Parents are often the last to know how very unsafe the Internet can be for recovering eating disorder patients. For several reasons, parents should exercise caution and consider limiting access.
Eating disorders are brain disorders and it is important to remember that a malnourished brain is usually not able to rationally process information about food and eating and body image. Messages about "health" and "calories" and "weight" can become distorted, obsessive and provoke extreme anxiety. Malnutrition of various forms is present with all eating disorder diagnoses (not just anorexia) and is often independent of weight status. As patients regain their nutritional, physical and mental health, they will regain the ability to assess and use information rationally.
Online "Support" and "Pro-Ana" Communities
Because a common symptom of an eating disorder is a sense of exaggerated virtue around the behaviors, there are over a million websites and online communities of patients who share tips on how to conceal the illness. Many sites also share methods to maintain the appearance of health despite medical risk. These websites are considered quite dangerous and damaging by many in the eating disorder treatment community. These sites spread incorrect ideas about the illness, and promote a belief that an eating disorder is a "lifestyle choice." They also offer very disturbing photographs of ill people and extreme thinness - content that can be both validating and triggering to sufferers.
Many families are shocked to discover their own child has created a "blog" or "online diary" with explicit information about his or her own eating disorder, and communicates directly with other sufferers. This use of the Internet to find "support" may seem natural and positive, but it is often the case that the comfort offered and received is for the eating disorder and not for the suffering person.
Calorie Counting: Labels, Apps, and Gadgets
Dieting, and weight loss literature, are ubiquitous on the web. Because the language of dieting is both attractive and reinforcing to patients suffering from an eating disorder, this can create an unhealthy environment for people struggling to comply with doctors' orders to regain weight and eat normally. As people with eating disorders tend to think about food a great deal, they may frequent both dieting and cooking sites.
Calorie information, which can be a dangerous fixation and an unneeded distraction, is now available online for most packaged foods and restaurants. In addition, calorie and exercise tracking "apps" are readily available for free download on smartphones and tablets, some of which will integrate with exercise tracking gadgets, like a "Fitbit." For families who are in charge of a loved one's meal preparation, efforts to relieve the patient of calorie and exercise tracking may be undermined by these searches, apps and gadgets.
Online Caregiver Resources & Support
Patients often try to limit PARENT use of the Internet. A need to control the activities of others, including caregivers, is a common (temporary) symptom of eating disorders. Just as a patient may insist that family members follow certain rules about eating and food, there may be anger when a parent uses the Internet to seek information or support online.
Parents have the right to use the Internet and other resources according to their own judgment. If necessary, separate accounts on a shared computer can allow parents the freedom to do their research and surfing without monitoring by other family members. It is also simple to erase one's surfing "history" (check your browser help section). This advice, of course, goes both ways: parents should know that their children may be covering their Internet tracks as well.
Many clinicians and families advise limiting Internet use in the home during recovery. Just as a family might bar the viewing of inappropriate movies and unmonitored chat rooms, it is appropriate to treat unwelcome Internet content as a threat to a child's health during recovery and beyond. What may seem at first to be intrusive or controlling can be a helpful boundary for patients trapped in obsessive thoughts. One option is to have family computers available only when adults are present and in view of the screen. Other options involve using software to block certain content, or to track Internet usage.