I worry about the young women who might stumble upon - or seek out - these communities, and pick up some destructive coping mechanisms.

It might be a stretch to say that a healthy young girl will find a pro-ana site and in a matter of weeks turn into an emaciated anorectic. It isn't a stretch to say that a young girl with already shaky self-esteem could easily find a pro-ana site, try out some unhealthy practices, and find herself using them as a crutch for years to come.

Which brings me to my other point: even with the best treatment currently available - and it's available for very few - complete recovery from eating disorders is rare. The behaviors and thought processes symptomatic of EDs take years to unlearn, and often re-root during times of stress. Most discussion of eating disorders glosses over this as well.

Most of what I'm saying comes from a combination of reading (even before the arrival of pro-ana communities, a common symptom of EDs has been extensive reading and research on the subject) and personal experience. I have a scab on my thigh from cutting myself after eating a pint of ice cream, to punish myself for being fat. Not a scar, a scab. This is recent. My doctor says I am quite healthy, I am a relatively normal weight, I am happy most of the time, I eat mostly normally, I am in my late twenties and by all means should be smarter than the fashion-magazine hype. But there is still some broken part of me that thinks I deserve to be punished for enjoying ice cream. It's not narcissism, I can yell you that.

The worst part is that I am not anorexic. I never was, not even when I was neatly cutting PowerBars into thirds for breakfast, lunch, and dinner, hiding from my friends at mealtimes, and constantly stumbling from low blood sugar. Not according to the DSM-IV. Even then, because I was never underweight, I would have been diagnosed as ED-NOS. I was never formally diagnosed; even when I went to the doctor with diet-pill-induced heart palpitations, I hid it from her - I figured I'd seek help, but not until I got thin. These days, still not thin, I suppose I'm just someone with "food issues."

And that's the shitty part, of course. The part, years later, when you're mostly normal, and certainly functional, but you can still somehow attribute every misfortune in your life to "because I'm fat." When you are certain you're crazy - not the interesting tragic-romantic-heroine-bestselling-memoir sort of crazy, but the boring neurotic kind of crazy that no one wants to hang out with - and not so certain you'll find a therapist who knows what the hell you're talking about. When you still have all sorts of cruel messed-up attitudes about food and body image that somehow only apply to you, even though you know they're wrong and harmful, and fuck, you're still not even thin and you never were.

How many others like me are out there? People who look healthy but struggle underneath the surface with these thoughts, year after year, under doctors' radars and outside of many insurance plans?

I am somewhat scared to post this comment, for fear of being labeled a narcissist or an attention whore, for either malingering online or causing false alarm when I'm fine, really. (I'm staring the button right now debating whether to hit post.) But it saddens me that there is so much misunderstanding of eating disorders from so many different perspectives, so I might as well add my own perspective, however flawed.
posted by Metroid Baby at 11:11 AM on November 25, 2008 [116 favorites]

anorexia, yet another 1st world aliment.

By which I am not completely belittling the disease, it is pretty horrible, just an observation.
posted by edgeways at 11:15 AM on November 25, 2008

Well, you have to be able to regularly eat to have a compulsion to starve yourself.
posted by Astro Zombie at 11:24 AM on November 25, 2008 [5 favorites]

Metroid Bay, well said.
posted by docpops at 11:30 AM on November 25, 2008

I sometimes wonder if rampant obesity has a paradoxical worsening effect on anorexia incidence, or is that stating the obvious? It seems as though we tend to consider the commonality of obesity with making it more normal, if not acceptable, but I wonder if it doesn't make the whole idea of gaining weight that much more repellant. Metroid makes some very good points about "control", and how for many people being hungry is not a noxious feeling but one of reassurance.
posted by docpops at 11:40 AM on November 25, 2008

Metroid: That was neither incoherent nor a rant. I'm disappointed.

Also thanks for that link, it led me to this: Online Support. It's useful to remember that the internet can be a powerful community for health as well as sickness.
posted by Potomac Avenue at 11:45 AM on November 25, 2008

Does a "disorder" eating or otherwise count as a mental illness?

I am have always had a hard time understanding anorexia / bulimia. When I am out and see a person with a serious mental illness (come to San Francisco) I feel troubled that they have such problems.

Yet when I see the seriously anorexic woman who runs daily in my neighborhood I just think that she's fucked up in a self inflicted way.

It seems that only in the USA could we have so much food that people are compelled to reject it outright to the point of physical harm or cram a finger down their throat to expel it.
posted by pianomover at 11:48 AM on November 25, 2008

Neat. When I pointed out that FaceBook was in decline among all but 13yos in AskMe yesterday.... I didn't expect such support from an FPP.

On topic: we create anorexia, then we halfheartedly complain about it or make token efforts to stop it. Compare the "positive" messages with the relentlessness of daily advertising or TV that bombards the message that "thin woman = worthwhile woman".

The "efforts" we make to fight anorexia in the face of the onslaught of bone-thin-is-necessary are no better than slapping a "save the trees" sticker on our collective Humvee.

It must really, really suck to be a pre-teen girl in our society.
posted by rokusan at 11:56 AM on November 25, 2008 [2 favorites]

edgeways, did you really mean aliment? Funny. (At any rate, I'd say most of what's posted at MeFi has to do with first world issues and interests, ailments and aliments.)

This is a tricky problem, though, in that I can't think of another compulsion or addiction (if we can compare this to addiction, which it seems to closely resemble, at least) that has such a dichotomy of being heavily, rampantly promoted in advertising, media, and social approbation.... riiiiiiiiiiiight up to the point where it suddenly becomes "a problem". The girl has passed the limit of "hot" thinness, and is now merely irritating and inconvenient. But five pounds earlier, she was ideal. I do see how with alcohol, for example, yes - one is fun, wild, outrageous, party guy/girl... then, suddenly a disgusting bore. But we are not surrounded by representations of dangerously drunk people as the most attractive and successful group in our society.

preview... rokusan... yes
posted by taz at 12:00 PM on November 25, 2008 [2 favorites]

I don't agree with this at all. If it were a bunch of middle-aged men we'd be even more judgemental of their feelings and emotions and consider them weak for having them.

But that's because we already read it through the lens of a female condition. The idea is that if it were a male condition overall, we would read the whole thing differently. Like if knitting were the male activity and carpentry the female activity, we would see knitting as intricate, mathematical, pattern forming and complex, while carpentry would be simple, clean, meditative, careful, slow and close to nature. We would highlight different elements of the activity or condition based on what we associate it with.

So if anorexia were male and asperger's were female, the conditions would be understood differently. it's very possible there would be a lot more sympathy for people suffering a kind of neurotic self-starvation if it were known as something middle aged men dealt with (not immediately or always, surely, just as there isn't always sympathy for asperger's, but around here, for instance)
posted by mdn at 12:08 PM on November 25, 2008 [16 favorites]

The part I don't get is how they also have difficulty realizing that joining groups supporting their life-threatening mental condition is a bad thing.

This is a fraught issue, of course, but mental illness solidarity and support groups have done wonders for the Autism community and the Bipolar community.

