The Pros of Proana and Promia (Yes, Really)
UPDATE (March 2019): This blog post absolutely blew up. It is the most read article on my site, with 20x more views than the next most read article. I wrote about this, and some of the important ramifications it has, here: I’m the #9 Result for One of the Deadliest Google Searches.
Trigger Warning: ED glorification talk / diet talk / pictures
If you know what the terms “proana” and “promia” mean, the title of this blog post undoubtedly left you wondering what good things I could possibly say about any such community. If you aren’t aware, then let me fill you in briefly. It should be noted that even if you think you know what these terms mean, this next section will be important to read. There was a lot of preconceived notion-challenging I was forced to do when coming up with this piece, and I’d like for you all to keep the same open mind I did.
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“Proana” and “Promia”
The terms “proana” and “promia” were originally used to refer to online communities and individuals advocating for eating disorders, such as anorexia (proana) and bulimia (promia). You read that correctly; these were originally started as communities that rejected the notion that these are dangerous, possibly deadly diseases requiring medical attention. Rather, they promoted the view that anorexia nervosa and bulimia nervosa are lifestyle choices, and ones they recommend, at that.
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It’s fair to say this was spurred on by people going through eating disorders who were in denial of the situation and wanted to rebel against the conventional knowledge that stated these are medical conditions, not casual lifestyle choices.
So, what might one find on a proana website, forum, Tumblr account, or other social media platform? Here are just a few examples of what they offer:
Advice on [oftentimes extreme] weight loss
Encouragement to power through one’s eating disorder and reject recovery
“Thinspiration,” otherwise known as “thinspo,” which is inspiration (via pictures, stories, videos, etc.) to lose weight and be extremely thin
“Meanspiration,” otherwise known as “meanspo,” which is essentially reinforcement for that “Ed voice” that sufferers report. These posts will say things like, “You’re a pig for eating that donut. Don’t believe what anyone else tells you; self-love is for fatties and uncaring therapists. You want to lose weight; don’t give up now.” Yeah, pretty cruel stuff. It hurt just writing that.
Tips on “cheating” in treatment or ideas for less detectable ED behaviors (i.e. food-hiding or hoarding, chewing/spitting, microbiting, mini-purging, sublingual or buccal drug/food-hiding, etc.)
Support for others going through a tough time
Don’t let that last point go unnoticed, because it’s central to the point of this article. But for now, let’s finish discussion of what exactly this community involves and how it has developed over the years.
From Oprah to Censorship
The popularity of these sites and affiliated platforms emerged on the public’s radar right about the same time internet service providers and other hosting sites began taking action. In 2001, Oprah Winfrey hosted a special in which she discussed the growing phenomenon of proana and promia resources, something that was brand new to most anyone watching at the time. Not too long after, Yahoo responded to official concerns of the messages sent out by such sites and decided to remove them from the “Yahoo Clubs” services.
Throughout the years, sites like Facebook continued to maintain a strict zero-tolerance policy on such material, readily banning anything obviously proana. And in 2012, one of the biggest changes in tide occurred, as Tumblr (notoriously known as the hub of proana and promia material) announced it would shut down any suspected proana accounts.
But agreement on the danger of the proana community was far from universal. The Russian blogging platform “LiVEJOURNAL” refused to join in this wave. In 2007, staff member thevelvetsun argued that suspending such communities “will not make anyone suffering from the disorder become healthy again” and that these communities “[reassure] those who join them that they are not alone in the way they feel about their bodies.”
MySpace was equally against a blatant ban on proana communities, stating it can be difficult to distinguish between recovery/support groups and so-called “ana” or “mia” platforms.
While the concept of anybody promoting a disease as deadly as anorexia (combining statistics tells us about 1400 American women alone will die from anorexia each year*) might be appalling to most of us, we similarly cannot afford to scoff at this community of hundreds of thousands of people (the largest proana site alone boasts well over 300,000 active members). So instead, we owe it to ourselves to ask some important questions.
The Appeal of Ana
As was elucidated in a podcast interview on “Other People’s Lives” featuring an anonymous woman in charge of a major proana platform, there are some very real reasons members of these sites join and stay in these communities. If you’ve been through an eating disorder (or are actively going through one), this might not be too difficult to understand, but for those who have not, let’s think about it like this:
You come to find out a coping mechanism you’ve been using for years is medically recognized as being a “disorder” you need to be treated for. Your parents tell you you’re sick and you need to cut out this behavior and start eating again. Your friends don’t understand or make unhelpful, insensitive comments. The media massively mis-portrays your struggles. You can’t seem to find clear answers anywhere you look. Then, suddenly, you run into one of these communities. You’re now speaking with other members going through similar struggles, scared of the same possibilities you are (“What if I never kick this restricting habit?” “What if I’m a lost cause?” “What if my treatment team and parents are lying to me?”), and not trying to sell you anything (ostensibly).
While the messages often spread in these communities can be incredibly toxic and counterproductive, we should at least understand that there is an element of support and understanding that these communities offer. To discount that would be to give up on half a million people going through an eating disorder.
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What’s Wrong with Them? What’s Wrong with Us?
