America Online, which has about 23 million U.S. subscribers, has removed several pro-eating disorder Web sites in the past few years under its policy prohibiting "material that defames, abuses, threatens, promotes or instigates physical harm or death to others, or oneself," according to company spokesman Andrew Weinstein. "Encouraging an eating disorder would fall into the category of promoting physical harm to others," Weinstein wrote in an e-mail.
Grefe said NEDA realized that its time was better spent getting the word out about eating disorders and treatments, rather than pushing to eliminate the sites. "We can't rid the world of these sites . . . but we can be more proactive in trying to get real information out to the public," Grefe said.
Alison Devenny, 19, visited pro-eating disorder Web sites regularly until seeking treatment three months ago.
(Andrea Bruce Woodall - The Washington Post)
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NEDA sets up booths at schools to educate students about eating disorders and available treatments, and it runs a confidential telephone help line. It also offers eating disorder information on its Web site.
Health professionals said people who think they may have eating disorders should seek medical treatment, rather than surf the Web for advice.
"I would prefer that individuals not access that particular door [pro-eating disorder sites] because I think there are dangers involved," said David B. Herzog, president of the Harvard Eating Disorders Center.
Most sites offer a disclaimer on their home pages: "If you are currently in recovery from an eating disorder or if you are offended or otherwise disturbed by the existence of pro-ana, I suggest you go no further," warns a site called The Thin Files. Others discourage visits by those under 18.
The Blue Dragon Fly site takes a different approach. It acknowledges that eating disorders are mental illnesses. Still, discussions on its forums resemble those on other sites. But its creator warns on the home page: "Tips are to give you fresh ideas on how to stay on track so that you don't fall into a depression and kill yourself -- not to teach you how to 'not eat.'"
Some site visitors are harshly critical of former anas and mias who have sought treatment. The creator of a site called Help Me Ana explains on her home page that she has gotten treatment and will no longer be maintaining the site. Some visitors signed her site's guest book and wished her well, but others accused her of turning against them.
"HAH recovery, u r jus like the rest of them, u tune in & cop out wen it gets tough, i hope ur happy wen u get fat & hideous. Ana loved u & ur rejecting her 2 join the obesians," read a message signed by someone using the screen name "witchyfingers."
"I feel kind of bad for girls who go into it with a little less maturity and buy into everything they read," said Devenny, an international studies major from New Jersey who is now in therapy and on medication for anorexia, bulimia and binge-eating disorder.
"I think it's dangerous, especially in the wrong hands. . . . This is a life and death matter for a lot of people."
Resources
To reach the National Eating Disorders Association's confidential help line, call 800-931-2237. For more information about eating disorders and treatments, visit www.nationaleatingdisorders.org/p.asp?WebPage_ID=337, www.hedc.org or www.nimh.nih.gov/publicat/eatingdisorders.cfm.
