A Secret Society of the Starving
Claire is 18. She is a pretty teenager, with long strawberry-blond hair, and she is almost abnormally self-possessed for a girl from a small town who has suddenly been descended upon by a big-city reporter who is there to talk to her, in secret, about her secret life. She is sitting on the track that runs around the field of her high school's football stadium, wearing running shorts and a T-shirt and shivering a little because even though we are in Florida -- in the kind of town where, according to Claire, during "season" when you see yet another car with New York plates, you just feel like running it down -- there's an evening chill.
Claire's is also the kind of town where how the local high school does in sports matters. Claire herself plays two sports. Practice and team fund-raisers are a regular part of her life, along with the typical small-town-Florida teenage occupations -- going to "some hick party," hanging out with friends in the parking lot of the Taco Bell, bowling, going to the beach.
Another regular part of her life, also a common teenage occupation, is anorexia -- refusal to eat enough to maintain a minimally healthy weight. So she is possibly shivering because she hasn't consumed enough calories for her body to keep itself warm. Claire first got into eating disorders when she was 14 or 15 and a bulimic friend introduced her to them. But she was already kind of on the lookout for something: "I was gonna do it on my own, basically. Just because, like, exercise can only take you so far, you know? And I don't know, I just started to wonder if there was another way. Because they made it seem like, 'You do drugs, you die; be anorexic and you're gonna die in a year.' I knew that they kind of overplayed it and tried to frighten you away. So I always thought it can't be that bad for you."
Bulimia -- binge eating followed by purging through vomiting or laxatives -- didn't suit her, however, so after a little while she moved onto anorexia. But she is not, by her own lights, anorexic. And her name isn't Claire. She is, in her terms, "an ana" or "pro-ana" (shortened from pro-anorexia), and Claire is a variation of Clairegirl, the name she uses on the Web sites that are the fulcrum of the pro-ana community, which also includes people who are pro-mia (for bulimia) or simply pro-E.D., for eating disorder.
About one in 200 American women suffers from anorexia; two or three in 100 suffer from bulimia. Arguably, these disorders have the highest fatality rates of any mental illness, through suicide as well as
the obvious health problems. But because they are not threatening to the passer-by, as psychotic disorders are, or likely to render people unemployable or criminal, as alcoholism and addiction are, and perhaps also because they are disorders that primarily afflict girls and women, they are not a proportionately imperative social priority.
They have been, however, topics of almost prurient media fascination for more than 20 years -- regularly the subject of articles in magazines that have a sizable young female readership. In these forums, eating disorders are generally depicted as fundamentally body-image disorders, very extreme versions of the non-eating-disordered woman's desire to be thin, which just happen, rivetingly, to carry the risk of the ultimate consequence. "So many women who don't have the disorder say to me: 'Well, what's the big deal? It's like a diet gone bad,"' says Ellen Davis, the clinical director of the Renfrew Center of Philadelphia, an eating-disorder treatment facility. "And it is so different from that. Women with the vulnerability, they really fall into an abyss, and they can't get out. And it's not about, 'O.K., I want to lose the 10 pounds and go on with my life.' It's, 'This has consumed my entire existence.' "
And now there's pro-ana, in many ways an almost too lucid clarification of what it really feels like to be eating disordered. "Pain of mind is worse than pain of body" reads the legend on one Web site's live-journal page, above a picture of the Web mistress's arm, so heavily scored with what look like razor cuts that there is more open wound than flesh. "I'm already disturbed," reads the home page of another. "Please don't come in." The wish to conform to a certain external ideal for the external ideal's sake is certainly a component of anorexia and bulimia. But as they are experienced by the people who suffer from them, it is just that: a component, a stepping-off point into the abyss.
As the girls (and in smaller numbers, boys) who frequent the pro-E.D. sites know, being an ana is a state of mind -- part addiction, part obsession and part seesawing sense of self-worth, not necessarily correlating to what you actually weigh. "Body image is a major deal, but it's about not being good enough," says Jill M. Pollack, the executive director of the Center for the Study of Anorexia and Bulimia, "and they're trying to fix everything from the outside." Clairegirl, like many of the girls who include their stats -- height, weight and goal weight -- when posting on such sites, would not receive a diagnosis of anorexia, because she is not 15 percent under normal weight for her height and age.
