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Pro-ana is an attitude or movement promoting anorexia, particularly through online communities. These websites are meant to encourage the extreme eating, exercise, thinness, and other attitudes and behaviors associated with anorexia. Although the movement exists, mental health professionals have still classified anorexia as a harmful and sometimes deadly eating disorder, and ongoing research continues to support this assertion. These experts often attempt to counter the movement by shutting down pro-ana websites, despite how difficult it is to do so.
Anorexia is defined by pro-ana supporters as a lifestyle choice. As such, the behaviors and outcomes that characterize anorexia are highly regarded, such as severely limiting caloric intake, having an extremely low body weight, and overexercising. Advocates typically consider thinness to the point where skin and bones, but no body fat, is visible as their desired shape. They often reject the medical establishment's view that anorexia is unhealthy, sometimes arguing that being obese or even a healthy weight is the epitome of body harm. Anorectics tend to be isolated from others because of criticism and the demands of maintaining anorexia, but in the late 1990s, pro-ana websites began to emerge, and, with them, burgeoning online social communities.
Creators and participants of pro-ana websites usually encourage anorectic behaviors and insist that extreme thinness is healthy or ideal. Jargon might be prevalent on these sites; for instance, in addition to "ana" and "pro-ana" to refer to anorexia or its promotion, pictures of emaciated individuals might be labeled as "thinspiration," with the intent to inspire anorectics to reach the level of thinness displayed. Since the 1990s, many pro-ana websites are now designed to appear less obvious or provide restricted access due to criticism from those who state that anorexia is not a lifestyle, but a disease.
As of 2011, the American Psychiatric Association, as well as other physicians and mental health professionals worldwide, maintain that anorexia is a serious but treatable psychiatric illness. The documented effects of anorexia include cardiac, gastrointestinal, bone, and skin deterioration or disease; hair loss; increased isolation and depression; and even premature death. Researchers are also uncovering the dangers of being pro-ana and using related websites. A study published in the September/October 2010 European Eating Disorders Review revealed that a group of college-age women with no history of eating disorders significantly reduced their caloric intake after short-term exposure to pro-ana online materials. While policing the Internet is nearly impossible, groups like the National Association of Anorexia Nervosa and Associated Disorders (ANAD) have successfully persuaded some website administrators to remove or revise pro-ana sites.