It seems like the real problem with eating disorders is that we can't decide whether they're mental illnesses or cultural illnesses. Is it media's fault that some people try to control their eating and lose track of their body image, or is it neurochemistry's? Can you 'catch' it, or is it already there, in your DNA or your family life? If we could comfortably slot anorexia into one or the other category, we'd be better able to address it, but it unfortunately seems to be liminal and aporetic: both/and instead of a comforting either/or.

Personally, I suspect that the women I've known with eating disorders are suffering from a kind of dual diagnosis. Like Bipolar or schizophrenic people who turn to drugs and alcohol to manage their illness, the supplement becomes its own problem, and they've got to address both the drug use and the mental illness if treatment is going to have an effect. For anorexics, it seems like an underlying OCD finds relief in the feeling of control over diet, and then starvation exacerbates the OCD while the feeling of control becomes addictive. But I am not a doctor, this is just my anecdotal analysis of three different women about whom I've formed folk psychological judgments... just pragmatic theorizing in order to manage my relations with them. In this, I suspect (again, unscientifically) that anorexia has a lot in common with cutting, which offers the experience of control and self-mastery alongside the addictive hit of pain-dispelling endorphins.
posted by anotherpanacea at 12:12 PM on November 25, 2008

If a bunch of middle-aged men suddenly became addicted to starvation thanks to neurological control issues, would we so cavalierly discount anorexia as narcissistic, and would men feel so isolated that they'd resort to secret, enabling pro-ana sites? No, we'd have official "Pro-Rex" resources that didn't discount the validity of the sufferers' conditions.

Middle-aged men do resort to their own enabling sites:

Testosterone Nation
Getbig.com
.. and thousands more.

Doesn't mean people still don't make fun of steroid using bodybuilders. Doesn't mean there's not a narcissistic element to bodybuilding. And it doesn't mean that a lot of bodybuilders don't have body image disorders.

It's not the job of the "pro-ana" or "pro-x" resources in general to discount the validity of the sufferer's conditions, it's the job of the anti-pro-ana resources to do that. And it's our job to teach children how to skeptically analyze information resources.

If I was a university counseling or health service, I would love the fact that these Facebook groups are out there. While there are no doubt privacy issues, these groups provide a convenient list of students who may need help. A simple targeted email indicating that resources are available if they need it could help thousands of people.
posted by formless at 12:15 PM on November 25, 2008 [3 favorites]

Hokay.

Regarding this thread in specific:

1) If you don't suffer from anorexia, you don't understand it, and frankly, you can't understand it.
2) Just because some anorexics can learn to control it or even "recover" does not mean that all of them can.
3) If you do suffer from anorexia, you cannot assume that others with the same diagnosis as you experience it in the same way that you do.
4) Mental illnesses are infinitely complex; stop trying to reduce them to yes-or-no questions.

Regarding all MeFi mental illness threads in general:

1) If you don't suffer from mental illness, you don't understand it, and frankly, you can't understand it.
2) Just because some mentally ill people can learn to control it or even "recover" does not mean that all of them can.
2) If you do suffer from mental illness, you cannot assume that others with the same diagnosis as you experience it in the same way that you do.
4) Mental illnesses are infinitely complex; stop trying to reduce them to yes-or-no questions.

And don't be surprised if people come after you if you make a comment that implies you know the "truth" about any given condition related to a mental illness.

Now, hand over the Effexor, Lamictal, and Klonopin, and nobody gets hurt.
posted by tzikeh at 12:19 PM on November 25, 2008 [7 favorites]

Pro-alcoholic facebook group? Yup!

Pro-obesity facebook group? Yup!
posted by nathan v at 12:20 PM on November 25, 2008

Personally, I suspect that the women I've known with eating disorders are suffering from a kind of dual diagnosis.

I have worked with three women who would fit this criteria at the totally deathbound end of the severity spectrum and can't adequately describe how bleak this picture looks. Cushy eating disorder joints like the Renfew Center here in Philly ironically won't touch these cases, and your average mental health provider has little expertise in eating disorders which is a pretty highly specified practice area. So the eating disorder with cooccurring psychotic disorder types wind up super, duper extra fucked because there so little understanding of how their conditions interact. There's very little by way of adequate inpatient resources available; the eating disorder places aren't equipped to deal with psychotic episodes and the psych wards don't know eating disorders from auto engines. It's essentially a death sentence.
posted by The Straightener at 12:22 PM on November 25, 2008 [1 favorite]

I can totally see why anorexia would be a community thing. It's difficult to give up eating, and any advice that could help you do that would be hard to turn down. For me eating is all about control. When I'm busy and happy, I don't worry about food at all. But when I'm down or bored or things are going badly at work, I usually start to analyze my meals. I'm not anorexic; I eat when I'm hungry, but I definitely get some weird satisfaction from counting my calories. I don't feel comfortable talking about it with my friends or my mother, so I can see how an online community would be incredibly attractive. It's fairly anonymous and there are all these people telling you it's ok to feel the way you do, and here's how to attain your goals.

It's really scary. I took one look at those sites and had to look away; I think I could be easily swayed into the "cult" otherwise.

I wish we could shut them down. Basically the group is giving people tips on how to kill themselves. Starving will kill you if you're strong willed (or weak-willed depending on how you look at it) enough to do it. But, from a free speech point of view, I don't think they should/could be shut down. I don't think there are laws against discussing ways to injure yourself. Facebook as a private entity may have its own rules though.
posted by bluefly at 12:33 PM on November 25, 2008

But, from a free speech point of view, I don't think they should/could be shut down. I don't think there are laws against discussing ways to injure yourself. Facebook as a private entity may have its own rules though.

I agree with this. Pro-ana people should be allowed to discuss their pro-ana viewpoint if they want to since the First Amendment protects such unpopular speech, but, as a matter of policy, Facebook is completely within their rights as a private entity to shut down any such groups and ban people that participate in pro-ana sites (or whatever other actions they want to take).
posted by Falconetti at 12:48 PM on November 25, 2008 [1 favorite]

This is a fraught issue, of course, but mental illness solidarity and support groups have done wonders for the Autism community and the Bipolar community.

I don't spend much time on support groups, but I do read quite a few blogs about bipolar disorder (and also write one), I've never seen anyone suggest that people should stop taking their meds because hypomania is fun and stability is dull. There's enough controversy with people who suggest lifestyle changes alone are a path to recovery. It's almost exclusively about people's experiences living with the disease and how they're trying to cope with it. It's solidarity in the sense that everyone with the disorder faces a similar set of problems, but there's no suggestion that it's not a problem.

Maybe I just haven't seen the pro-bipolar sites and it's happening somewhere, but if so it's definitely much less visible than these pro-anorexia groups.
posted by xchmp at 12:52 PM on November 25, 2008

Thanks, Metroid Baby. I wish you the best of luck.

Prior to reading your comment, I was dithering about posting how, as a man, how shocked I've been when female friends--together, smart, successful, feminist friends--have mentioned their flirtations with eating disorders. Many men, it seems, have no idea how pervasive this sort of thing is or a clear idea of the emotional toll it can take on women.

