On the Web, many sites talk about anorexia nervosa, bulimia nervosa and other eating disorders (EDs). The provocative tone of some of them, going as far as to say that EDs are a lifestyle choice rather than a disease, has attracted the attention of the media and of policy makers, and has earned them the title of “pro-ana” or “pro-mia” websites. Yet most of them are simply personal pages, discussion forums and blogs on which people with EDs can express themselves freely, without fear of being judged, reprimanded, or censured. Internet, especially since the rise of the social Web, offers them a way to confide in others and realise that they are not alone: they can now share their concerns, seek advice, help one another, and learn from the experience of others.

But more precisely, how do these Web-based communities work? To what extent can they help users to better cope with their problems – and possibly, even guide them to treatment-seeking and recovery? To what extent, on the contrary, do they channel harmful influences, reinforcing users’ risky behaviours? And how do they relate to the linkages, activities and interactions that occur face-to-face – in the family, at school, on the workplace? It is essential to answer these questions to advance our understanding of EDs today, and their linkages to the daily life, the social relationships and the practices of affected persons. It is well known that EDs are not easy to live with; neither are they easy to explain, and despite significant progress, recent research still leaves grey areas. As a result, the motivations and behaviours of persons with EDs are often unintelligible to their families, their friends and even their doctors.

The ANAMIA project has this ambition: to improve our knowledge of the structure, function and evolution of the myriad Web sites, blogs and forums that revolve around EDs. At the heart of the study are the daily life and sociability – both online and offline – of users: how do they form friendship ties among themselves and with others, with whom do they talk when things get wrong, from whom do they seek advice about nutrition and health? The project aims to know, without judging and without the ambition to heal. Its ultimate goal is to provide a new understanding to health professionals, to relatives and friends of persons with disorders related to food and body image.

Improved knowledge of these online communities will also help to design better-tailored public health policy interventions. For example, information or prevention campaigns might reach a larger number of vulnerable persons through word-of-mouth circulation on the web pages of members of these communities, rather than being simply displayed on a generalist site. Further, the credibility and effectiveness of such campaigns could be strengthened by identifying influential actors (administrators of forums, authors of frequently visited blogs) and actively seeking their support.

The project ANAMIA is funded by the Agency for National Research (ANR): it has no commercial purposes and is not directly associated with any medical institutions. It is led by a multidisciplinary team involving sociologists, psychologists, philosophers, lawyers, economists and computer scientists from five institutions of higher education and research in France.

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