The UK's Royal College of Psychiatrists ("Let Wisdom Guide") wants something done about websites that encourage anorexia and bulimia. "Pro-ana" and "pro-mia" sites appear to attract "a significant number of teenage girls... in particular those with a high risk of eating disorders," say the psychiatrists, and they encourage people to see anorexia and bulimia as "lifestyle choices" rather than mental health problems. But banning such sites outright isn't appropriate.

Internet information exists on all sorts of terrible topics, but the RCP singles out pro-ana and pro-mia sites as for special comment because eating disorders "have a peak age of onset in adolescence, at a time in life when peer influences are particularly strong." Such disorders also show a "social contagion effect," showing up in clusters rather than a random distribution. Pro-eating disorder sites are therefore more than a reflection of a problem; they can encourage more of it (in the same way that sensational suicide reports in the media can lead to an increase in suicide).

We checked in with Kerry DeVries, a Chicago-area psychotherapist who works with adolescents who have eating disorders; she confirms that eating disorders can be increased by putting girls who suffer from them into group settings with fellow sufferers. "Girls that struggle with anorexia are extremely competitive with each other," she says, "so groups in general have been contraindicated for their treatment. It spikes the behavior when they get around each other, they start trying to outdo each other in degrees of skinniness."

Pro-ana websites present exactly this sort of scenario. "Having the websites offline would diminish access to a worldview that is deemed by scientists and psychologists to be incredibly unhealthy, one that can compromise [girls'] health in a very strong way and shorten their lifespans significantly," says DeVries.

But controlling such sites runs into freedom of speech issues in most democracies; and as the RCP notes, "making them illegal would lead to criminalizing a vulnerable group of young people," since most sites are set up by people who have an eating disorder themselves.

Instead, the RCP recommends that pro-ana and pro-mia sites become a part of the government's action plan for Child Internet Safety, which encourages industry self-regulation and education for parents and teachers.

This is a less dramatic recommendation than one proposed last year in France to ban all such sites outright (this failed to become law). The Netherlands, under one proposal, would address the problem by leaving the site content alone but requiring a "click-through" notice to appear on first load, warning about its content. Such schemes are always difficult to enforce on the Internet, though, as sites can easily be hosted in other countries where the laws are different.

For now, though, the sites serve as a reminder that the Internet "globalizes" all sorts of material—bringing even pro-ana and pro-mia communities into the smallest towns and schools where they might not otherwise exist.

And it's not just the Internet, of course; in the UK, a part of the Liberal Democrats' new "Real Women" (PDF) campaign involves a push to "help women make informed choices by requiring adverts to clearly indicate the extent to which digital retouching technology has been used to create overly perfected and unrealistic images of women."

Listing image by Lib Dems