And again, as a man built on the skinny side of things, I found sharing my life with my feminist, articulate (also clean and well-dressed!) wife who labels herself a "fat girl" has opened my eyes to the gobsmacking amount of crap that women have to put up with about their bodies and their weight. And, with this sort of pressure finally being emotionally real to me, it's pretty obvious how a Western, first-world woman or girl could very easily end up expressing a mental health disorder as anorexia when, in a culture with different ideas about health, food, and women's bodies, the same underlying causes would result in very different behavioral expressions.

And, as a side rant, I'm another self-diagnosed asperger's-on-the-internet and my therapist taught me a neat distinction. You don't self-diagnose a mental illness. It's just a fucking label. A more productive way to think of it is not, "I have asperger's/ADD/whatever." It's more productive to say, "I find it effective to use behaviors that are used to mitigate asperger's/ADD/whatever," because it's possible to have a hard time in social situations without having asperger's and it's possible to have a hard time concentrating without having ADD and it's possible to have a shitty body image or control issues without being anorexic or bulimic. What tends to grate is when people will self-diagnose and then act as though the self-diagnosis is an excuse. I know, I've been there and it did shit for me. A self-applied label isn't an excuse, it's a suggestion for how to get along more easily in the world.

And, appropos of fuckall, it turns out that the most productive way for me to deal with what I've always considered to be a case of terminal laziness is to adopt strategies used to mitigate ADHD, which is the last thing I am.
posted by stet at 12:55 PM on November 25, 2008 [15 favorites]

Well xchmp, many people with bipolar don't know they're sick, and many with the more classic (less common) bipolar I really really enjoy their manic episodes. They have boundless energy and willpower, don't require much sleep, and generally feel superhuman. Not the same thing as what you're saying, there's no organized group, but when you're on a manic run, it can be intensely wonderful, I'm told. NOTE THAT I AM NOT SAYING THAT ALL BIPOLAR PEOPLE ARE LIKE THIS ALL THE TIME.
posted by Mister_A at 1:00 PM on November 25, 2008

I sometimes wonder if rampant obesity has a paradoxical worsening effect on anorexia incidence, or is that stating the obvious?

My money is on both obesity and anorexia being expressions of the fact that American food culture is seriously and epically fucked the fuck up.
posted by stet at 1:01 PM on November 25, 2008 [5 favorites]

Community support or rejection is one of the most powerful forces affecting the human brain. Addictions and anorexia and other compulsive behavior disorders occur on a spectrum and no one can truly find the gradation that distinguishes someone who "has the disorder" from someone who is "choosing to engage in problematic behavior."

This is because at a certain point, the behavior becomes self-perpetuating but the person never has zero free will, just impaired will to varying degrees.

this is why we get these boring debates over 'disease' no 'moral problem' no 'free choice."

So, if you have a support group that pushes in favor of the compulsion, it can make it worse. This was the concern people had about needle exchange programs. However, because addicts already hang out together and encourage each other to get high, adding needle exchange in an environment that promotes health was going to exert a counter-pressure, not a "pro use" pressure. That was already there because the addicts coming to the needlex were already hanging out to score! And at a well-run needle exchange, there are ex-users who can divert those who are thinking about getting into recovery into a group where the pressure will be towards that.

Similarly, if you are a moderate drinker and start hanging out with alcoholics, your drinking will likely become heavier and you could potentially slip into alcoholism if you don't check yourself or spend time away from them and with normal drinkers.

This group part of human dynamics poses a problem for prevention and intervention with these disorders because it is hard to predict how it will work. For example, with abstinence pledges on virginity, if you get the "cool kids" to buy in, they will increase abstinence until the geeks start joining in. Then abstinence is uncool and the intervention starts to backfire. So, what do you do with data like that?

I think it might be possible to have an "anorexia harm reduction" group that might help people moderate this behavior but not be "pro-ana" but it would be risky. Like a group of drug users that will be influenced either to or away from increasingly risky behavior by high status users in the group, it would depend a great deal on how it was set up and run whether it would heal or harm.
posted by Maias at 1:04 PM on November 25, 2008 [7 favorites]

Just wanted to agree with Falconetti and others that whether or not FaceBook allows this group isn't a free speech issue - it's a business decision. Freedom of speech rights exist against the state, not against private entities. Facebook can restrict the types of speech it allows all they want, just as a religious website could restrict speech, or a racist website can restrict speech, or an anti-racist website can restrict speech, or, um, MetaFilter can restrict speech.
posted by Miko at 1:28 PM on November 25, 2008

Long time reader, first time poster, snark away.

I've had the unfortunate luck of being attracted to and being attractive to women that suffer from eating disorders. They have all been smart, successful, confident*, and resilient. Unfortunately, I've also witnessed each of them destroy every ounce of what made them attractive to me.

It was the little things: the fights over how much oil I could use to cook with, whether or not they needed to eat a whole breast of chicken or just half a breast, did I use too much peanutbutter on the crackers, what way could they weasel out of the food I made them by claiming contamination of fat. Yet every week there would be a bag of candy slid into the grocery cart, until the day I found literally $300.00 worth of almost all unopened candy squirreled away in an unused cabinet. It was the fight over the stool softener and then the natural laxatives hidden in the medicine cabinets. It was the decrease in any sex-drive (technically she dried up and was too embarrassed to be discovered). With my longest relationship it was then the complete mental breakdown and end of her last semester of education - as we began a year long process of trying to help her recover.

$15,000 is what I estimate it took out of my own pocket for her various treatment programs - excluding the engagement ring I walked away from. Her parents probably shelled out tripple - I know they double mortgaged their house to pay for one program. From 6 ER visits, 5 lock down psych wards, countless group therapy sessions, 3 different day programs, walk-in clinics, an in-house treatment program, and finally an intensive 5-6 week residential therapy progam. During the last year of our relationship, and before her admittance into the residential program, she attempted to kill herself 3 or 4 times (really, I lost count), lost her vision in her right eye as it ulcerated from a bacterial infection (normal immune systems would have been able to fight the specific bacteria off with no problem).

My role changed in the last year from being her fiance to becoming her chauffeur. I'll never forget coming home a day early from a business trip to find her slunk out on a couch about two hours into a pickled liver from an attempted overdose. That was her second suicide attempt. It was at some point around then that my underlying goal became to stablize her so I could walk away and save myself. I took a leave of absence from work, and basically served as a 24-hour concierge. I remember before I did that, I fantasized about driving my own car into oncoming traffic to avoid having to deal with more of her problems. I felt trapped: if I didn't watch her, she'd kill herself, and if I did watch her, she'd pull me more into her very very dark world. Eventually, FMLA ran out and I left my job.

I was not innocent. I'm sure that my success at work made her feel preassure to succeed (toughest internships, hardest classes), the increased amount of travel I was being asked to do, as well as her parents general disapproval and lack of support for us living nowhere near them. She felt controlled and out of control. Until she started trying to actively kill herself I was too blind to see it. She hid her body - which was becoming more and more emaciated, she hid her candy, she hid her dieuretics. I didn't look too hard.

And it took two months or so after she finished the program which I do think reached her and helped her 'recover' before I left her. There was no love for her left in me; I did the nice things for her out of routine. And finally, there came a point where she jeopardized my new work and I asked for us to be over.

