Life in the fasting lane

Pro-ana is shorthand for promoting anorexia nervosa. Websites which encourage and even justify the eating disorder have been widespread since 2001.

Liane Lurie, a clinical psychologist in Johannesburg, says: "Individuals who battle with eating disorders often feel that nobody understands their difficulties. A pro-ana community essentially functions as a peer group, where they may find acceptance."

But Lurie warns that "the danger is that individuals in these communities often share destructive habits as a way of maintaining their restrictive routines".

On these sites, under the anonymity that the internet provides, anorexia sufferers can openly discuss their disorder in "supportive communities", share their unhealthy weight loss goals and exchange advice on how to reach them.

"How many calories are in toothpaste?" and "Do I still consume calories if I chew but don't swallow my food?" are some of the disturbing questions that are casually asked in pro-ana forums.

To inspire and motivate devotees, these sites provide thinspiration (thinspo) - images of celebrities, models and other people who fit their ideal of the perfect body.

Think pictures of "coveted" body parts like razor-sharp ribs, protruding collar bones and emaciated models who can stand without their inner thighs touching (inner thigh gap). These images are often accompanied by thinspirational quotes like: "Don't reward yourself with food, you're not a dog" and the line "nothing tastes as good as thin feels", which was popularised by waif-like model Kate Moss.

Some websites even advocate the ABC Diet (Anorexia Boot Camp), a controversial 30-day eating plan that causes rapid weight loss by varying caloric intake from "as much" as 500 calories (less than half the daily minimum requirement for women) on some days to nothing on others.

When devotees reach their goal weight they are congratulated for staying in the fasting lane, then new goals are set.

"For the individual who strives to be super-thin, there is never a limit. Too thin is never thin enough," says Lurie.

People's acceptance of anorexia has recently become more popular with the advent of blogging and social networking.

In recent years some of the (largely female) users who frequent pro-ana sites have even rid themselves of pseudonyms, replaced avatars of painfully thin models with pictures of themselves and openly joined pro-ana pages on Facebook.

But after several complaints from users, Facebook and blog hosting site Tumblr installed stricter terms of service agreements, prohibiting pro-ana and other self-harm content.

Toby Shapshak, editor of Stuff magazine, says: "The internet by its very nature is resistant to censorship. Even though I now find it morally reprehensible and clearly unhealthy, the nature of the technology is that it resists that type of thing [censorship], so people [will always] find a way to communicate, in spite of easily enforceable censorship mechanisms."

Shapshak is right.

As a result, a large portion of the pro-ana community have migrated to Pinterest. But last week Pinterest established new terms of service which come into effect on April 6.

They "prohibit users from posting content that creates a risk of harm, loss, physical or mental injury, emotional distress, death, disability, disfigurement or physical or mental illness to yourself, to any other person, or to any animal" - in short pro-ana content will be banned.

"Blocking pro-ana sites is one solution. However, it doesn't address the root of the problem. Food- and weight-related issues are often symptomatic of underlying problems. Interventions and education need to take place on all levels, from parents and teachers to peer groups themselves," says Lurie.

Source: The Times