The Weird Pro-Ana World


Obesity and Anorexia Nervosa (listed in the Diagnostic and Statistical Manual of Mental Disorders under “Feeding and Eating Disorders”) have been known to exist in the same person at different stages of life. The odd paradox is that while actual obese people often do not think they are obese, people afflicted with anorexia mistakenly believe that they are obese.

The two states are similar, in that all kinds of eating disorders appear to originate in the patient’s psyche. Writer Morgan O’Toole Smith phrased it this way:

Both AN and OB are complex neurobiological disorders with widespread metabolic consequences. Both have strong genetic and epigenetic underpinnings. People with both conditions can be exposed to and influenced by obesogens in the environment. Thus, a patient who is starved and thin during the years of their AN can develop the same higher body weight issues later in life, when exposed to obesogens.

Today’s subject is a pathological offshoot of concern over weight — the pro-ana movement, whose adherents obsessively promote anorexia (or rather, their erroneous understanding of it). Like any other hermetically sealed subculture, it has its own jargon. For instance, a similar term, pro-mia, glorifies bulimia nervosa. Adherents of the pro-ana gospel have invented something called the ABC (Ana Boot Camp) diet, which consists of between 200 and 600 calories per day.

They love to burden the Internet with photos of clinically emaciated humans, which they label as “thinspiration.” The genre, familiarly known as “thinspo,” (or its subcategory, “bonespo”) is similar in its unwholesomeness to “porno,” and such imagery is banned from responsible social media platforms.

One anonymous correspondent wrote:

If you have ever seen a World War II documentary, you have surely seen death camp prisoners who are in their 80-90′s, and even if they are old, they often look like they could still kick some serious butt if they had to. Don’t tell me that my controlled diet will kill me when all these people survived extreme starvation in a nazi death camp!

The mentation behind that paragraph is so messed up, it can barely be approached even for the purpose of rebuttal. For starters, what this person more likely saw were photos of concentration camp survivors who were really much younger, but looked like they were in their eighth or ninth decades.

Proselytize and evangelize

Pro-ana advocates (the very large majority of whom are women) congregate in online forums where they encourage one another to sink deeper into this dysfunction, and recruit new members along the way. When people go down this rabbit hole, chasing ways to rationalize their eating disorders, in their path of destruction is not a good place to be. Feuds and flame wars abound.

One important function of these social spaces is to provide a platform for self-justification. “I need to be so tiny, that he’s able to pick me up with ease,” says a disturbed woman. “I want to be a feather, a beautiful, delicate, feather.” Some of the defenses, like “You fatties are just jealous,” are clearly delusional.

Another pro-ana woman states that even though some people may not like her skinny body many more will be attracted to it. “That’s just how we work,” she insists, blaming all of human nature for her misguided mission.

This is the world into which many sane adults fear that their children and patients, pushed by unrelenting anti-obesity messages and pulled by the voices of a toxic subculture, will disappear.

(To be continued…)

Your responses and feedback are welcome!

Source: “The Biological Similarities Between Anorexia and Obesity,”, 04/15/15
Source: “I hear you but,”, 2016
Photo on Visualhunt

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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