Anyway, my point...
If you have an eating disorder, no matter how small, now is the time to really think about what direction you are really headed in: how committed are you? Are you willing to sacrifice your schooling? Are you willing to sacrifice your relationships? Are you willing to sacrifice your family? Are you willing to sacrifice their financial security and well being? Are you willing to sacrifice your sex drive and functionality? Are you willing to sacrifice your eyeball (no, seriously, do you you want to be a one-eyed freak?) If what you really want is respect, and control - then you need to say that that is what you want. The world spins out of control for everyone, and yes - its the little stuff that matters. So yes, demand to be heard before you seriously commit to killing yourself.

Had one of my girlfriends had these pro-ana resources, she would have been dead long before. Arguably that might have been better for me - the jury is still out on that one.
posted by Nanukthedog at 1:34 PM on November 25, 2008 [32 favorites]

Speaking as an ex-anorexic, I'm surprised that pro-ana groups exist on Facebook. This basically tells all your Facebook friends (mostly real-life friends) that you're ana.

When I was anorexic, I didn't want anyone to know. I wanted everyone to think that I was naturally thin. The pro-ana communities on Livejournal were largely made up of secondary Livejournal accounts. I certainly didn't want any of my real-life friends going through my profile and finding out that I was a member of various pro-ana and thinspiration groups.

Before this level of public exposure, the closest it ever got was the color-coded bracelets. This was a few years ago: red for anorexic, and probably blue for bulimic, green for ana-mia (mix of anorexia/bulimia). The whole point was that it would serve as a secret handshake, not a Times Square bulletin board. This facebook thing is like putting up a yard sign saying "Hi, I'm ana!" And then Kabbalah took off, and the red bracelets sort of died off.

I've been rambling, and not very coherently. I guess what I'm trying to say is: It's hard to get an anorexic to quit. Give them Wasted, and instead of taking it as a cautionary tale, they'll use it as a guidebook. Shut down the pro-ana groups, and they'll only go back to their secret accounts. Or re-emerge as a Facebook group that says "dieting" instead of "pro-ana".
posted by Xere at 1:53 PM on November 25, 2008 [1 favorite]

After reading some of these comments, I've lost my appetite.
posted by gman at 2:11 PM on November 25, 2008

I was visiting a friend in the psychiatric ward the other week - a bipolar girl, she had just been sectioned & was in the heavy observation ward; maximum security, so to speak.

While I was there, I recognised another girl who was in the same ward back in late 2005. Dressed in a pink flannel dressing gown, toothpick arms & legs, sunken cheeks & hollow eyes, she was lying on a couch with a drip in her arm, staring vacantly at the ceiling.

Last time around, I remember the psych nurses saying they had to keep a close eye on her, because if left unwatched for too long, she'd secretly remove the needle of the drip (but leaving it secured beneath the plaster) because she resisted even the saline & glucose solution as somehow introducing too many calories into her already skeletal & completely energy-devoid body.

Her parents used to visit daily, in concern over this total ghost of a person, and spend an hour or two trying to brighten her mood, affirm their love & her worth, and to persuade her to take tiny sips of a low-fat energy/protein milk drink that the hospital provided for cases like hers. As often as not, they'd leave again without succeeding, worry & hopelessness all over their faces & body language, probably wondering what on earth went wrong with their daughter, who once must have been a normal & bubbly young girl like any other.

Seriously, fuck anorexia & fuck to hell anybody who promotes it.
posted by UbuRoivas at 2:33 PM on November 25, 2008 [7 favorites]

I should be clear on a few things.

#1. If you think you might have issues with food (eating, overeating, binging/purging, etc) tell someone. Tell anyone - heck, tell me (seriously, its O.K.) Ultimately though, start talking to a councilor. If you are a student, seek out health services, if you are in the work force, start talking to your EAP provider. Your first councilor may stink, so plan to shop around and find someone that works for you. The best $20/week I ever spent was 5 years after all this blew over chatting for an hour with my own councilor. If I knew then what I know now I would have probably avoided some other (small) relationship pitfalls.

#2. Talking to other anorexics is a good thing, just remember - they're sick too, so do so with some serious caution: there's a reason that councilors mediate in group therapy. Pro-Ana facebook pages sound like a group with no councilor: that's pretty much Lord of the Flies until Piggy dies... Socialize and talk to people with your disorder, but do it in a moderated group setting.

#3. There is a strong likelihood if you are anorexic that you will not be successful in your first treatment program, or your second, or your third. Failing at a program isn't a bad thing and shouldn't seem like a reason not to go or try another program. *A lot* of recovering from an eating disorder is a timing thing. You won't get over it when your family drops you off at the expensive program and you are still in denial. You won't get over it when you know you've got an eating disorder but you still aren't comfortable talking about the emotions that are keeping you needing control. You won't get over it until you really want to and you have really lost something that you really care about. In my girlfriend's case she lost her eye and thought she still had me - though I'm pretty sure she knew she'd lost me as well.
posted by Nanukthedog at 2:50 PM on November 25, 2008

It at some point becomes difficult in this life to continue tearing one's self up over what others do to themselves.

But it's infinitely easy to tear others up. Way easier than offering some understanding or even shutting your mouth and opening your ears and trying to learn something once in awhile.
posted by Solon and Thanks at 3:13 PM on November 25, 2008 [2 favorites]

cjets: My concern is the way in which neurotypical people will grab onto some sort of a popular psychological theory or diagnosis in order to justify not even trying to do something, usually on the basis of minimal information. It annoys me because I have a family history with mental illness and to me, it really trivializes just how complicated living with them can be.

KJS: My direct interaction with Autism is with children under six. So, while I can understand your perception of it and it makes much more sense now, I hope you can understand why that has absolutely no bearing on mine.

Again, sorry for the derail.
posted by cjets at 3:29 PM on November 25, 2008

orange swan writes "And of course I support free speech, but as everyone knows, free speech has its limits. I'm not going to state categorically that all pro-ana groups on Facebook should be shut down... but I think the possibility should be examined."

Then, respectfully, orange swan, you don't support free speech.

That's like someone claiming to be a Christian, but questioning the divinity of Jesus. That may be a lot of things, but it ain't Christianity by any accepted definition.

Free speech is dangerous, and it will result in some people starving themselves, or becoming neo-Nazis, or blowing themselves up with plans downloaded from the internet, or saying vile hateful things.

We don't support free speech because we like those outcomes. We support free speech because the alternative -- government deciding what we can read, say, or think -- is far more pernicious, as it leads to tyranny.
posted by orthogonality at 3:52 PM on November 25, 2008 [2 favorites]

How many others like me are out there? People who look healthy but struggle underneath the surface with these thoughts, year after year, under doctors' radars and outside of many insurance plans?

I'm here. I'm one of those "women with low self-esteem" who found a pro-ana site during a particularly low point and have never been able to completely let go. Of course, I'm overweight though, so no one would ever imagine my secret stack of thinspo, my repertoire of self-loathing mantras, my secondary and tertiary livejournal accounts, my running internal monologue. I slip under the radar because I am smart, confident, and not skinny.

