title: e-Ana and e-Mia: A content analysis of pro-eating disorder Web sites.
abstract: OBJECTIVE
  The Internet offers Web sites that describe, endorse, and support eating disorders. We examined the features of pro-eating disorder Web sites and the messages to which users may be exposed.
  
  
  METHODS
  We conducted a systematic content analysis of 180 active Web sites, noting site logistics, site accessories, "thinspiration" material (images and prose intended to inspire weight loss), tips and tricks, recovery, themes, and perceived harm.
  
  
  RESULTS
  Practically all (91%) of the Web sites were open to the public, and most (79%) had interactive features. A large majority (84%) offered pro-anorexia content, and 64% provided pro-bulimia content. Few sites focused on eating disorders as a lifestyle choice. Thinspiration material appeared on 85% of the sites, and 83% provided overt suggestions on how to engage in eating-disordered behaviors. Thirty-eight percent of the sites included recovery-oriented information or links. Common themes were success, control, perfection, and solidarity.
  
  
  CONCLUSIONS
  Pro-eating disorder Web sites present graphic material to encourage, support, and motivate site users to continue their efforts with anorexia and bulimia. Continued monitoring will offer a valuable foundation to build a better understanding of the effects of these sites on their users.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. dborzeko@jhsph.edu
authors.forename: Dina L G
authors.initials: DL
authors.lastname: Borzekowski
authors.forename: Summer
authors.initials: S
authors.lastname: Schenk
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Wilson
authors.forename: Rebecka
authors.initials: R
authors.lastname: Peebles
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000704:Analysis of Variance; D001294:Attitude to Health; D001504:Beauty; D001828:Body Image; D002755:Choice Behavior; D003196:Computer Graphics; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet / Q000458:organization & administration*; D008019:Life Style; D009042:Motivation; D000297:Psychology, Adolescent; D012649:Self Concept; D012944:Social Support; D014584:User-Computer Interface; D055815:Young Adult