But she does have self-devised rules and restrictions regarding eating, which, if she does not meet them, make her feel that she has erred -- I kind of believe it is a virtue, almost," she says of pro-ana. "Like if you do wrong and you eat, then you sin." If she does not meet her goals, it makes her dislike herself, makes her feel anxiety and a sense of danger. If she does meet them, she feels "clean." She has a goal weight, lower than the weight she is now. She plays sports for two hours a day after school and tries to exercise at least another hour after she gets home. She also has a touch of obsessive-compulsive disorder regarding non-food-related things -- cleaning, laundry, the numeral three. ("Both anorexia and bulimia are highly O.C.D.," says Pollack. "Highly.")
And she does spend between one and three hours a day online, in the world of pro-ana. Asked what she likes best about the sites, Claire says: "Just really, like at the end of the day, it would be really nice if you could share with the whole world how you felt, you know? Because truthfully, you just don't feel comfortable, you can't tell the truth. Then, like, if I don't eat lunch or something, people will get on my case about it, and I can't just come out and tell them I don't eat, or something like that. But at the end of the day, I can go online and talk to them there, and they know exactly what I'm going through and how I feel. And I don't have to worry about them judging me for how I feel."
pro-ana, the basic premise of which is that an eating disorder is not a disorder but a lifestyle choice, is very much an ideology of the early 21st century, one that could not exist absent the anonymity and accessibility of the Internet, without which the only place large numbers of anorexics and bulimics would find themselves together would be at inpatient treatment. "Primarily, the sites reinforce the secretiveness and the 'specialness' of the disorder," Davis says. "When young women get into the grips of this disease, their thoughts become very distorted, and part of it is they believe they're unique and special. The sites are a way for them to connect with other girls and to basically talk about how special they are. And they become very isolated. Women with eating disorders really thrive in a lot of ways on being very disconnected. At the same time, of course, they have a yearning to be connected."
Perfectionism, attention to detail and a sense of superiority combine to make the pro-ana sites the most meticulous and clinically fluent self-representations of a mental disorder you could hope to find, almost checklists of diagnostic criteria expressed in poignantly human terms. Starving yourself, just on the basis of its sheer difficulty, is a high-dedication ailment -- to choose to be an ana, if choice it is, is to choose a way of life, a hobby and a credo. And on the Web, which is both very public and completely faceless, the aspects of the disorder that are about attention-getting and secret-keeping are a resolved paradox. "I kind of want people to understand," Clairegirl says, "but I also like having this little hidden thing that only I know about, like -- this little secret that's all yours."
Pro-ana has its roots in various newsgroups and lists deep inside various Internet service providers. Now there are numerous well-known-to-those-who-know sites, plus who knows how many dozens more that are just the lone teenager's Web page, with names that put them beyond the scope of search engines. And based on the two-week sign-up of 973 members to a recent message-board adjunct to one of the older and more established sites, the pro-ana community probably numbers in the thousands, with girls using names like Wannabeboney, Neverthinenuf, DiETpEpSi UhHuh! and Afraidtolookinthemirror posting things like: "I can't take it anymore! I'm fasting! I'm going out, getting all diet soda, sugar-free gum, sugar-free candy and having myself a 14-day fast. Then we'll see who is the skinny girl in the family!"
That ana and mia are childlike nicknames, names that might be the names of friends (one Web site that is now defunct was even called, with girlish fondness, "My Friend Ana"), is indicative. The pro-ana community is largely made up of girls or young women, most of whom are between the ages of 13 and 25. And it is a close community, close in the manner of close friendships of girls and young women. The members of a few sites send each other bracelets, like friendship bracelets, as symbols of solidarity and support. And like any ideology subscribed to by many individuals, pro-ana is not a monolithic system of belief.