I would never claim to have anorexia or bulimia, because I don't and according to all definitions I never have. I was depressed and feeling shitty about myself a few years back though, and stumbled on a pro-ana/mia site. That's where I learned tricks on how to most effectively binge and purge, how to prepare yourself and then get through the crippling stomach pain, what pharmaceuticals would ease the process, and - most importantly - how to hide disordered eating from loved ones. I managed to get through a few weeks of 500 calorie days, but luckily my wife noticed quickly and confronted me early. I'm glad I didn't have the chance to be left alone for long with this. I'm also glad that I was able to prioritize my relationship more than my weight loss. Who knows, maybe I just didn't have what it took after all.

Regardless, every once in a while, a couple times a year, I find myself back at a few certain sites, looking at the thinspiration, saving some for later. Reminding myself that quod me nutrit me destruit, or that nothing tastes as good as being thin feels. Then I find myself scheduling my day so that my partner doesn't see me at mealtimes, making sure that when I eat, others are around so they see me doing so, eyeing the laxatives at the grocery store, googling phen-fen. Usually, I recognize what I'm doing and tell my partner. Most importantly, I tell her my specific strategies, partly so that she can watch out for them, but also because talking about it can humiliate me out of doing it.

I'm not mentally ill, and I don't actually have an eating disorder. Most of the time, I'm fine. I eat three square, lots of veggies, enjoy cooking and eating, and I am losing weight though perfectly legitimate and healthy means right now. Still, once in a while something happens to make me vulnerable. I try to buy some new clothes, for example. Or I go to a party and I'm the fattest one there. Or I am the only one in the group that he didn't flirt with. Or, or, or.... And when that happens, I always know that there is a group of women ready to talk me through it, to offer solutions to my problems, to give me definite strategies with quick results, and I know where to find them.

Yeah, there are some who can't be helped, as tragic as that is. But there are way more who are on the borderline, and for whom the pro-ana sites are a siren call to unhealthy but very satisfying, very rewarding, behavior.
posted by arcticwoman at 4:05 PM on November 25, 2008 [8 favorites]

Nice use of the nihilism tag.
(say what you will about nihilists - at least they’ll eat a sammich)

“Long time reader, first time poster, snark away.” - Nanukthedog

*bugs bunny voice*
Yeah, ya fucker...

no, I got nothing. Admirable.

“This is very true. Anorexics band together, competing with each other, encouraging each other, and giving each other tips on how to get thinner”

That seems to be (as a layman) one of the insidious parts of the disorder. It does have a social component which does camoflage it to some degree as a disorder.

I have been in the gym with guys who compulsively exercise. I mean until the point that it’s unhealthy. I do some intensive stuff, but these guys tear themselves up, pass out, things like that.

Same form of dissasociative body perception.

Gets even weirder when they focus on one particular part of the body. I haven’t seen that personally, but I’ve seen photos of guys who are sort of flabby - except for their gigantic biceps.

But yeah, I don’t get the hate. It’s a disorder. It needs to be treated.
The decision to be skinny or some other facet is a choice, sure. Just as deciding to be healthy and work out is a choice.

Where it stops being a choice is where it becomes compulsion. We’re looking at two disparate concepts of ‘responsibility’ here.

Is it someone’s choice to start smoking? Sure. If they then choose to stop - but can’t because of the addictive affects of nicotine, is it their choice then to fail?
No, of course not.
Individual compulsive behavior is not a choice.

The choice is in whether to recognize it as a compulsion or not and accept help.

Just as, say, having brain cancer is not a choice, but going for treatment is.
That is also accepting responsibility for your actions.

That’s very different from using your illness to avoid personal responsibility - which is yet another facet of failing to recognize the compulsion. Not some sort of character flaw.

And hell - so what if it is? We don’t have to kiss anyone’s ass because they’ve got an illness, but it’s like blaming poor inner city kids for not rising above their limitations.
Not everyone is that strong. Not everyone can make it on their own.
It’s up to those of us who can make it or who have to teach those who can’t how.

In the meantime it’s our duty to help them - because what the hell else is that strength for?
And we need to organize to do it, fund outfits, get government help, whatever we can and support each other, because we can’t help them alone either.

Certainly we need to do it in a cogent methodical way, but as to whether it needs to be addressed, I don’t think the fear that some folks might be gaming the system in order to avoid personal responsibility justifies any action other than caution and oversight in treatment methods.

Like saying people who are depressed should snap out of it. Or folks with PTSD are just cowards.

Don’t forget that they have a responsibility to themselves as well.
And either you care to help them regain that control, or you don’t.
If you don’t - than why even comment?

It’s like telling the Samaritan he’s wasting his time for stopping.
Why not just keep walking if you didn’t want to be involved in the first place?

I suspect the answer is something other than altruism and empathy for the Samaritan.

Insofar as having a group - I’d go the other way. I don’t have to like the group, I’d probably prevent my kids from going there if they had anorexia. But free speech is free speech.
Someone wants to discuss - I’ll emphasize *discuss* - the merits of heroin addiction, I’m not going to support a law to stop them.

Hell, if we’re talking self-destruction, there are pro-suicide groups and discussions of best methods.
I wouldn’t want my kids on there either. But if they were they would have a whole lot of my attention for a quite some time.
I wouldn’t blow the problem off like they just want attention. I’m going to give it to them. A lot of it. And perhaps in a way they did not intend.

But what I’m not going to do is let the premise that because they had the initiative behavior that they’re seeking control stop me from getting involved.
There’s no excuse for failure. There is only what one did or did not do.
I’ll choose do.
Damn me for wasting my time, but it’s my time. And that sure as hell is my choice.
posted by Smedleyman at 4:06 PM on November 25, 2008 [1 favorite]

“I miss Pro-Scurvy.”

It got taken out by the big vitamin C conspiracy. Ever notice how much play “frozen concentrated orange juice” gets in the media? Think about it sheeple.
posted by Smedleyman at 4:08 PM on November 25, 2008

Ex-anorexic here. Hi.

On the issue of choice:

I once spent an afternoon attempting (unsuccessfully) to choke down a single serving of yogurt. This was soon after I finally realized that something was terribly, terribly wrong, that the method I thought I was using to exercise control over some aspect of my life had somehow flipped around and was controlling me instead.

So I took the container of yogurt, dipped a spoon in it, put it in my mouth, and tried to swallow.

I couldn't do it.

It was like trying to eat when you're so impossibly full that you're already in pain. It was like trying to swallow vomit. It was like trying to take a heaping spoonful of maggots and chow down. Worse than that, maybe. It did not seem possible to swallow.

Did I have a choice at that time?

There is a perception that certain mental illnesses are actually moral failings. Of the "substance" disorders, alcoholism has largely gotten past this stigma; drug addiction and anorexia hover on the cusp; compulsive eating is still perceived as lying squarely in the "moral failing" zone. I wonder if it is because they are associated, consciously or subconsciously, with "sinful" behavior. Do you have more sympathy for a narcissist or a psychotic? A sex addict or a autistic child? A kleptomaniac or a schizophrenic? If your answer was always the latter ones, is it because you see the former more as expressions of vanity, lust, and greed than mental disorders? Just a thought. We still live under the shadow of puritanism in many ways.

Anyway.

