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Going down the Pro-Ed pipeline

TRIGGER WARNING: The following article discusses mental health behaviors that may be troubling to some readers. Reader discretion is advised. –Ed.

I’ll wear this dress when I lose 5 kg,

I told myself after hours of looking at my reflection. No matter how long my eyes stare at the mirror, my brain tells me I’m not skinny enough. In response, I go on a diet consisting of water, cigarettes, and malatang binges that I end up vomiting. As I sat in front of the toilet bowl, neck burning, eyes tearing up, I refused to believe that this was a problem.

Pro-eating disorder (Pro-ED) and Pro-Anorexia (Pro-Ana), are terms referring to those who believe anorexia is a lifestyle choice instead of an illness. But, under a wider definition, it refers to a community of mostly young girls who struggle with an eating disorder, and are not yet ready to recover. Those who identify as Pro-Ana, unlike public perception, do not necessarily advocate for the promotion of anorexia.

Nevertheless, I used to feel a hint of resentment towards these Pro-Ana girls, believing that I would have developed into a stronger person, both mentally and physically, had I not been exposed to this content at such a young age. I believe this is why lawmakers seek the easiest solution: to ban all Pro-Ana communities completely and criminalize the act of sharing Pro-Ana content (which is what happened in France, in 2015).

It is easy to demonize the community. Nonetheless, we must recognize that they are people, suffering with one of the deadliest psychiatric disorders. Most users I’ve interacted with were underage children and even the “adults” of the community whom I used to look up to were only 18 and 19. These individuals shouldn’t be shamed, dehumanized, or even silenced, but instead treated with empathy.

As a matter of fact, Pro-ED communities fulfill the need for a community that can understand the affected individuals’ struggles, and provide a source of non-judgmental support. However, despite the intention to remain hidden from non-EDs, Pro-ED communities have gained a new audience in recent years.

Pro-ED content is not a new phenomenon. In fact, these communities have existed online since the early 2000s. Early Pro-ED communities were founded mainly on blogs and forum websites. These Pro-Ana websites did not wish to garner a non-anorexic audience, and heavily discouraged them to join. The majority of members were those who had already suffered from an eating disorder for years and did not wish for other young girls to follow their path. Those who were curious would be met with disclaimers before entering Pro-ED websites. There were several different ED and Pro-ED forums, and they each had their own culture and regulations based on their differing levels of how “pro” they really were. Some allowed insights into their members’ struggles to recover, but banned any descriptions of body image. Some banned sharing tips on using substances, but allowed tips on how to starve “safely.” Additionally, the forums that actively glamorized anorexia and bulimia were the ones most underground, because a rise in the website’s popularity would lead to the danger of it being removed.

Expert opinions on the restriction of Pro-ED websites vary. Annie Hayashi, spokesperson for the National Association of Anorexia Nervosa and Associated Disorders (ANAD), warned in a 2006 ABC News interview that these websites were "potentially deadly" as they reinforce behaviors associated with the disease, and advocated for their removal. However, a recent research study published in Perspective Public Health argues against censoring all Pro-Ana websites, and even highlights their therapeutic value for individuals feeling isolated due to their illness.

Despite the complexity of this issue, media coverage during the 2000s ignored these nuances by sensationalizing the story. NBC described the “Pro-Ana movement” as having a “cult-like appeal,” and a New York Post headline wrote, “Sick World of Pro-Anorexia Internet Sites.” A tabloid went so far as to appropriate a girl’s picture posted on a private Pro-Ana website to shock the audience.

In response to public scrutiny, hosting websites such as Yahoo took down any websites that were tagged Pro-ED. Alongside this mass removal, blogs and forums started to decline in popularity as an online platform. As a result, By the 2010s, Pro-ED communities found refuge in emerging social media websites such as Tumblr, Instagram, and Twitter.

Twitter in particular is known to have the most severe ED culture, under the tag Edtwt. However, this is only half true. Unlike previous Pro-ED forum websites which had their own cultures and regulations, users can find a diverse range of content under the umbrella of Edtwt, including Pro-ED and Pro-Recovery communities. Users who actively encourage recovery and those who share life-threatening starving tips all share the same space. A typical timeline can consist of a few aesthetically pleasing thinspo threads, what i eat in a day posts, tweets fantasizing what they would do when they are skinnier (with a general sentiment of hopes that people will be nicer and clothes will look better), ED related memes, and lastly tweet after tweet with vents and a desire to be understood.

Most accounts are made dedicated to ED content, and recognize how to use Twitter’s algorithm: only follow ED related accounts to create an ED dedicated echo chamber. Thus, although existing on a public online platform, the unwritten rules of Edtwt are to not interact with non-ED accounts and to refrain from using Edtwt specific terms outside the community in order to minimize the spread of eating disorders to other users. They recognize that their content can be mentally damaging, yet they themselves rely on it for the shared understanding it offers. Furthermore, many Twitter users dissuade users on other platforms, especially TikTok, from participating in Edtwt. ED-TikTok users are deemed as young, impressionable posers. While longtime users call ED-TikTok users “wannarexics” and eventually cyberbully them off the site, there is a hint of endearment and concern towards the youth; a desire to prevent children from ending up in the same destiny as their older counterparts, despite them also being mere teenagers themselves.