At its most militant, the ideology is something along the lines of, as the opening page of one site puts it: "Volitional, proactive anorexia is not a disease or a disorder. . . . There are no victims here. It is a lifestyle that begins and ends with a particular faculty human beings seem in drastically short supply of today: the will. . . . Contrary to popular misconception, anorectics possess the most iron-cored, indomitable wills of all. Our way is not that of the weak. . . . If we ever completely tapped that potential in our midst . . . we could change the world. Completely. Maybe we could even rule it."
Mostly, though, the philosophical underpinnings of pro-ana thought are not quite so Nietzschean. The "Thin Commandments" on one site, which appear under a picture of Bugs Bunny smiling his toothy open-mouthed smile, leaning against a mailbox and holding a carrot with one bite taken out of it, include: "If thou aren't thin, thou aren't attractive"; "Being thin is more important than being healthy"; "Thou shall not eat without feeling guilty"; "Thou shall not eat fattening food without punishing thyself afterward"; and "Being thin and not eating are signs of true willpower and success."
The "Ana Creed" from the same site begins: "I believe in Control, the only force mighty enough to bring order into the chaos that is my world. I believe that I am the most vile, worthless and useless person ever to have existed on this planet."
In fact, to those truly "in the disorder" -- a phrase one anonymous ana used to describe it, just as an anonymous alcoholic might describe being in A.A. as being "in the rooms" -- pro-ana is something of a misnomer. It suggests the promotion of something, rather than its defense, for reasons either sad or militant. That it is generally understood otherwise and even exploited ("Anorexia: Not just for suicidal teenage white girls anymore" read the home page of Anorexic Nation, now a disabled site, the real purpose of which was to push diet drugs) is a source of both resentment and secret satisfaction to the true pro-ana community. Its adherents might be vile and worthless, but they are the elite.
The usual elements of most sites are pretty much the same, although the presentation is variable enough to suggest Web mistresses ranging from young women with a fair amount of programming know-how and editorial judgment to angry little girls who want to assert their right to protect an unhealthy behavior in the face of parental opposition and who happen to know a little HTML. But there are usually "tips" and "techniques" -- on the face of it, the scariest aspect of pro-ana, but in reality, pretty much the same things that both dieters and anorexics have been figuring out on their own for decades. There are "thinspirational" quotes -- You can never be too rich or too thin"; "Hunger hurts but starving works"; "Nothing tastes as good as thin feels"; "The thinner, the winner!" There are "thinspirational" photo galleries, usually pretty much the same group of very thin models, actresses and singers -- Jodie Kidd, Kate Moss, Calista Flockhart, Fiona Apple. And at pro-ana's saddest extreme, balancing the militance on the scales of the double-digit goal weight, there are warnings of such severity that they might as well be the beginning of the third canto of Dante's "Inferno": "I am the way into the city of woe. I am the way to a forsaken people. I am the way into eternal sorrow." The pro-ana version of which, from one site, is:
Please Note: anorexia is not a diet. Bulimia is not a weight-loss plan. These are dangerous, potentially life-threatening disorders that you cannot choose, catch or learn. If you do not already have an eating disorder, that's wonderful! If you're looking for a new diet, if you want to drop a few pounds to be slimmer or more popular or whatever, if you're generally content with yourself and just want to look a bit better in a bikini, go away. Find a Weight Watchers meeting. Better yet, eat moderate portions of healthy food and go for a walk.
However.
If you are half as emotionally scarred as I am, if you look in the mirror and truly loathe what you see, if your relationships with food and your body are already beyond "normal" parameters no matter what you weigh, then come inside. If you're already too far into this to quit, come in and have a look around. I won't tell you to give up what I need to keep hold of myself.
Most of the pro-ana sites also explicitly discourage people under 18 from entering, partly for moral and partly for self-interested reasons. Under pressure from the National Eating Disorders Association, a number of servers shut down the pro-ana sites they were hosting last fall. But obviously, pretty much anyone who wanted to find her way to these sites and into them could do so, irrespective of age. And could find there, as Clairegirl did, a kind of perverse support group, a place where a group of for the most part very unhappy and in some part very angry girls and women come together to support each other in sickness rather than in health.
