In August 2012, Daphna Yeshua-Katz and Nicole Martins published a co-authored study in the journal Health Communications titled “Communicating Stigma: The Pro-Ana Paradox.” In the study, Yeshua-Katz, lead author, and Martins offer a frank and unusual look at a much-stigmatized group: “pro-ana” bloggers, the online world of people with eating disorders.
“Pro-ana” stands for pro-anorexia. Pro-ana sites provide instructions for how to initiate and maintain anorexia nervosa as well as “thinspiration” photo galleries, poetry, song lyrics, and the like. Needless to say, such sites are met with “public vilification,” say Yeshua-Katz and Martins, and have been shut down by Internet service providers and blog-hosting services.
Such censorship doesn’t work, though. As Yeshua-Katz and Martins note, “an online search of ‘pro-anorexia websites’ quickly reveals that these site administrators and bloggers are resilient, having set up new sites and/or blogs under different names.”
Yeshua-Katz is a third-year doctoral student from Israel, and Martins is an assistant professor, both in the IU Bloomington College of Arts and Sciences Department of Telecommunications. In their study, they explored the personal experiences of 33 pro-ana bloggers from seven countries to study the motivations, benefits, and drawbacks of blogging about anorexia nervosa, from the bloggers’ perspectives. The study is believed to be the first to focus on interviews with the bloggers, rather than on content analysis of the sites’ postings.
Overall, Yeshua-Katz and Martins learned that the study participants were motivated to continue pro-ana blogging because they found social support, a way to cope with a stigmatized illness, and a means of self-expression that they did not find elsewhere. “Our participants were clearly active online in order to compensate for the lack of resources in their offline environment,” they write. “Their offline environment, family and friends, usually wish for them to recover. Nevertheless, according to a number of studies, conventional modes of treatment for eating disorders are extremely ineffective.”
Online resources may, in fact, help more. “Moral panic about [pro-ana] websites might not be appropriate,” the co-authors say. “Efforts to censor an outlet for a group who cope with a mental illness that has no effective treatment might not be the right step. Instead, efforts should be concentrated in providing more comprehensive online resources for information about effective treatment.”
Yeshua-Katz acknowledges that the study’s non-judgmental approach to the pro-ana community may be disparaged because it differs from from media coverage and research about people with anorexia nervosa. “This research that contradicts what we assume we know,” she says. She says the in-depth interviews account for the difference.
“The strength of in-depth interviews is that we got to ask about the views of the bloggers, their own perspective about their media use, instead of analyzing the text and images they post,” Yeshua-Katz says. “Using systematic and rigorous methods, our goal was to provide knowledge about the experience of the bloggers themselves, whether people like what they hear or not.”
Yeshua-Katz frequently researches how marginalized people mediate stigma through their use of social media.”Interaction among anorexic patients is not new, it happened before in hospitals and clinics but was hidden from the public sphere,” she says. “What is new here is that in social media, this interaction is suddenly visible to the rest of society and has a much bigger volume. This makes it controversial and hard to digest.”
Despite the uncomfortable content, Yeshua-Katz says “the normals” have much to learn from studying stigmatized individuals. She hopes this research will shed more light on the needs of women with anorexia and help to improve future treatments.
“The majority of the participants started publishing their blogs to receive the emotional and esteem support that they felt was missing in their offline environment. They were also looking for non-judgmental and 24-hour support,” she says. “If we know this is the type of support they are missing, that can help us design better recovery blogs. We also hope this study can inform health professionals who treat people with EDs.
“Some of these [pro-ana] images are disturbing for us, the healthy people, especially the images of emaciated bodies or self injuries,” Yeshua-Katz continues. “It is also hard to read about the personal experience of people who have to cope with not only a deadly disease but also a disease that is highly stigmatized. But we conducted the research to understand the stigma experience better, and therefore, there was no room for judgment. And, when you know that what you do matters, it makes [the blog content] a lot easier to deal with.”
To read the full paper, visit http://www.tandfonline.com/doi/full/10.1080/10410236.2012.699889