Pro-ana groups scare the hell out of me. I suspect that the worst thing you can do for anorexics is let them hang out with other anorexics. The second worst thing you can do is try to control their behavior directly -- such as by banning pro-ana groups. What's the solution here? Don't know.
posted by kyrademon at 4:11 PM on November 25, 2008 [22 favorites]

I can totally see why anorexia would be a community thing.

Yeah, they can all get together and go out to not eat.

Jokes aside, it's a mental illness, I believe. I'm not a shrink, but my layman's opinion is that it's kind of a delusional disorder in that you're not seeing things as they are (ie: being 95 pounds and considering yourself fat), and yes these things can manifest themselves in men, as well, as someone mentionedm, with pumping yourself full of steroids (and insane dietary habits, Read Sam Fussell's memoir Muscle for more on this).

As for the Facebook groups, I don't see it as a free speech issue. Yes, people have the right to be pro-anorexia and to voice that opinion. Facebook is a private entity and under no obligation to provide them with a pulpit.

also, mdn, good to see ya back.
posted by jonmc at 4:46 PM on November 25, 2008

Also, I kind of have a problem with the false dichotomy of 'everthing's a disease' vs. 'personal responsibility.' The world is way more complicated than that.
posted by jonmc at 4:47 PM on November 25, 2008 [5 favorites]

and yes these things can manifest themselves in men

Oh god does it. I work in fashion/media/photography-ish fields and thus are surrounded by people whose entire livelihood revolves around thier body. The tacit-and-not-so-tacit eating disorders, drug abuse, and working-out-til-passing-out are as common as carpets. It spills out into the people who work with them and are around them, it's hard being in the 60th percentile when everyone around you is in the 1st. So even people who don't have a mental disorder end up conforming to some of the practices.

I, a dude, have had nasty run ins with self-esteem and body issues. If I didn't keep reminding myself that these people are a rarefied breed for whom Being Pretty is their job, I would have gone much crazier by now.

And it still happens. It hurts being the only guy without a six-pack in the room. It hurts having crooked teeth when everyone else has caps. It's hard being the fattest guy in the room even if you're only 10 pounds overweight.
posted by The Whelk at 5:27 PM on November 25, 2008

many young women have been recorded from the Middle Ages onwards starving themselves

The "Fasting Maidens" of the Victorian era, yes? Claimed their body's were nourished by God. They also became famous and loved for thier "devotion". Hmm.

When it comes to the actual disorder, control seems to be a big point. Look at the pro-ana sites. The domintant theme is determination, willpower, control. Think about being a teenager, or young adult, one of the more chaotic times in a person's life. So many choices are being made for you, so many forces are out of your hands. Wouldn't having total control over something be very appealing? It's a very basic, almost elemental control; No one can tell me what to eat. No one can make me eat. Anorexics want to be made of iron.

It's spooky, sad, and deadly. I really hope researching of these sites will help in treatment.
posted by The Whelk at 5:36 PM on November 25, 2008 [1 favorite]

It hurts being the only guy without a six-pack in the room. It hurts having crooked teeth when everyone else has caps. It's hard being the fattest guy in the room even if you're only 10 pounds overweight.

Like you said, you're ina very rarified world, and those exceptionally pretty people are only using their assets to make a living the same way a differently gifted person might become an athlete or a stockbroker or a scientist. And (among non-mentally ill people at least), it's more people reactions or lack thereof which hurt. Because exceptionally attractive people (male and female) do get treated differently than the rest of us.
posted by jonmc at 5:42 PM on November 25, 2008

orthogonality: I'm Free Speech's #1 Fan. But I can understand France making these sites illegal. I don't condone that in America, slippery slope and so on, but I also feel like working towards getting big sites like Facebook to be ashamed of themselves and delete these groups (or better, regulate 'em with rational moderation and real support).

This is a culture of suicide and lies that is attacking people with low self esteem and other mental disorders. As UbuRoivas said, Fuck Anorexia, but more than that, fuck the self-abnegating mental diaphragm of pop culture that makes us all want to annihilate our bodies and spirits, and worse, makes us not give a shit about other people's stated intentions to do it all the way. We denizens of Internet have to work as a democracy to kick out the bombers and fakes and fire-screamers or at least talk sense to them til they melt like a bad dream.

Damn I should not drink and post in my own thread.
Gonna go join that alchy group brb.
posted by Potomac Avenue at 6:03 PM on November 25, 2008

“It's hard being the fattest guy in the room even if you're only 10 pounds overweight.”

Well, yeah man, but...
I get some of the same thing. Different for gym rats. But y’know, a bit back someone was telling me I was looking a little flabby.

It just didn’t register. I mean - winter’s coming. If I want to train outside, if I want to dive in cold water, I’ve got to put on some fat. And it’s just plain healthier to have a little pudge come wintertime.
He didn’t get where I was coming from either (the chicks love the six pack dood!).

But that’s the difference in goals. You want to look good or do you want to be healthy?

I think - generally speaking - this conceptualization in our society that it’s ‘thin’ that is attractive, not ‘fit’ is harmful and self-sustaining.
A bit back I was chatting with some folks about attractive women and they mentioned blah blah movie stars or singers - typically waifish or with those pouty lips, etc., and I said Jackie Joyner-Kersee (Oh, sure, she’s older than me, but still...)

I never got what was so attractive about being a porcelain doll. It might photograph well, but in person? I think it’s more learned value response, like money or status.
Or hell, maybe I’m a barbarian. I don’t know.
posted by Smedleyman at 6:14 PM on November 25, 2008

“I'm Free Speech's #1 Fan.”

You...uh...you are aware of Stephen King’s work?
posted by Smedleyman at 6:16 PM on November 25, 2008 [2 favorites]

And of course I support free speech, but as everyone knows, free speech has its limits. I'm not going to state categorically that all pro-ana groups on Facebook should be shut down... but I think the possibility should be examined."

Then, respectfully, orange swan, you don't support free speech.

But I do. All freedoms have natual limits and it's necessary to practice them responsibly.

We support free speech because the alternative -- government deciding what we can read, say, or think -- is far more pernicious, as it leads to tyranny.

And I wasn't talking about governmental control.
posted by orange swan at 6:28 PM on November 25, 2008

I think - generally speaking - this conceptualization in our society that it’s ‘thin’ that is attractive, not ‘fit’ is harmful and self-sustaining.

Thanks, Smeddo. Now I really feel like I have to post my modified version of the "Thin Commandments" that Metroid Baby linked to earlier. I'd been holding off because it reeks of the same kind of body-fetishism & moralism that contributes heavily to these problems in the first place, but hey, anything to counter our culture's obsession with lame, starvation-induced thinness...

If you aren't ~~thin~~ fit & capable, you aren't as attractive as you could otherwise be.

Being thin is not more important than being healthy.

~~You must buy clothes, cut your hair, take laxatives, starve yourself, and do anything to make yourself look thinner.~~ Cultivate your own personal style; whatever suits you. You'll never feel happier than being yourself, and never more miserable than trying to conform to unrealistic ideals imposed upon you by an industry that doesn't give a flying fuck for your wellbeing.

Thou shall not eat unhealthy food without feeling a tinge of delicious guilty pleasure.

Thou shall ~~not~~ eat fattening food (every now and then) without punishing oneself afterwards.