Then there's chaos -- also her Web name -- who like her friend Futurebird (ditto) runs an established and well-respected pro-E.D. site. Chaos, whom I met in Manhattan although that's not where she lives, is a very smart, very winning, very attractive 23-year-old who has been either bulimic or anorexic since she was 10. Recently she's been bingeing and purging somewhere between 4 and 10 times a week. But when not bingeing, she also practices "restricting" -- she doesn't eat in front of people, or in public, or food that isn't sealed, or food that she hasn't prepared herself, or food that isn't one of her "safe" foods, which since they are a certain kind of candy and a certain kind of sugar-free gum, is practically all food. ("You're catching on quickly," she says, laughing, when this is remarked on.) Also recently, she has been having trouble making herself throw up. "I think my body's just not wanting to do it right now," she says. "You have the toothbrush trick, and usually I can just hit my stomach in the right spot, or my fingernails will gag me in the right spot. It just depends on what I've eaten. And if that doesn't work, laxis always do."
Chaos, like Clairegirl, is obsessive-compulsive about a certain number (which it would freak her out to see printed), and when she takes laxatives she either has to take that number of them, which is no longer enough to work, or that number plus 10, or that number plus 20, and so forth. The most she has ever taken is that number plus 60, and the total number she takes depends on the total number of calories she has consumed.
While it hardly needs to be pointed out that starving yourself is not good for you, bulimia is in its own inexorable if less direct way also a deadly disorder. Because of the severity of Chaos's bulimia, its longstanding nature and the other things she does -- taking ephedra or Xenadrine, two forms of, as she says, "legal speed," available at any health food or vitamin store; exercising in excess; fasting -- she stands a very real chance of dying any time.
As it is, she has been to the emergency room more than half a dozen times with "heart things." It would freak her out to see the details of her heart things in print. But the kinds of heart things a severe bulimic might experience range from palpitations to cardiac arrest. And although Chaos hasn't had her kidney function tested in the recent past, it probably isn't great. Her spleen might also be near the point of rupturing.
Chaos is by no means a young woman with nothing going for her. She has a full-time job and is a full-time college student, a double major. She can play a musical instrument and take good photographs. She writes beautifully, well enough to have won competitions.
But despite her many positive attributes, Chaos punishes herself physically on a regular basis, not only through bulimia but also through cutting -- hers is the live-journal page with the picture of the sliced-up arm. To be beheld is, to Chaos, so painful that after meeting me in person, she was still vomiting and crying with fear over the possible consequences of cooperating with this story a week later. "Some days," she says of her bulimia, "it's all I have."
One thing that she does not have is health insurance, so her treatment options are both limited and inadequate. So with everything she has going for her, with all her real-world dreams and aspirations, the palpitating heart of her emotional life is in the pro-E.D. community. As another girl I spoke with described herself as telling her doctors: "Show me a coping mechanism that works as well as this and I'll trade my eating disorder for it in a minute."
And while in some moods Chaos says she would do anything to be free of her eating disorders, in others she has more excuses not to be than the mere lack of health insurance: she has a job, she is in school, she doesn't deserve help. And what she has, on all days, is her Web site, a place where people who have only their eating disorders can congregate, along with the people who aspire to having eating disorders -- who for unknowable reasons of neurochemistry and personal experience identify with the self-lacerating worlds of anorexia and bulimia.
Futurebird, whom I also met in Manhattan, says that she has noticed a trend, repeating itself in new member after new member, of people who don't think they're anorexic enough to get treatment. And it's true, very much a function of the Internet -- its accessibility, its anonymity -- that the pro-ana sites seem to have amplified an almost-diagnostic category: the subclinical eating disorder, for the girl who's anorexic on the inside, the girl who hates herself so much that she forms a virtual attachment to a highly traumatized body of women, in a place where through posts and the adoption of certain behaviors, she can make her internal state external.