But, of course, the downsides of these communities speak for themselves. “Meanspo” posts, new member bullying, insanely unhealthy or misguided diet suggestions, and encouragement to continue with (or adopt, even) purging habits, laxative abuse, restriction, drugs, or even self-harm? No thanks.
This leads us - or, at least, me - to the all-important concluding question:
How do we take the “pro” from proana and promia while removing the toxicity?
How do we gain the appeal these communities have, while emphasizing care and recovery? The answer to that seems dependent on one other question:
Well, what is it about our current anti-ana or anti-mia communities - if you will - that eating disorder sufferers are turning away from?
Maybe it’s the fact that we are anti-ana or anti-mia. I know there’s a tendency to look at our own communities through rose-colored glasses and continually give them the benefit of the doubt, but let’s not do that for just one second. I personally see tons of room for improvement within the ostensibly pro-recovery community (at least the communities I’m a part of). For starters:
We prioritize fat acceptance over body acceptance.
This one might not resonate with everyone, and if you do disagree, I encourage you to either comment below (and keep it civil, please) or contact me directly. What I mean by this is that the “fat acceptance” movement, for all of its positive and important messages, still misses the mark on body diversity.
Yes, people in larger bodies face disproportionate discrimination, they are not given the same privileges thin people get, they are not taken as seriously, they are not granted fair medical treatment (something I posted about on Instagram recently, which blew up with angry or trolling sizeist comments), and more. So I’m far from downplaying the impact of weight stigma or fatphobia. In fact, I have nothing wrong with identitarian movements, like the “fat acceptance” movement, because different groups need specialized representation. I hear that.
But it hurts to hear our community literally laugh off the idea of “fit shaming” or - implicitly or not - invalidate the experiences of thin people dealing with eating disorders. I constantly see people berating others for using the #bodyposi or #bodypositive hashtags because they’re “not fat enough,” claiming this was originally a movement for fat people.
And here’s Part 2 of that, which I imagine even fewer people will agree with me on: Eating disorders are not “cured” by reinforcing a body-positive message. With increasing evidence that anorexia nervosa is purely genetic and metabolic in nature (i.e. the psychological element only comes secondary to that) and the understanding that many, many people’s eating disorder experiences have nothing to do with body image (such as in the case of the oft-misdiagnosed Avoidant/Restrictive Food Intake Disorder [ARFID]), we do run the risk, as a community, of fetishizing this “fat is beautiful” message at the risk of pushing anything else forward.
I know some people will read that and already start putting me in a box, labelling me a “false prophet” of body-positivity or whatever. But that’s the problem. We’re so infiltrated with infighting and cliques that it sometimes makes sense to me that those going through an eating disorder wouldn’t want to be a part of our community. Again, though, to reiterate: I think fat acceptance is super important, and I don’t want to see that message go away.
But as long as “body diversity” images refuse to include thin or “fit” people, as long as tongue-in-cheek comments to the effect of “I don’t want to be skin and bones” are part of our collective message, and as long as we try stuffing this social justice message down every possible channel we can, we’re pushing away people who need our help. There are some absolutely wonderful advocates of recovery and “positive nutrition” out there, and I hate to see us so disorganized and lacking in a unified message.
We make intuitive eating out to resemble yet another diet.
Am I alone in this observation? It seems like intuitive eating has become its own diet recently, at least from what I’ve seen over social media and from the responses I get when I ask others what they’ve heard about it. People are selling “intuitive eating meal plans” and marketing “intuitive eating for weight loss” fairly commonly now, which of course completely defeats the point. Intuitive eating literally refers to realigning the body’s hunger and satiety cues, so that you’re no longer fighting against yourself and your metabolism can re-normalize and appetitive cues can become more apparent. Intuitive eating is supposed to be about self-care and body respect, not “self-improvement” or body punishment.
We foster more negativity towards diet culture than we do positivity towards self-love and recovery.
Look, I hate diet culture as much as the next intuitive eater, but there comes a point where we’re doing more shunning than we are helping. Telling anyone in a vulnerable, unsure place of all the horrors of the diet industry is only helpful to the extent that it’s followed up with advice on body respect and giving yourself permission to eat. Otherwise, we’re not doing anything to separate ourselves from the very fear-mongering the diet industry thrives off of.
I’ve found this to be true in my own practice, too. People as a whole are still not quite ready to accept the “anti-dieting” or “health at every size” messages. They’re scared these are empty social justice movements or reactionary yelling.
And, if I’m being honest, I sometimes find it hard to deny this, because of everything I see from our communities. I dream about the day our community, as a whole, becomes a super positive and welcoming place that “kills the diet industry with kindness.”
Let’s focus on how amazing it feels to know you have unconditional permission to eat whatever you want. Let’s focus on how freeing it is to remove any perceptions of “personal fault” from the equation. Let’s emphasize the fact that you, as you are right now, are enough.
People will see those messages from us after scrolling past posts trying to sell them “My 8-Week Gut Blaster!” or “The 5-Week Paleo Meal Plan,” and it’ll be an obvious choice which group is offering them acceptance and respect, versus commands and rules.
We offer solutions, not support.