Thou shall count ~~calories and restrict intake accordingly~~ your five serves of fruit & veg daily, then try to double or triple them - if not in quantity, then at least in variety.

What the scale says is ~~the most important thing~~ barely important at all. Muscle weighs more than fat, and (in general & without going to extremes) the more muscle, the better.

~~Losing weight is good/ gaining weight is bad.~~ Refer to the previous point. Gaining tone is good, losing tone is not the end of the world.

You can never be too ~~thin~~ fit, flexible, healthy & strong. A thin cow is only ever a thin cow, never a gazelle.

Being thin and ~~not eating~~ still eating enough for a herd of elephants are signs of true will power and success, because by getting off your arse & actually doing some exercise, you get to have your cake & eat it too.

If you are ~~thin~~ a decent person, you will be loved and accepted, no matter how fat or thin, fit or slobby you are.
posted by UbuRoivas at 6:55 PM on November 25, 2008

...and to put Smedleyman's comment into its proper context, he's a chainsaw toting Marlboro Man; John Wayne’s father’s boss.
posted by UbuRoivas at 7:38 PM on November 25, 2008

If we're talking about starvation in historical terms, I'm surprised no one's mentioned Kafka's A Hunger Artist.
posted by emjaybee at 8:02 PM on November 25, 2008

I've been intrigued to read here about what some posters know about the research on 'what works' for anorexic patients. Seems control doesn't work, in general, and shame doesn't work. Seems that anorexic girls want and need to feel support from one another and encourage one another.

It would be nice to see an advocacy and/or treatment group work employ a proactive plan of online advocacy. I envision something like a web community made up of current sufferers but also mentors women who have had eating disorders and have recovered, and professional therapists. Outreach workers could 'infiltrate' these ana message boards occasionally and just post a reminder that if your life is falling apart and you're scared and you want to find another way, you could come to [whatever].com and be in a supportive community that will help you get your life back on track. It could provide testimonials, resources, and a supportive community - which these girls seem to really need - but be focused on healing and self-directed learning about the condition.

No, it's not treatment - but neither are the communities girls are building themselves with absolutely no connection to a world of professional help - even with fear of and avoidance strategies to keep away from professional help. I certainly understand the need not to be shamed, to unburden oneself, to tell the truth, to be encouraged and supported. But can't therapeutic communities be built to provide some of the same emotional reinforcement, only directed at a different end behavior?

Has it ever been tried?

I can see that there are some serious ethical concerns and logistical problems with creating safe places on the web for healing from mental disorders. This is a brave new world issue, though, and it seems to me like the mental health profession is going to have to deal with it. Right now it's so reactive - individual businesses (LiveJournal, FaceBook) decide whether or not they will host these communities. But isn't that just plain denial on the part of the mental health industry? Like it or not, people use the web to assuage their miseries, to seek information, and to build community. Knowing that, where's the parallel community being built by people who have the knowhow to help sufferers start to get better? Could there not be a set of limited expectations established for the web presences of mental health organizations that would at the very least provide a pathway toward individual personal assistance? I can hear the objections already - liability, misunderstanding, etc - but right now there's nothing, and ad hoc groups fill the gap. And they do serious damage to one another - encouraging eating disorders, suicide, cruelty, vandalism, hate crime. Are we all that confident that the minimum harm here is to do nothing at all about online communities?

The onus for responding really shouldn't be falling on FaceBook or any other web application. Any communications platform will be turned to these ends if those who control the means allow it. The onus is really on the mental health profession, and of course the broader society which needs to support mental health, to provide alternatives that make sense in a world where social networking is not only inevitable, but entirely normal and expected. There's a real need, it seems to me, for strategies to evolve.
posted by Miko at 8:24 PM on November 25, 2008 [3 favorites]

Thanks to everybody who's posted comments about dealing with your own or others' anorexia or borderline experiences. Thanks for posting despite thoughtless or assholish comments above, because if anything can cut through the bullshit and reach those men and boys and women and girls susceptible to or in the grip of eating disorders, your personal stories have a good chance. They say, I've been there, this is what happened, this is how I worked or am working through it, you are not alone, you're part of my community.

on preview, what Miko said. (As usual.)
posted by cybercoitus interruptus at 8:43 PM on November 25, 2008 [2 favorites]

"a chainsaw toting Marlboro Man; John Wayne’s father’s boss."

heh. Yeah. Y'know tho, that can be off putting to some folks. Buddy of mine was obese all through high school. I mean like very very fat. Over time he lost a lot of weight. Said he felt in competition with me.
But I never saw him as anything but my friend. I mean, I look at him now and sure he looks different, but he's the same guy. And - except for eating right and getting more exercise - he does pretty much the exact same things. So I don't really see any change.
Me, I've always been into training, but then, I like fighting and contact sports, so that's my thing.
But y'know, I've spoken with a lot of good looking people who have nothing inside. I dated this girl in college who was a model (I hear that term and I keep thinking "of what?"), in good shape, outwardly very attractive. One day she asked me how I could have a nigger as a suitemate.
Pretty much killed that relationship and radically altered her attractiveness to me.

That's the other thing tho' about some kinds of behavior - they can be ugly things. You see guys forgo time with their families, kids, all that, to be in the gym 24/7 (ok, I'm pretty high energy myself - but I've got a sleep disorder so that's a whole other kettle of fish). Won't go to thanksgiving, stuff like that.

Ironic that they engage in behavior guaranteed to drive people away, just when they need supportive people in their lives.

Which, my buddy had in spades. We were all behind him. Plus, the guy has just a phenomenal mind. I don't know if he's a genius, but he's got a number of degrees in varied fields, speaks a bunch of languages. Not a doubt in my mind he could do it if he wanted to.
As it was, seems like he didn't want to until, frankly, he got laid.

Bit anecdotal and far afield there. But reading what Miko said I kind of wanted to lay it down from my personal experience.
posted by Smedleyman at 9:01 PM on November 25, 2008

(to clarify - not that they have control really over elements of that behavior of course)
posted by Smedleyman at 9:03 PM on November 25, 2008

pianomover: Isn't anorexia / bulimia a primarily a problem in developed countries?

Actually, no. A friend of mine is doing graduate work on this topic. Anorexic behaviour follows in the wake of every famine; starving people who don't want food. It's not that hard to understand, really: starvation makes you go a little wonky in the head.
posted by Hildegarde at 9:36 PM on November 25, 2008

I dated this girl in college who was a model (I hear that term and I keep thinking "of what?")

In most cases, the answer is "a model of what a 16yo girl would look like, if dressed up in clothes she could never afford, and photographed in situations & attitudes that bear no resemblance to anybody's reality".
posted by UbuRoivas at 9:43 PM on November 25, 2008 [5 favorites]

Thank you to everyone who posted testimonials about your experiences with this.

They got me thinking about how I relate to those stories, and to anorexic behaviors, more than I initially thought. I consider myself not-at-all anorexic, (you should see what I enjoy eating these days), but earlier in my life, I felt full of shame for eating a pint of ice cream, and I felt closest to one of my brothers when he was a wrestler starving himself to make weight. We could constantly talk about calories, which he was suddenly interested in, and which I realized I was incredibly knowledgeable about from decades of reading women's magazines.