Futurebird and Chaos are sitting in a little plaza just to the south of Washington Square Park, with the sun behind them. Futurebird is a small African-American woman. As she notes, and as she has experienced when being taken to the hospital, it is a big help being African-American if you don't want people to think you have anorexia, which is generally and inaccurately considered to be solely an affliction of the white middle class. Futurebird has had an eating disorder since she was in junior high school and is now, at 22, looking for a way to become what you might call a maintenance anorexic -- eating a little bit more healthily, restricting to foods like fruits and whole-grain cereal and compensating for the extra calories with excessive exercising.
Like Chaos, she is opposed, in principle, to eating disorders in general and says that she hates anorexia with a blind and burning hatred. Although she also says she thinks she's fat, which she so emphatically is not that in the interest of not sounding illogical and irrational, she almost immediately amends this to: she's not as thin as she'd like to be.
Both she and Chaos would vigorously dispute the assertion that the sites can give anyone an eating disorder. You certainly can't give anyone without the vulnerability to it an eating disorder. But many adolescent girls teeter on the edge of vulnerability. And the sites certainly might give those girls the suggestion to . . . hey, what the hell, give it a try.
"What I'd like people to understand," Futurebird says, "is that it is very difficult for people who have an eating disorder to ask for help. What a lot of people are able to do is to say, well, I can't go to a recovery site and ask for help. I can't go to a doctor or a friend and ask for help. I can't tell anyone. But I can go to this site because it's going to quote-unquote make me worse. And instead what I hope they find is people who share their experience and that they're able to just simply talk. And I've actually tested this. I've posted the same thing that I've posted on my site on some recovery sites, and I've read the reactions, and in a lot of ways it's more helpful."
In what ways?
"The main difference is that if you post -- if someone's feeling really bad, like, I'm so fat, et cetera, on a recovery site, they'll say, that's not recovery talk. You have to speak recovery-speak."
"Fat is not a feeling," Chaos says, in tones that indicate she is echoing a recovery truism.
"And they'll use this language of recovery," Futurebird continues. "Which does work at some point in the negative thinking patterns that you have. But one tiny thing that I wish they would do is validate that the feeling does exist. To say, yes, I understand that you might feel that way. And you get not as much of that. A lot of times people just need to know that they aren't reacting in a completely crazy way."
The problem is that by and large, the people posting on these sites are reacting in a completely crazy way. There are many, many more discussions answering questions like, "What do you guys do about starvation headaches?" than there are questions like, "I am feeling really down; can you help me?" And in no case, in answering the former question, does anyone say, "Um . . . stop starving yourself." A site like Futurebird's, or like the message board of Chaos's, are designed with the best intentions. But as everybody knows, that is what the way into the city of woe, the way to a forsaken people and the way into eternal sorrow are paved with.
What Clairegirl, sitting shivering on the running track, would say today is that when she reaches her current goal weight, she will stay there. But she can't ever really see herself giving ana up altogether. "I don't think I could ever stop, like, wanting to not eat. Like, I could keep myself from eating below 300 calories a day. But I could never see myself eating more than 1,000," she says, wrapping her arms around her knees. "I consider myself to be one of the extreme dieters. Like, I could never want to be -- I mean, it would be so awesome to be able to say a double-digit number as your weight, but it would look sick, you know?" (Clairegirl is 5 feet 7 inches.)
And what about the people on the pro-ana sites who are not so happy, who describe the disorder as a living hell, who are in very bad shape? "Those girls have been going at it a lot longer than me. But you can't ever really say that ana isn't a form of self-hatred, even though I try to say that. If I was truthfully happy with myself, then I would allow myself to eat. But I don't. And it's kind of like a strive for perfection, and for making myself better. So I can't honestly say there's no. . . . "
She trails off, and gazes up, as if the answer were written in the night sky, waiting to be decoded. "Like, you can't say that every ana loves herself and that she doesn't think anything is wrong with her at all," she says. "Or else she wouldn't be ana in the first place."
