Anorexia can be debilitating

Doctors at one of the country's largest eating disorders treatment centres said they needed to act more responsibly.

The eating disorders charity, B-eat, said little progress had been made on combating "pro-ana" sites.

The networking sites said it was hard to distinguish between support groups and "pro-anorexia" groups.

But a spokesperson for MySpace said they were working with organisations such as B-eat.

Over 1.1 million Britons are known to suffer from an eating disorder.

The vast majority are women, although experts believe the numbers could actually be much higher as many cases go undiagnosed.

Social networking sites can censor their material and we expect them to act responsibly

Dr Ty Glover, consultant psychiatrist

Specialists and charities say the rise of the internet and new media has played a significant part in providing easier access to information on how to get thin.

Research has shown that young women exposed to pro-ana websites felt more negative, had lower self-esteem, perceived themselves as heavier and were more likely to compare their bodies with other women.

'Common theme'

Dr Ty Glover, consultant psychiatrist on the Eating Disorders Unit at Cheadle Royal Hospital, said it had proven difficult to shut down pro-ana websites, but the situation was slightly different for sites such as Facebook.

"Social networking sites can censor their material and we expect them to act responsibly," he said.

Rather than censor these groups, we are working to create partnership

MySpace spokesperson

"We are horrified at the content of these sites and the tips they give on how to be thin.

"People with eating disorders are extremely vulnerable and often have very low self esteem, so pro-ana and pro-mia sites can be very damaging as they are sending out the wrong advice."

It is thought there are more than 500 pro-ana and pro-mia internet sites.

Cheadle MP Mark Hunter has asked the government to promote awareness of the dangers of such websites.

"These websites are truly despicable and only help to reinforce the myth that having an eating disorder isn't a problem," he said.

Susan Ringwood from B-eat, who are due to launch a report this week calling for better support for families of people with eating disorders, said the websites encouraged people to avoid treatment.

"We believe that the sites should act responsibly.

"They have acted to remove other content that is seen as 'dangerous', or could encourage young people to do dangerous things."

She said they were not calling for such sites to be banned completely, but for greater awareness of the dangers and for more support online so the sites are not the "only refuge".

But Shannon Bonnette, who is recovering from anorexia, told the BBC that looking at anorexia web pages actually helped her overcome the illness.

"What I found through visiting those site was that there was a common theme - everybody stays miserable," she said.

A spokesperson for MySpace said: "It's often very tricky to distinguish between support groups for users who are suffering from eating disorders and groups that might be termed as "pro" anorexia or bulimia.

"Rather than censor these groups, we are working to create partnerships with organisations like B-eat.

"We have also placed ads on pro-anorexia profiles for up to a year from the National Eating Disorder Association to target these groups with positive messaging about how and where they can get help."

A spokesperson for Facebook said the site supported the free flow of information.

"Many Facebook groups relate to controversial topics; this alone is not a reason to disable a group.

"In cases where content is reported and found to violate the site's terms of use, Facebook will remove it."

Read a selection of your comments on this story:

I recently realized that I suffer from anorexia, and have begun treatment. My case is probably on the mild side, but even so I am astonished that anyone could want to be anorexic. The dreadful constipation, the depression, the feeling of isolation - it's miserable being anorexic, and dangerous to your health. Most people do not realize how damaging anorexia is to the body. If the social networking sites do not crack down on these pro-ana and pro-mia sites, they will be placing many girls and boys with poor self-esteem in harm's way. It could even lead to a lawsuit, and I'm certain MySpace etc. would find that vastly inconvenient.

Ces, USA

Pro-anorexia sites, like anything which advocates harmful lifestyles, should ideally be banned. Unfortunately, this just drives them underground. This makes it even more difficult for those caring for sufferers of eating disorders to understand what messages and signals are being sent. What is important is that everyone should be aware of how sudden, death from starvation can occur, especially when it is combined with excessive exercise!! Gyms should be aware that people with eating disorders will over-exercise in order to burn off more calories. These people are then putting themselves in greater danger. I speak from the experience of seeing my daughter do this. No gym ever suggested to her that she was no longer fit enough to maintain her exercise regime, suggested a shorter time, or stopped her from using their facilities. She did reduce her exercise when she began to recover, and, with more food put on some weight. Unfortunately, after a few months she relapsed, and she died last year. It is this fact that people should be made aware of. Anorexia is not a fad to lose weight; she wanted to eat, but could not bear to do so.

