Blog entry by Rcgp Learning
While an undeniable force for the good, the internet was not designed with children in mind. Nevertheless an astonishing one third of internet users are under the age of 18, with 12-15 year olds spending over 20 hours a week online. These figures demonstrate the extraordinary influence online media now has over young people, with parents rightly concerned about the impact digital devices have on their children’s wellbeing (1).
According to statistics from the Priory Group, teenagers and young people aged 14-25 are typically the most affected by eating disorders in the UK (2). They are also extremely likely to be active on social media, where they could be exposed to links promoting anorexia as a fashion or as a source of beauty, sharing tips and tactics on how to become and remain anorexic. So what do GPs need to know about pro-eating disorder pages?
Social media is more widespread than ever and with so much information pushed onto mobile devices and desktops, it can be hard to shield teenagers and young people. A survey by EU Kids Online found that 10% of children aged 9-16 had seen eating disorder websites before, with girls more commonly exposed to them than boys (3). Worryingly, these websites are rapidly filtering through to online social networks, such as Facebook, YouTube, Twitter, Instagram and Snapchat.
Pro-anorexia (pro-ana) and Pro-bulimia (pro-mia) websites are part of an online community, promoting eating disorders as a lifestyle. They provide interested users with tips on how to resist eating and suggestions on how to hide the symptoms of doing so from friends and family. They also post ‘thinspiration’: images and quotes to ‘motivate’ their readers. These messages of ‘support’ can easily influence teenagers and young people and the groupthink infusing these communities can provide them with a sense of belonging. They may also encourage sufferers not to listen to concerned adults, such as their parents and GPs.
Although it’s impossible to keep track of the amount of pro-ana and pro-mia information on the internet, there is an increasing number of anti-eating disorder websites out there too. Oksanen, Garcia, & Rasanen (2016) conducted a study into different eating disorder channels on YouTube. Their findings revealed that there is also an anti pro-ana community, who promote recovery and provide information on health organisations. The results of the study showed that anti pro-ana channels were actually more popular than pro-ana channels, generating more views, comments and ‘likes’ (3).
There is a plethora of conflicting messages for teenagers and young people online, and GPs may be relied upon for advice by patients and their parents. Therefore, it is a good idea to be aware of the impact of social media and online communities on your young patients. As an introduction to the topic, why not visit the sites of Anorexia and Bulimia Care or Beat, two of the UK’s eating disorder charities, to learn more about Eating Disorder Awareness week, which runs from 27th February to 5th March 2017.
For more information about the range of different eating disorders and how to manage them in general practice, the RCGP offers an eLearning course on ‘Eating Disorders’ which is FREE to access for all healthcare professionals and also gives you 1 hour towards your CPD.
(1) The Children’s Commissioner. ‘Growing up digital’ A report of the Growing Up Digital Taskforce. 2017 http://www.childrenscommissioner.gov.uk/sites/default/files/publications/Growing%20Up%20Digital%20Taskforce%20Report%20January%202016.pdf
(2) Priory group. ‘Eating disorder statistics’ [Internet] Available from: http://www.priorygroup.com/eating-disorders/statistics
(3) Oksanen A, Garcia D, Räsänen P. Proanorexia Communities on Social Media. Pediatrics. 2016;137(1):e20153372