To the attention of Honorable
Michela Marzano (MP),
Paola Binetti (MP),
Mara Carfagna (MP),
and 49 other members of the Italian Chamber of Deputies.
In June 2014, you have proposed a bipartisan bill that would give jail time for up to one year and hefty fines (10,000 to 50,000€, that is 13,000 to 67,000$) to people “encouraging eating disorders”. The not-too-implicit targets of the proposed law are the so-called “pro-ana” and “pro-mia” websites.
The preamble of the new bill starts from the right angle – reminding of the severity of eating disorders and the dangers especially for adolescents and young people. But then oddly, you give up any effort to tackle the problem seriously or to understand the root causes that lead to the spread of eating disorders in Italy and elsewhere. Without looking for a real solution, you resort to the easiest option: sheer repression of the websites and criminalization of their authors. Repression is easy: you put yourselves on the “right” moral side and punish the “wrong” side. This posture may appease your consciences and generate media exposure for you, but alas, it is unlikely to do any good in dealing with a complex issue as eating disorders and their online manifestations. In this context, it is difficult to tell apart the right and the wrong sides.
In fact repression may turn into a social disaster.
The proposed bill is based on a wrong assumption — that those contributing contents to forums and websites centered on anorexia and bulimia are shady, morally questionable, agenda-driven “agents provocateurs” inciting young internet users to embrace anorexia and bulimia.
We regret you didn’t take the time to leaf through the body of existing scientific literature on the so-called “pro-ana phenomenon”. In fact empirical evidence reveals a completely different scenario. Those who contribute contents to websites and social media groups centered on eating disorders are mostly young sufferers themselves, expressing their discomfort and looking for understanding and support from their peers. That they incite, let alone provoke, unhealthy behaviors in others, is by no means proven.
Some of this evidence comes from our own work. Since 2010, with a multidisciplinary team of scholars from universities in France and Great Britain, we have researched online communities of persons living with eating disorders (see our Anamia project). Via questionnaires and interviews, after mapping the existing websites, we have analyzed behavioral patterns, motivations and attitudes of their authors. And the conclusion of years of research is that the very notion of pro-ana is out of touch with reality.
The glorification of anorexia is far from representing the diversity of practices and attitudes found in these sites. Their users and contributors do not aim to proselytize but rather to create spaces for information-seeking, self-help and support. Somehow, the internet is experienced as a complement for healthcare, albeit an imperfect one. Especially in regions where appropriate infrastructures are absent and professional care is hard to get. “If you’re not in hospital, there’s very little guidance or support for you … they haven’t got money to fund anything”, admits one participant to our study. Online communities also help when symptoms are unrecognized, or so mild that formal care is not offered: “The sad thing is”, concedes another participant, “until you get a really really low weight, you can’t really get the help”. Online communities of persons living with anorexia, can act as online “early warning systems” for persons at initial stages of these disorders.
Online communities and platforms can even do actual good by countering the isolation that is typical of persons living with eating disorders. By hiding their food intake and purging behavior, by underplaying their weight fluctuations or excessive exercise, persons living with eating disorders often obstruct the formation of trusting relationships and refrain from support-seeking, to the detriment of their health. In this context, participation in “ana” and “mia” online communities (the “pro-” prefix seems now unsuitable) is sometimes the only opportunity to recover some form of sociability, to share experiences with others and to communicate again about food. According to another young woman interviewed for our study: “Internet helped me a lot in the sense of not feeling alone anymore, because it is true that at the beginning of my eating disorder… I was all alone, you know. Nobody to understand me and all that (…) I realized that I was not the only one to live with it. I learned that I could get better, or I could die.”
As far as websites centered on eating disorders can open paths to recovery, or raise awareness as to the heavy risks related to disordered eating patterns, they can be sources of information for anorexia sufferers, and provide insight to healthcare professionals willing to get a better understanding of the behaviors of their actual and potential patients. Unfortunately, criminalization of eating disorder websites would prevent such circulation of health information and interrupt the budding online dialogue between persons with eating disorders and healthcare intermediaries.
Another false assumption is that repression and censorship of online “ana” and “mia” contents will prevent their proliferation. The evidence in our possession indicates that these online communities do not proliferate. They migrate, they dissolve and regroup to escape censorship, but their number is unlikely to be as high as the preamble to your bill suggests: 300,000 is not the number of actual anorexic websites, but only the websites displayed by Google after a simple search, most of them pointing to sensationalist media stories and pages warning against the dangers of eating disorders. The French-speaking web, which we have explored and mapped extensively, counts a meager 593 websites (that is to say the 0,2% of the proposed Italian estimate!). These are mainly blogs, plus some forums and social media groups, and their number has remained stable since 2010.
This is not to say that ana-mia online connections are never harmful. Community members themselves recognize the dangers involved in discussions that revolve constantly around eating and might precipitate them further into their disorder. But they do not remain passive against these perils. Administrators, moderators, and simple members often activate themselves to keep the community a welcoming place for all, for example by not letting too many negative messages in. Some actively encourage fellow members to seek treatment if they feel they are at serious risk. In short, there is some degree of self-regulation, so much so that massive polarization toward extreme “pro-ana” opinions is hardly ever observed. There is no need for external forces to police these websites, pace your belligerence. Criminalizing these websites, means criminalize mental illness – a double burden for sufferers.
Yet there is something that you as policy-makers can do for web users with eating disorders. They are in need of information, guidance and support, as many of them told us: “If there is a message to pass [to law-makers], it is that they should listen to anorexics and bulimics, who are not futile people who care only about their look… it is real suffering”. Then, why not use the Internet itself to deliver the extra care needed? Why not think of some form of online support service to be provided by health professionals, as a complement to existing care provision? Of course setting up such a service would be highly challenging and would require serious preparatory work in consultation with medical experts and civil society stakeholders. But it would contribute to a tangible improvement in the life of sufferers. Don’t be content with just appeasing your conscience — take the opportunity to make a difference, for real.
Thank you for your time and consideration.
Antonio A. Casilli (Associate professor ParisTech / researcher EHESS, Paris)
Paola Tubaro (Reader University of Greenwich, London / researcher CNRS, Paris)