Abstract

BackgroundThere is widespread use of the Internet to promote anorexia as a lifestyle choice. Pro-anorexia content can be harmful for people affected or at risk of having anorexia. That movement is actively engaged in sharing photos on social networks such as Flickr.ObjectiveTo study the characteristics of the online communities engaged in disseminating content that encourages eating disorders (known as “pro-anorexia”) and to investigate if the posting of such content is discouraged by the posting of recovery-oriented content.MethodsThe extraction of pro-anorexia and pro-recovery photographs from the photo sharing site Flickr pertaining to 242,710 photos from 491 users and analyzing four separate social networks therein.ResultsPro-anorexia and pro-recovery communities interact to a much higher degree among themselves than what is expected from the distribution of contacts (only 59-72% of contacts but 74-83% of comments are made to members inside the community). Pro-recovery users employ similar words to those used by pro-anorexia users to describe their photographs, possibly in order to ensure that their content appears when pro-anorexia users search for images. Pro-anorexia users who are exposed to comments from the opposite camp are less likely to cease posting pro-anorexia photographs than those who do not receive such comments (46% versus 61%), and if they cease, they do so approximately three months later. Our observations show two highly active communities, where most interaction is within each community. However, the pro-recovery community takes steps to ensure that their content is visible to the pro-anorexia community, both by using textual descriptions of their photographs that are similar to those used by the pro-anorexia group and by commenting to pro-anorexia content. The latter activity is, however, counterproductive, as it entrenches pro-anorexia users in their stance.ConclusionsOur results highlight the nature of pro-anorexia and pro-recovery photo sharing and accentuate the need for clinicians to be aware of such content and its effect on their patients. Our findings suggest that some currently used interventions are not useful in helping pro-anorexia users recover. Thus, future work should focus on new intervention methods, possibly tailored to individual characteristics.

Highlights

  • BackgroundEating disorders, such as anorexia nervosa and bulimia, are highly prevalent in most developed countries [1]

  • JMIR--Pro-Anorexia and Pro-Recovery Photo Sharing: A Tale of Two Warring Tribes | Yom-Tov | Journal of Medical Internet Research We identified tags related to anorexia content by representing the tags using a vector space model and selecting all tags that appeared solely in this content or were at least 10 times more likely compared to content that was identified as neutral by the labelers

  • We examined tags that identify the photo as pertaining to the photographer him or herself

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Summary

Introduction

BackgroundEating disorders, such as anorexia nervosa and bulimia, are highly prevalent in most developed countries [1]. Generally viewed as highly negative by the general public, there is an online movement of people promoting anorexia as a lifestyle choice [3,4] These communities are variously referred to as pro-anorexia, proana, or “ana”. Several studies of content published on pro-anorexia websites and forums have identified the following characteristics of pro-anorexia communities [3,4,5] Members of these communities use particular websites to share photographs and text designed to inspire members to lose weight (or maintain an immoderately low weight), as well as tips on how to lose weight to extremes that are far beyond reasonable. Future work should focus on new intervention methods, possibly tailored to individual characteristics

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