Table 2.
Characteristics of the studies included in the review.
| Author | Aim | Sample | Type of Measure | Findings |
|---|---|---|---|---|
| Almenara et al., (2016) | This study explored the individual differences associated with adolescents’ exposure to ‘‘ana-mia’’ websites. | N = 18,709 girls, aged 11–16, 50% | -Exposure to ‘‘ana-mia’’ websites -Daily use of the Internet -Digital skills -Online disinhibition -Sensation seeking -Socioeconomic status of the household. |
The results of this study showed that sensation seeking and online disinhibition were both associated with an increased risk of exposure to ‘‘ana-mia’’ websites in girls as well as in boys, although some gender differences were apparent. In girls, but not in boys, the older the child and higher the socioeconomic status, higher the chance of being exposed to ‘‘ana-mia’’ websites. |
| Bates (2015) | This study examined the metaphors the members of a pro-ana group invoked in their personal profiles on a popular social networking site, to talk about the self. | 757 text profiles. | -The Metaphor Identification Procedure to 757 text profiles. |
This study identified four key metaphorical constructions in pro-ana members’ self-descriptions: self as space, self as weight, perfecting the self, and the social self. These four main metaphors represented discourse strategies, both to create a collective pro-ana identity and to enact an individual identity as pro-ana. |
| Bert et al., (2016) | The aim of this study is to investigate the presence, popularity, and content of the ‘‘proana’’ accounts on Twitter. | 341 accounts. | -Investigated the most used hashtags and the main contents of these profiles. -Twitter search. -For the statistical analysis of the retrieved data, used Stata MP11. |
The authors found high number and popularity of Twitter proanorexia groups. These accounts contain dangerous information, especially considering the young age of the users. |
| Bragazzi et al., (2019) | The aim of the current investigation was to systematically perform a reliability and content analysis of Italian language anorexia nervosa-related websites. | 402 unique website. | - Health on the Net Foundation Code of Conduct Standards (HonCode®) certification mark. | This study showed that the quality of Italian language anorexia nervosa-related websites was rather moderate-poor, being generally inconsistent with the principles of the HonCode® certification mark. |
| Çelik et al., (2015) | The aim of this study was to investigate the relationship between problematic internet use and eating attitudes in a group of university students. | students. | -The Problematic Internet Use Scale -Eating Attitudes Test -Personal Data Form. |
The research findings showed a significant positive correlation between problematic internet use and eating disorders, the problematic internet use is a predictor of eating disorders. |
| Chang & Bazarova (2016) | The aim of this study was to explore online negative enabling support dynamics in pro-anorexic websites through the language analysis of initiating disclosure and response sequences. | Analyzing 22,811 messages from 5590 conversations from the Pro-Ana Nation online discussion board forum. | - Linguistic Analysis. | The findings showed that initiating disclosures containing stigma-related emotion words, anorexia-specific content, and sociorelational content are typically met with negatively valenced responses from other members of the pro-anorexic community. |
| Gale et al., (2015) | The present study aimed to explore the underlying functions and processes related to the access and continued use of pro-ED websites within a clinical eating disorder population using a qualitative research design. | Seven adult women in treatment for an eating disorder who had disclosed current or historic use of pro-ED websites. Interviewees ranged in age from 20 to 40 years. | -Face-to-face semistructured interviews. | This study showed that Pro eating disorder websites maintaining eating disordered behaviour. This websites appeared to offer a sense of support for adolescents with eating disorder. |
| Hernández-Morante et al., (2015) | The objective of this study was to determine both general and information quality of eating disorder websites, including obesity websites. | 50 websites. | - Three key terms (obesity, anorexia and bulimia) were entered into the Google® search engine. Websites were assessed using two tests (HonCode® certification and Bermudez-Tamayo et al. test) to analyze overall quality, and a third test (DISCERN test) to analyze specifically information quality. | This study determinated that the pro eating web sites influenced the eating disorders, including obesity. |
| Hilton (2018) | The aim of this study was to studied the Qualitative Exploration of the Role of Pro-anorexia Websites in User’s Disordered Eating. | 151 members of pro-ana website. | - The analysis revealed five main themes: eating disorders are mental illnesses and websites do not cause mental illness, pro-ana websites and eating disorders. | This research revealed the role of pro anorexia websistes in eating disorders. |
| Tan et al., (2016) | The aim of this study was to assess a group of patients with eating disorders in Singapore who presented for treatment. | 56 participants. | -Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) -Eating Attitudes Test26 (EAT-26) -Clinical Impairment Questionnaire 3.0 (CIA 3.0). |
This study looked at the Internet and smartphone app usage patterns of participants who presented with an eating disorder in Singapore, and whether it corresponded to severity of illness. Overall, any smartphone application usage was associated with younger age and greater eating disorder psychopathology and psychosocial impairment. |
| Yom-Tov et al., (2016) |
The aim of the current study is to explore the characteristics of people who participate in different pro-anorexia web communities and the differences between them. | Posts from the discussion board of the myproana.com website (A total of 57,911 post). | Identified users who used the terms in the 5 categories above. For those users, the most popular terms were categorized as follows: Myproana: users who queried for the myproana.com website. Tumblr: users who queried for the social network tumblr, Manorexia: users who queried for the term “manorexia”, meaning anorexia in males, Thinspiration, Yahoo Answers: visitors to the popular Yahoo Answers website. |
Members of the main pro-ana website investigated appear to be depressed, with high rates of self-harm and suicide attempts, users are significantly more interested in treatment, have wishes of procreation and reported the highest goal weights among the investigated sites. |
| Yom-Tov et al., (2018) | The objective of this randomized controlled trial (RCT) was to examine if online advertisements (ads) can change online search behaviors of users who are looking for online pro-ana content. | 10 different Bing Ads system. | -Using the Bing Ads system. | Exposure to the pro eating disorder websites, was associated an increased of eating disorders. |