These unwritten rules, self-regulation, and “gatekeeping” give the impression that Edtwt is secluded from the general public. However, despite these efforts, the algorithm still suggests Pro-ED content to outsiders. A user under ED recovery once tweeted that a single thinspo tweet on her timeline led to a temptation to relapse.

Recommendation algorithms are what differentiate the landscape of old forum websites and social media. Previously, websites were exclusively available to only those who sought out specific information, whereas social media websites introduce users to potential topics of interest through a personalized algorithm, granting an opportunity to discover new content, which one may have not found otherwise. In the case of Pro-ED communities, the switch in platforms has led them to - unintentionally - garner a new audience.

Recommendation engines are used by social media companies to maximize engagement. Not only does a specific algorithm predict what we like, but it also helps us discover new content, and continues to refine itself based on our reaction to such.

Recommenders help users discover new content that they are unaccustomed to, but still potentially interested in, by using an algorithm which classifies users into clusters based on data, such as demographic information, interests, behaviors, and connections. The algorithm adapts to the user to create a more personalized experience by altering certain calculations when a user interacts or doesn’t interact with the content.

Therefore, it can be concerning when the Pro-ED community migrates from forums and blogs to social media. Not only is Pro-ED content more accessible to the public on these new platforms, but algorithmically, recommenders can target those most vulnerable to this content and profit from their engagement with it.

According to a study conducted by FairPlay, a nonprofit organization dedicated to reducing the influence of harmful commercial culture on children, Meta’s algorithms specifically suggested Pro-ED content to insecure young girls. The study documented the potential process whereby young users start to engage with this type of content. This process begins with young girls being exposed to diet and fitness content or trends, focused on beauty and appearances (such as the “thigh gap” or facial symmetry ). Those who engage with this content are grouped together, which tells the algorithm to continue feeding them with similar, yet more addictive content. To a young teenager struggling with insecurities, this type of content increases dissatisfaction with their body, but is still captivating.

As an adult who was once a teenage girl myself, this study resonates. I remember my feed being filled with beautiful women with bodies that I did not have. Then, all the suggested content about weight loss tips from non-professionals would be in my “saved for later” folder. It did not feel like a lot of scrolls and clicks were necessary for my feed to be swarmed with thinspirations and timetables of how many calories I should eat in a day—Pro-ED content that I was not aware of.

This is what FairPlay describes as the “Pro-ED bubble,” and as users continue to engage with this type of content, they become stuck. The recommendation engine algorithmically classifies them into this cluster, and recognizes that continuing to suggest this type of content will result in continued engagement. And even if one wishes to recover, being in this bubble would make it very hard to escape the algorithm.

In social media spaces where anyone can fall into this bubble, eliminating Pro-ED communities may seem like the simplest solution. Yet, it is a dangerous one. Some pro-recovery accounts find themselves attached to the Pro-ED side of the community because of the mutual understanding among friendly users; some even say they started recovery because another Pro-ED user urged them to do so. I may have started my accounts for the thinspo, as well as to continuously trigger myself, but under the security of anonymity, I ended up confessing my deepest darkest childhood memories—I felt as if I had a community of girls who were truly emotionally supportive. Pro-ED communities can alienate users from the “real world” and professional help, even convincing them that eating disorders are a mere lifestyle. Still, eliminating them entirely would make ED patients feel a different kind of alienation, stemming from their need for a deeper understanding and for support in addressing the underlying issues that contribute to their problematic eating patterns.

Although censoring all Pro-ED content is potentially harmful to those who rely on these communities, technological regulations can help prevent the spread of Pro-ED content among young users, even if it may result in loss of profits by tech companies. Recommendation engines lead some young users down the Pro-ED pipeline, yet what if this nudge was not directed at what would grab attention, but rather at content that could lead users to a healthier alternative?

Meta proposed a solution after it was criticized for using algorithms that unintentionally promoted ED and other mentally damaging content. In response to this criticism they started recommending irrelevant content, from pictures of cats to travel vlogs, to young users who were spending concerning amounts of time viewing content on diet and body image. They would nudge them to stop thinking about their body. Technology can lead users to personalized help and be a force for good, but only with the initiative of the corporations that develop it.

Meta’s proposed solution can be effective in diverting young users’ attention away from obsessing over their bodies before developing an eating disorder. Although it may result in a loss of profit for tech companies, this method can prevent users from falling down the Pro-ED pipeline. However, the solution cannot be purely technological: we too must make efforts to alter current culture.

Eating disorders are a form of addiction. Yet, unlike other addictions, the supposed promises of anorexia are praised by our culture. In the early 2000s, the very media that sensationalized pro-anorexia, raising concerns about their health, were simultaneously the ones glorifying a certain type of body and shaming the other. Although Meta implemented their “nudge” solution, Instagram still provides filters to alter one’s body in pictures. Therefore, how could we expect a disordered youth to recover when our culture perpetuates the idea of an unrealistic and non-diverse body image as ideal?