“Solutions” seem like the obvious… solution, right? This might be a message most of us ED professionals understand explicitly but have not internalized completely.
We like to say, “You are enough, and you don’t need to change anything about yourself” out of one side of our mouths and “You have to stop demonizing foods!” out of the other, and we reconcile this by saying we’re still better than the diet gurus, so what’s the harm?
But this is another aspect of our communities we have lost touch with over time. Instead of broadcasting ourselves as sources of support and understanding (which, unfortunately, the proana communities capitalize on), we instead remain “coaches” and “counselors.”
Let me give you an example of how I fell prey to this myself. This was a lesson I needed to learn the hard way, and though I felt like garbage for it in the moment, it has completely changed how I interact with clients and even the role I see myself as playing as a nutrition coach.
Case Study: The First Client I Ever [Tried to] Refer Out
So I was working with a client dealing with some serious overeating tendencies, which I’d been cautious about not labeling as “binge eating” (so as to avoid the liability of diagnosing Binge-Eating Disorder). But as these behaviors proved resistant to a lot of the low-grade, basic habits I often use with clients facing similar problems (habits like slow eating, basic habit substitution, journaling, etc.), I started to think she just needed a higher level of care.
Having limited knowledge about the referral process and still being relatively new to the coaching profession, I thought it would be prudent to send her an email explaining why I think it would be better for us both if she would join an Overeaters Anonymous group (a group I’ve come to learn from others is not exactly a perfect answer). I assumed we would go our separate ways, she would join an OA group, and I could go to sleep knowing I did the right thing. But that was the exact opposite of what happened.
This client, who I now still work with and have seen tons of progress in ever since, did not take this well (in hindsight, who would have?). She stopped responding to my emails and later admitted to feeling unheard and invalidated by all of this. She felt as though my professional opinion that she was “untreatable” by me felt damning and like further evidence that she is just a lost cause.
She said that in the interim period where we’d stopped talking, she reverted back to binge-eating habits worse even than when we started (to be sure, she had made some small improvements since we started working together, but I had decided these weren’t enough).
We decided to keep working together, and I got to see the life return to her eyes. That’s not an exaggeration, nor is it an overestimation of my abilities. Rather, this whole situation was a testament to the crucial role we play (as dietitians, coaches, therapists, counselors, doctors, etc.) in not necessarily “fixing” things but hearing people and validating people.
With me, she felt like she had a source of accountability and like she had an advocate. Even if I had been giving her the dumbest, most useless habits ever (not that I would), what was most important was just having someone there who has been there for you and helped you work through the rough patches.
That is what we need, as a collective community. We don’t need to “fix” people or even really “solve” problems as much as we need to make sure people feel safe and heard. Before responding to the person who posts, “I just ate 2 donuts and a yogurt; why can’t I stop and finally lose weight??” in a binge-eating recovery support group, ask yourself some questions.
How many people in this person’s life do you think dismissed what they’re going through or somehow implied they just need to “have more self-control”?
What kind of a mental place is this person in right now? Do they need answers, or do they need compassion?
Why is this person posting in here in the first place? What do you think they are asking for, on the deepest level?
We’re still so focused on body image.
This might be one of the hardest ones to get to work on. As a society, we have a difficult time breaking away from body image ideals or standards, even when we think we’re doing the exact opposite.
I spoke about this in much greater depth in my podcast appearance on Sigma Nutrition Radio!
I certainly don’t want to call anyone out, lest I contribute to the very infighting I said we need to cut off. But, there are some unhealthy behaviors (predominantly prevalent in social media, but also heard in little sentiments here and there during treatment or casual conversations) we need to take a hard look at. Here are some examples:
People in recovery from their eating disorders showing how much weight they’ve lost, or even how much muscle they’ve gained.
People showing their “rolls” to help normalize beauty standards. I realize this is something we’ve become accustomed to seeing as wholly helpful, and certainly there are some Instagram and YouTube personalities who do this from a good place. But the reality is it often still spills over into the body-comparing and referencing we want to escape from. No one should feel ashamed to show their bodies online, but at the same time, we should do so with discretion and the understanding that - if you at all target an audience of people with eating disorders - there are bound to be those who are going to see the wrong things in these images.
People showing how they got rid of “bloating” (a concept I will eventually address specifically).
What Can We Learn from the Enemy?
Here is the takeaway I’d like to leave you all with: This community (our body-positive, anti-dieting community) did not exist, at least not in these numbers, 10-20 years ago. We have been fortunate that, despite the growth of social media and the toxic diet culture component that has latched onto it, we have some recovery warriors, intuitive eaters, and body-positive advocates out there doing great work.
The fact that hundreds of thousands of people suffering from eating disorders are turning to these potentially dangerous “proana” and “promia” forums for support should not make us lose hope, and it certainly should not be met with further negativity. We ought to give some serious consideration to how these sites are able to make people with eating disorders feel at home and supported, and we ought to use this as a model for the growth we still need to undergo.
We are far from perfect, but we have the potential to radically transform the positive, welcoming community we’ve worked so hard to build. Now, share this post or make your own and let’s spread the message!
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