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Eating disorders (EDs) are psychiatric illnesses involving disordered relationships with food and pathological body weight/shape dissatisfaction. As both psychological and biological illnesses, EDs are notoriously difficult to treat, with high rates of relapse.1
A unique characteristic of EDs that makes recovering from these illnesses especially challenging is the ED voice.2 The ED voice is a negative, internal dialogue people with these illnesses have that comments on their weight, body shape, weight-related behaviors (i.e., laziness), and overall self-worth. This internal voice is difficult to quiet and helps maintain EDs by distorting reality, prioritizing thinness, justifying ED behaviors, and contributing to anxiety and depression.
Unfortunately, friends and family of people with EDs may not fully understand why EDs are so difficult to treat, and, consequently, may blame those with an ED for their illness and relapses. These misunderstandings can cause people with these illnesses to perceive they lack support during their recovery.3
Digital Media and Eating Disorder Support Systems
Digital media provides opportunities for people with EDs to build the support systems they perceive they lack (e.g., the Full of Beans podcast). Through online platforms, these individuals can connect with and relate to people in similar situations, which may help them stay with the recovery process. Moreover, individuals who have recovered from EDs can use digital platforms to share their stories worldwide and show that recovery from an ED is possible.
Nonetheless, online ED communities aren’t always beneficial for ED recovery and can even be dangerous to those with these illnesses. Such is the case with pro-eating disorder (pro-ed) online communities.4
Pro-Eating Disorder Online Communities
Pro-eating disorder online communities (e.g., pro-anorexia, pro-ana; pro-bulimia, pro-mia) are groups of people who believe ED behaviors are a lifestyle choice and not a psychological disorder. Consequently, these individuals encourage, normalize, and glamorize these behaviors while minimizing their negative consequences (e.g., heart complications and death). In this way, these groups become echo chambers that justify the eating disorder voice that helps maintain these illnesses.
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Often, people join pro-ed online communities because they want help with losing weight, want to achieve a certain body type, and want to find like-minded individuals to normalize their lifestyle. Like weight loss groups, members of pro-ed communities help each other lose weight—however, unlike many weight loss groups, the weight loss tactics used in pro-ed communities are extreme and unhealthy.
For example, to motivate members to restrict their eating, pro-ed groups share visual content across social media using hashtags such as #thinspo (i.e., photos idealizing thinness, such as severely thin girls or inspirational quotes), #fatspo (photos of fat individuals in unflattering contexts to discourage eating), and #bonespo (photos idealizing severely underweight bodies). Members of these communities also post images of themselves and request that people degrade them based on their weight to discourage them from eating.
People in pro-ed online communities text each other using various social platforms, such as X, Tumblr, Discord, Kik, Reddit, Chatzy, and even Band.US (a site for music promotion). These conversations often include topics such as how many calories everyone ate that day, requests for low-calorie food ideas, ways to hide ED behaviors from parents, desires to lose weight, and weight loss celebrations.
One of the most dangerous things about pro-ed online communities is that, despite these groups largely being public, they aren’t easy to find, even for those who are looking for them. Reddit is full of adolescents inquiring about where to find pro-ed online communities. The discrete nature of these communities not only makes it difficult for parents to monitor the conversations their kids are having about eating disorders but also creates the perfect outlet for the sexual exploitation of minors (i.e., pro-anorexia “coaching”).
Pro-Anorexia “Coaches”
A pro-anorexia (pro-ana) coach is someone, often an adult man, who encourages an individual, usually an adolescent female, to adopt and maintain an anorexia mindset; such a mindset includes obsessional desires for weight loss, a goal of obtaining a severely thin body, and food restriction.5 In this way, pro-ana coaches become an external “anorexic voice” that helps maintain ED behaviors.
Eating Disorders Essential Reads
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As self-proclaimed professionals with an impressive “track record” of clients who have lost weight, pro-ana coaches are in unique and powerful positions to manipulate people with or susceptible to EDs.5 People seeking help from pro-ana coaches are in vulnerable states and willing to do whatever it takes to achieve their ideal body—they are also desperate to keep their behavior secret from their caregivers. The discrete nature and power imbalance of these coaching relationships create the perfect opportunity for grooming.
Grooming is when an adult develops a close, trusting relationship with a child to sexually exploit and abuse them, and it is the primary intention of pro-ana coaches.5 In recent years, there was a court case in the Netherlands involving a pro-ana coach offering underage girls his coaching services in exchange for sex. There have been similar instances of pro-ana coaches grooming minors in England and Germany. Nonetheless, despite these emerging stories, only one research study (Simons et al., 2023) has explored the behaviors and motivations of pro-ana coaches.5
In their investigation, Simons et al. (2023)5 created fake social media accounts of 14-15-year-old girls to post ads on a pro-ana website. In these posts, they disclosed their age (i.e., 14 or 15), sex (i.e., female), contact info, and desire to lose weight. To communicate with coaches, the researchers used the messaging app Kik, which does not require identification to create an account.
After posting these inquiries, each account received messages from pro-ana coaches asking for photos of the adolescent girls. To respond to these requests, the researchers sent images of consenting, 18+-year-old women from a modeling agency wearing exercise wear or underwear; the faces of these women were not included in the photos and their photos were altered to protect their identities. In addition to this experiment, the researchers also surveyed girls who had previously encountered pro-ana coaches in “real life.”
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After analyzing the data from their “real world” surveys and lab experiment, the researchers discovered that pro-ana coaches approach children in ways that resemble traditional grooming, starting with trust establishment.5 This trust, either personal or professional, allows pro-ana coaches to “punish” clients when they deviate from their coach’s expectations (e.g., weight loss), including requiring clients to self-harm, vomit, or self-strangle.
Once trust with the child has been established, pro-ana coaches typically request photos from these children. These photos are often explicit and require children to photograph intimate areas of their bodies—the “justification” being that coaches can develop weight loss plans better if they see who they’re working with.
Once photos have been exchanged, pro-ana coaches usually become more demanding and aggressive towards the child with their media requests. If the child refuses to send these images, the coach may punish them by denying his services, threatening to share the child’s photos, telling the child’s family/acquaintances, or even physically harming the child.
The final stage of pro-ana grooming is usually a request to meet the child in person for sex. In the Simons et al. (2023) study, one coach even told the fake profile that she could lose weight by having sex with him.
How to Protect Children
To protect children with or susceptible to EDs from these adults, parents must develop a trusting and supportive relationship with their kids. If kids feel safe sharing their online behaviors with their parents, this can help prevent grooming from happening.
Moreover, parents need to equip their kids with the information they need to make smart choices without parental supervision. This means talking with their kids about online grooming, its warning signs, and what to do if they feel they have been targeted.
Finally, parents of children with EDs must be open to understanding the struggles that individuals with EDs have during recovery and be willing to support them through the recovery process. Blaming a child for relapse from an ED or telling them to “just eat” will further isolate them and drive them towards pro-ed communities.
More tips for protecting children from online grooming can be found here.
