Objectives: To compare how people communicate about eating disorders on two popular social media platforms — Twitter and Tumblr. Materials and Methods: Thematic analysis was conducted to characterize the types of communications posted, and a content analysis was undertaken of between-platform differences. : Three types of content pro-ana, anti-ana, and pro-recovery were posted on each platform.
Overall, across both platforms, extreme pro-ana posts were in the minority compared to anti-ana and pro-recovery. Conclusion: The findings have implications for future research and health care relating to the treatment and prevention of eating disorders. Developers of future interventions targeting negative pro-ana content should remain aware of the need to avoid any detrimental impact on positive online support.
Online communities which potentially encourage eating disorders ED are a cause of public concern Tong et al. Recent research suggests a link between viewing of online ED content and offline ED behavior Branley and Covey,although the nature of this relationship is currently unknown. For example, there are many pro-ED also known as pro-anorexia or pro-ana communities that construe ED as a lifestyle choice rather than disorders to be treated Wilson et al.
By encouraging each other to engage in associated ED behaviors, pro-communities normalize the behavior by making the user feel that it is acceptable, justifiable, and sometimes even desirable Schroeder, Concerns are heightened further due to the interactivity of social media, Borzekowski et al. These concerns generally result in a call for interventions based upon censorship, i.
However, these generic messages appear regardless of the type of ED content actually being returned by the search and Anorexic women tumblr have to bypass this message even if searching for positive content e.
This could render the warning meaningless. Many feature information on recovery and some communities are supportive of users who decide to seek treatment Brotsky and Giles, ; Csipke and Horne, ; Lipczynska, Therefore it is possible that social media provides a platform through which users can find help and guidance — this is particularly important as ED sufferers rarely seek professional help Cachelin and Striegel-Moore, It is important therefore that we truly understand the nature of online communities before introducing interventions.
In particular, we need to know more about the types of ED-related information people using social media are being exposed to.
Pro-ana versus pro-recovery: a content analytic comparison of social media users’ communication about eating disorders on twitter and tumblr
However, our understanding is limited because researchers investigating online ED content have tended to focus upon pro-ED content and not ED-related content more generally Norris et al. The current study addresses this limitation by analyzing the full range of ED-related content shared by social media users. With no restrictions this analysis provides a balanced insight into the different ways in which ED is portrayed on social media. Focus is placed upon comparing the content on two popular social media platforms that have been linked to disordered eating behaviors in the press, Twitter, and Tumblr e.
Whilst Twitter and Tumblr are both blogging platforms they differ in their functionality and the environment they create for users therefore allowing us to investigate whether the environment that is provided by the platform may impact upon the type of content shared by users.
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For example, users often perceive Tumblr as more private in comparison to Twitter therefore it is possible that this may influence the type or severity of the content shared Marwick and Boyd, The date was selected randomly from all dates within a 3 month period in May to July.
However, to ensure that the selected day was representative of a normal or typical day, dates within 2 days of a recognized holiday were not included in the selection particularly as religious holidays might impact upon eating behavior. The Firehose provides full, unlimited access to the complete database of publicly available data on the platforms. The website www. Although hashtagify.
Original research article
Using the list of terms gathered using this technique, the researcher DB manually searched for each of these terms on both the Twitter and Tumblr platforms and noted any other ED-specific terms which had not been captured. This produced a list of 55 potential search terms. In order to narrow this down to the most relevant search terms, each of the terms were entered into Topsy which provided an estimate of the daily of tweets. Any terms showing a frequency of less than tweets per fortnight were excluded from the list of terms used for data collection shown in Table 1.
The searches conducted using the terms shown in Table 1 produced a database of over 12, tweets and 73, tumblogs.
An inductive, thematic approach to the analysis was adopted to identify patterns or themes within the posts Braun and Clarke, ; Joffe, This approach has the ability to identify manifest and latent motivations that drive behavior Joffe, ; therefore helping to achieve the goal of understanding ED communities from the perspective of the users Vaismoradi et al. Posts were randomly selected from each database until data saturation was reached and no new themes were obtained.
Posts that were clearly spam or not written in English were excluded from the analysis. The themes identified from the thematic analysis were used to develop the coding scheme for Anorexic women tumblr analysis. The coding scheme was tested for inter-rater reliability on a randomly selected subsample of 80 posts.
The coding scheme was refined and repeatedly tested on new subsamples of posts until all codes had a Kappa value greater than 0. The final coding scheme is shown in Table 2. The content analysis was then conducted on a new random sample. TABLE 2.
Coding scheme for content analysis of Twitter and Tumblr between-platform differences. One hundred and ninety posts were sampled to reach data saturation in the thematic analysis. In order to ensure user anonymity no user IDs, names or profile photos are included in the .
