friends," because of the difficulty of "coming out" to someone who may not relate, Lauren says. Online communities such as hers take some of the pressure off because everyone shares the same issue, Lauren says.
Before Lauren created Not Otherwise Specified, the term given for non-categorized eating disorders, she hosted Diagnosed Pursuit of Perfection, a type of pro-ana site she now condemns.
Kelly, creator of Ana Lifestyle, anallifestyle.com, says the change in sites like Lauren's allow not only for comfort but also for a community and recovery. Feeling alone with her anorexia, Kelly, 28, formed her site to provide a community for people dealing with the disease. Even though she feels her site does promote eating disorders as a lifestyle, Kelly says her sites' goal was to offer a place of love and friendship.
"We need support from people who understand." Kelly says. "Otherwise we'd go off the deep end."
To help people struggling with anorexia, Kelly says her site has a buddy system and chat rooms. Kelly says these features, along with links to recovery sites like something-fishy.org, can actually promote health for those not ready to seek recovery and encourage those who are.
Tierney, author of the most recent research on these sites, writes in her article that professionals in the recovery field could actually benefit from visiting the sites. Because anorectics are more open on the sites, Tierney writes, professionals could visit and gain a better insight into the motives behind anorexia's self-destructive behaviors. Some professionals are even investigating the use of online sites as therapy. Tierney writes.
Jenny Wilson, Stanford University research assistant, says that while conducting a study on the new, pro-survival sites, she saw potential for recovery sites to learn from the survival sites. Participants in the study said online sites, both pro-anorexia and pro-recovery, were too extreme, Wilson says. It would be better if the sites could learn from each other, she says, and fall somewhere between triggering the disease and being too authoritarian.
Sarah, creator of pro-ana site Evanescence, evanescence.itgo.com, says in some cases the sites can be the last straw, prompting a relapse. But they can also serve as a reminder to those in recovery why they don't want or need to relapse, Sarah, 19,says.
Bunnell, NEDA board of directors member, says patients are already ambivalent about their recovery and any message that paints their disorder as acceptable may prompt a relapse. Studies show that out of 100 young girls who view positive anorexic material, five or six will develop symptoms while one or two will develop the disease, Bunnell says.
But while the benefits are still being explored, potential dangers of any site containing anorexic matters still exist. Both professionals and site creators worry that the sites could cause a relapse for someone in recovery or be misused to perpetuate harmful behaviors.
"It's not a black and white issue," Sarah says. "It's a fine line between helpful and harmful."
THE RIGHT APPROACH:
HOW TO VOICE CONCERNS EFFECTIVELY
The longer an anorectic goes untreated, the harder the road to recovery is. As it is, 10 percent of diagnosed anorectics will ultimately die from the disease, says Doug Bunnell, member of the board of directors for the National Eating Disorders Association. To increase your friend's chances at survival, follow this guide when voicing concerns.
Plan. Set up a time to talk. Find a private, relaxed meeting place where you can openly and honestly discuss your concerns in a caring, supportive way. Make sure the place is free of distractions.
Express. Share memories of specific times when you were concerned about their behavior. Explain that you think these times indicate a possible problem that needs professional attention.
Ask. Ask your friend to explore these concerns with a professional. If you feel comfortable, offer to help make an appointment or go along with them on the first visit.
Avoid Conflict. A battle of the wills is not the goal. If your friend refuses to acknowledge there is a problem, restate your feelings and reasons for them and leave yourself open and available as a supportive listener.
Refrain from Blame. Don't place guilt or shame onto your friend's actions or attitudes. Don't use accusatory "you" statements like,"You just need to eat." Instead, use "I" statements like,"I'm worried that you refuse breakfast and lunch."
Don't Simplify. Simple solutions aren't the answer. For example, "If you just stoll then everything would be fine."
Continue. Remind your friend that you care and want them to be healthy and happy. Leave by telling them you'll be open to talk at their convenience.
Source: The National Eating Disorders Association. www.edap.org
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