All this got me thinking about how anorexic ideals get perpetuated by culture (I realize that I'm naively re-inventing decades of feminist pop criticism here) and how to avoid doing it myself. In the Meta thread, davejay describes an episode where his wife felt horrible for commenting on the food he was choosing, which reminded me that at age 15 I "randomly" decided that it was the height of rudeness to comment on anything anyone was eating and resolved never to do that (in quotes because I thought it was random at the time, but it no longer seems that way). In search of other ways to avoid inadvertently contributing to the problem, I found two links worth sharing:
- how to approach someone you suspect has an eating disorder
- every woman has an eating disorder .blogspot.com
The blog has some interesting discussion about even commenting on people's appearances at all, eg, should people tell little girls they're pretty?
posted by salvia at 10:35 PM on November 25, 2008 [1 favorite]

Also, this website had good tips (it's more professional than the one I linked above), and this looks like an awesome book on the topic.
posted by salvia at 10:48 PM on November 25, 2008

This is a brave new world issue, though, and it seems to me like the mental health profession is going to have to deal with it.

I'm not sure why, or even how, mental health professionals can help people with eating disorders through the kind of talk therapy found on websites unless they can legitimately claim insight through personal experience. If the standard treatment is a drug therapy, than you've given up on persuasion. So this kind of outreach is going to have to happen from within the community, from that subsection of those who once suffered but are now cured. I guess you'd call it "in-reach:" sharing solidarity and hope. In this I think these pro-ana groups are building the foundations for that to happen.

There's a 12-step group for Overeaters. There's also one for other eating addictions and body image issues. This explains why I tend to view anorexia/bulimia/disordered eating through the lens of addiction: so do some sufferers!
posted by anotherpanacea at 5:51 AM on November 26, 2008

unless they can legitimately claim insight through personal experience

Yes, that was the model I had in mind since that seemed to be a requirement. And it's definitely a very important success factor in the 12-step programs. Their efficacy absolutely relies on the presence of people who have 'been there,' but who are committed to stopping the behavior. Often, therapists and doctors recommend 12-step groups to patients and often there's concurrent therapy and membership in those groups. I'm wondering if it would work to take recovering anorexics and train them for peer support to reach out to the existing groups and maintain a presence that keeps a line open to a responsible, supervised therapuetic entity or clearinghouse for services.
posted by Miko at 6:27 AM on November 26, 2008

It is worth mentioning/repeating that there are quite a few online communities for eating disorder support, and they are not the same thing as pro-ana communities. Something Fishy, as Potomac Avenue linked above (via my own link), is a good jumping-off point. Salvia's links are good too.

The F Word has a lot to read and discuss on eating disorders and body acceptance, as well as links to several related blogs.

On LiveJournal, ed_ucate is one of the best eating disorder support/education communities, a far cry from Proanorexia and its ilk.

The trouble, however, is that eating disorders are easily triggered, and someone with an ED can easily be using pro-recovery communities to self-trigger. As kyrademon says above, "I suspect that the worst thing you can do for anorexics is let them hang out with other anorexics." This is a pretty thorny issue and one I don't have an answer to.

Two recent books that discuss the prevalence of eating and self-image issues in American women that I've found interesting: Lying in Weight and Perfect Girls, Starving Daughters.

I'm grateful that others are sharing their stories here. Nobody really has an answer for the phenomenon of anorexia and pro-ana sites, but discussing the questions does help.
posted by Metroid Baby at 7:40 AM on November 26, 2008

France is absolutely the worst country, of all of those considered to be modern liberal pluralistic societies, when it comes to free speech. </hyperbole>

I would never, ever live there on a long-term basis.
posted by jock@law at 9:20 AM on November 26, 2008

If someone created a group on Facebook encouraging alcoholics to celebrate booze, I think you'd see the same level of incredulity and waning of empathy, and rightly so.
posted by xmutex at 12:59 PM on November 25 [1 favorite +] [!]

Definitely!

Not because I believe that either anorexia or alcoholism are "choices" - they aren't, they are serious, debilitating mental diseases.

But because pro-alcoholism groups, like pro-ana groups, would be encouraging self-destructive (if not really "chosen") behaviour, instead of supporting and encouraging the sufferers to get help. It would be like a "pro-depression" group, which encouraged depression sufferers to quit their jobs, stop taking their meds and stay home in bed all day. This would be really bad.
posted by jb at 9:51 AM on November 26, 2008

It would be like a "pro-depression" group, which encouraged depression sufferers to quit their jobs, stop taking their meds and stay home in bed all day.

I forgot, that's Metafilter.

(yes, I am joking....kind of : )
posted by jb at 10:51 AM on November 26, 2008 [1 favorite]

We could constantly talk about calories, which he was suddenly interested in, and which I realized I was incredibly knowledgeable about from decades of reading women's magazines.

Isn't that the crux of it, though? The fact that this sort of knowledge so permeates everything targeted to us that we can become experts in calorie and fat gram counts, that we know without knowing how we know, how many calories you have to burn to lose a pound, that we are aware of hundreds of strategies to control our intake - even if we have never worried about weight loss before, shows the enormous environmental pressure we face. I'm sure men's magazines put other kinds of pressures on men, but this is what women are surrounded by.

Regarding men and eating disorders - I think gay men actually have it worse than a lot of women. Dan Savage calls it "gay male body fascism" (or something to that effect), and I think he's right. There's an expectation, at least among the twenty-somethings that I'm friends with, that anyone with more than 1% body fat will never, and indeed doesn't deserve to, get a date.
posted by arcticwoman at 11:49 AM on November 26, 2008 [2 favorites]

Dan Savage calls it "gay male body fascism" (or something to that effect)

also known as "manorexia".
posted by UbuRoivas at 12:32 PM on November 26, 2008 [1 favorite]

Among men (and probably some women - I don't know), there is also bigorexia, which sounds like a joke, but the disorder isn't funny.

(It especially seems silly when you understand that "anorexia" basically means "without appetite" in Greek, and so "Bigorexia" would mean... Big Appetite? Anyway, it's ill-named.)
posted by taz at 12:49 PM on November 26, 2008 [2 favorites]

don't forget my personal favourite - orthorexia.

*slurps zero-fat soymilk, munches apple*
posted by UbuRoivas at 2:30 PM on November 26, 2008 [2 favorites]

If someone created a group on Facebook encouraging alcoholics to celebrate booze, I think you'd see the same level of incredulity and waning of empathy, and rightly so.
posted by xmutex at 12:59 PM on November 25 [1 favorite +] [!]

Definitely!

Please, a cursory look at the internet would find you zeppelinloads of eriting and photos celebrating excessive drinking.
posted by jonmc at 6:48 PM on November 26, 2008 [1 favorite]

« Older "Do you live here?" | Droste Effect Video Newer »

This thread has been archived and is closed to new comments

MetaFilter

"We're not deciding that anorexia is wrong. It just IS wrong."
November 25, 2008 7:40 AM Subscribe

Tags

Share

"We're not deciding that anorexia is wrong. It just IS wrong." November 25, 2008 7:40 AM Subscribe

Tags

Share

"We're not deciding that anorexia is wrong. It just IS wrong."
November 25, 2008 7:40 AM Subscribe