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Also, any posts referred to in the are paraphrased to prevent possible user identification. Three distinct types of posts were identified from the thematic analysis: pro-ana, anti-ana, and pro-recovery. Pro-ana posts included content that depicted a desire to engage in ED behaviors without any indication that recovery was desired and no apparent recognition of disordered eating as a negative behavior.
Emphasis was placed upon having self-control over hunger and doing so was regarded as an achievement. s of hunger were also indicators of success, i. Some posts expressed negative emotions such as sadness, frustration, anger, and self-dissatisfaction. Whilst still taking a largely pro-ana stance, some users depicted a love-hate relationship with their ED. Rather than simply posting pro-ana content occasionally, some users had blogs which were dedicated to pro-ana content.
Some users used their blog to document how much they ate, drank, and exercised. Generally, the dedicated pro-ana blogs seemed to have a gloomier feel than other blogs, particularly on Tumblr where greater user customisation is possible. Many displayed only black and white content and featured angsty music. Many blogs also referred to the user experiencing depression, suicidal ideation, self-harm, and other mental health disorders. Some posts expressed an explicit resistance against the pro-ana mentality, challenging the sharing of pro-ana material and expressing concerns regarding the potential harm it may elicit in vulnerable users.
Anti-ana users were generally not against discussion about ED providing this was done in a Anorexic women tumblr manner, e. However, they did not agree with any content that encouraged ED or portrayed it as a lifestyle choice.
They expressed concern that pro-ana content could trigger the development or worsening of ED including relapse from recovery in vulnerable users. Some anti-ana users had ED themselves, e. In contrast to pro-ana content, blogs by users who shared anti-ana content were the most diverse.
These users did not have blogs dedicated to sharing ED-related content and do not appear to be using social media solely to challenge pro-ana material. Pro-recovery posts encouraged recovery in the user or others. Other posts aimed to inspire recovery in others, providing reassurance that recovery is possible.
Some posts shared advice on how to combat disordered eating habits and stick to a healthier lifestyle. Other users suggested healthier ways to keep in shape such as healthy levels of exercise rather than extreme dieting. Some users simply offered support in the form of empathy, compassion, and understanding. The daily conflict between their desire to engage Anorexic women tumblr ED behavior and the desire to recover was highlighted.
One user described gaining weight due to her recovery, and although she ultimately thought of this as something to be proud of, another part of her was sad because that part of her still really wanted to lose weight. Similar to those found for pro-ana, some blogs were dedicated to sharing pro-recovery content. With the exception of a minority of blogs belonging to ED charities and organizations, pro-recovery blogs appeared to be run by users currently in recovery from their own ED.
Amongst the users sharing anti-ana and pro-recovery posts, two shared motivations became apparent: raising awareness about ED among the wider population e. The search also identified blogs in which ED terms were used in humor. The coding scheme also identified if possible the location from which the post originated, the gender of the user, whether they could be identified either from their name or photographand whether the post was written by the user themselves. Chi-square tests were conducted to test for ificant differences between the platforms. Nearly half of the posts It is possible that gender differences in the platform user group may contribute to these findings.
The current study is the first of its kind to look in detail at publicly accessible ED-related content on two social media platforms — Twitter and Tumblr. Encouragingly, pro-ana was in the minority compared to the latter two groups. That said, the potential impact of pro-ana posts should not be dismissed. Trigger warnings are a statement or keyword that warns the viewer that content on the blog may encourage disordered eating in vulnerable users.
However, it has been suggested that the use of trigger warnings may help users to purposefully search for pro-ana content Borzekowski et al. Some of the users who posted pro-ana material referenced their own depression and suicidal ideation which supports research which has shown negative affect to be comorbid with ED Braun et al. A recent meta-analysis suggests that exposure to online content depicting ED is linked to negative affect and negative body image Rodgers Anorexic women tumblr al.
Vulnerable users viewing or sharing pro-ana posts may be more influenced by the content that they see online due to their current state of mind. Therefore, some populations may be more at risk than others. Further research is required to investigate this further. There are some similarities between our findings and those from research which has investigated ED content on more traditional Web 1.
However, contrary to Web 1. This suggests that social media may not feature content as extreme as dedicated pro-ana websites. Most of the ED-related content was posted by females on both platforms. They also shared more pro-ana content than males. This may be a consequence of ED prevalence being higher amongst females Fairburn and Harrison, ; Hudson et al. Branley found that females are more likely to use social media for social reasons and therefore they may be most likely to turn to this platform for support.
Further research including interviewing participants with ED may be able to identify whether social media play a different role for males and females.