Jenny, Sheffield

I found much on anorexia on MySpace when I did a search, those pages I looked at seemed to be well intentioned with good advice. I can believe there are sites catering to the idea that anorexia is good though, just could not find them quickly. What bothers me is not that these sites exist but that the people who should see them as an opportunity to learn how these people think and engage them at their own level in a non confrontational way(anonymously even) are so blinkered. They may be otherwise intelligent people but they lack any kind of vision and apparent understanding how the Internet community works. All they do is some quasi- scientific study and come to the conclusion such sites may reinforce anorexic behaviour. Anyway, censor them and alienate them. Genius idea. Come one people. Do some of that thinking out side the box.

David Reynolds, Plymouth UK

I am the senior administrator of an eating disorder message board, and whereas our forum is definitely on the pro-recovery side of the "debate", it has to be said that websites don't cause eating disorders. Skinny celebs don't cause eating disorders. Eating disorders are almost always caused by severe childhood trauma either from abuse or severe emotional distress. I for one would like to see the BBC actually produce a documentary that tackles the real issues, with real science instead of just blaming anorexia on "Posh Spice"

Tom, Hackettstown, NJ

I have never been diagnosed with an eating disorder, although like most teenagers I had a phase where I starved myself and purged when I did eat. We live in a country of free speech and I do not think that pro-ed websites should be banned. They cannot give people eating disorders, the person must already be well on their way. Whilst agreeing that pro-ana/mia websites are not the best means of support, they can be useful in stopping the feelings of isolation that sufferers are likely to have. Also it makes it easier to target those with eating disorders as a lot of them will be on pro-ed sites!

Rachel, London

To say one supports "the free flow of information" without first deciding whether the information is ethical or not, is not acceptable. I have worked with anorexia patients who used the web to support their illness. They "knew" that participating in these sites was self destructive, but like other addicts, they found it very difficult to resist the allure, and seeming support of these sites. We need National and International bodies to search out and ban these sites. Also I would suggest hefty fines for sites like Facebook who don't do enough to keep there pages safe. Their owners can well afford to insure ethical behaviour on their sites. To see the suffering of anorexia close up is heart breaking, especially for the extended families. We must do all we can to limit this deadly illness.

Patrick Tummon, Cape Town South Africa

When I was in High School, my girlfriend had a serious eating disorder. When I confronted her about it she wouldn't admit to it right away. Eventually, we got through it together. However, it was made a lot harder because her friends were doing it. I think that girls are especially social creatures and will use sites that are pro-ana or pro-mia to justify/increase their disorders. I know there is a lot of concern about censoring web material, but if facebook was around 6-7 years ago when I was dealing with it, I think it would have been even harder for her to overcome.

Christian, Wheaton, USA

Having just read this story, I decided to have a look at one of these sites. I was shocked and sickened by it. The people who run sites like this are going to be responsible for the needless deaths of many young people.

SW, York, UK

Although not a direct experience - I find it disheartening that an MP would say that "these websites are truly despicable" - Come on. Generally the contributors to these websites are anorexics with low self image - the last thing they need is for some mis-informed MP to spout off about them being despicable! Maybe the MP should control his messages - please!

Barry Hearne, Johannesburg South Africa

If we are considering anorexia (and to some extent emotional overeating or obesity) as a form of self-harm, then pro anorexia or pro obesity sites should equally be areas of concern and debate. Each disorder has the potential to end life prematurely. These web sites should come with some form of responsibility, and resources of contact for consumers to activate support. Anorexia and obesity are both life threatening in their extreme and acute presentation. Both have been related to a form of neurological or brain dysfunction. Personal choice appears to play a smaller part to play in managing either anorexia or obesity according to research, although engagement and current easily accessible information is important. These key websites can become more empowering and informative to send people inspiring anecdotes of recovery. Pro anorexia is a very risky stance to promote is has very real consequences of mortality. Parents would and should be very concerned. Allied health has a responsibility to respond and join in the debate to activate change.

Yvonne Mitchell, St. Albans, Herts

Imagine a world where, instead of leaping on the internet as a convenient scapegoat, we tackled the all-pervasive lies about what women should look like that are the real cause of anorexia. No, I didn't think you would.

Vashti, Cardiff, Wales, UK