The so-called “pro-ana” craze has arisen as a growing trend amongst young South Korean women. Short for pro-anorexia, pro-ana refers to the promotion of habits related to anorexia nervosa, an eating disorder that causes extreme weight loss and fear of personal body image. According to the National Health Insurance Service, the number of anorexia nervosa patients in South Korea has increased by 23 percentage points over the past five years, of which women make up approximately 80 percent.
Across various social media platforms including Twitter and Instagram, the pro-ana community promotes anorexic behaviors by uploading “thinspiration” photos of emaciated people and spreading advice on purging. Within the pro-ana community, one must reach a weight that is 120 subtracted from one’s height in centimeters in order to qualify as “extremely skinny.” To examine the issue further, eating disorder therapist Kim Yu-na and university student Francesca Bas, who recovered from anorexia nervosa, shared their insights on body disorders.
Diet Culture restrains from building healthy relationships
Therapist Kim Yu-na specializes in eating disorder therapy, a form of psychological therapy that additionally focuses on managing diets and developing regular meal schedules.
According to Kim, one of the reasons why an eating disorder develops is attributed to the desire to be loved by others. People tend to go on a diet to be deemed desirable by society’s terms. Yet, when they fall into a mindset in which their body becomes their sole focus, they actually distance themselves from society. The irony of this situation is that what started as a method to be recognized leads to acts of detachment.
Social norms play a key role in popularizing diet culture. Pro-ana challenges and taking body profile pictures can lead to eating disorders. Kim explained the underlying cause is the beauty and entertainment industry, which profits off of selling unrealistic ideas about diets. People who are continuously exposed to these posts on social media gradually grow accustomed to the thought that focusing on one’s weight is normal.
In response to these recurring messages, communities emerge, giving people a sense of belonging. Even though developing an eating disorder may not have been the idea, such communities warp perceptions of body image and create a distorted perception of beauty that pressures people to try to fit in.
“The health and fitness industry, along with celebrities, give off the idea that ordinary people can also look like the people in the carefully staged photos on social media,” Kim said. “More and more people joining and supporting this pro-ana trend keeps it going.”
This is why Kim stresses the importance of eating disorder therapy, especially group counseling. Through group counseling, patients can realize that being on a diet or how their body looks is not needed to form relationships with others. She believes group counseling helps the patients reduce their obsession with diets, which is a big goal and benefit of the counseling sessions.
As much as eating disorders are a fundamentally psychological matter, a lot of convincing goes down in therapy sessions.
Kim has had personal experience struggling with an eating disorder. This experience allows her to better understand her patients and helps her patients put more trust in Kim. Yet, recovery is not an easy process. Letting go of a diet is difficult, and many patients give up during therapy.
“I try to help my clients realize the fact that their ultimate goal is not in reaching a certain body weight or shape but in being socially accepted,” Kim said. “I also tell them that their eating habits are taking a serious toll on their health, attracting various illnesses like hair loss, stomach trouble, and irregular periods.”
Instead of trying to achieve the perfect body image they crave, which ironically distances them from others in the process, Kim guides them to find healthier ways to get along with others and obtain the social acceptance they strive for.
To those suffering from eating disorders, Kim wants to say that it is unfair for them to direct the whole blame on themselves.
“Do not think that this happened because you lacked willpower or went wrong in any way because that is not true at all,” she said. “I know for a fact that there are people out there who have even the slightest obsession with their diet or body image but are not talking about it. Please do not feel ashamed of having those concerns or think that you are alone in it.”
Escaping anorexia, discovering happiness
The severity of eating disorder issues does not pertain only to South Korea, but spans the globe. According to the National Association of Anorexia Nervosa and Associated Disorders, at least nine percent of the world population is impacted by eating disorders. In the United States, for instance, 28.8 million people have struggled with eating disorders in their lifetime.
Francesca Bas, a student from University College Utrecht majoring in psychology and 2019 recipient of Oregon’s Mental Health Heroes, struggled with anorexia nervosa starting from the age of 15. Ever since achieving full recovery, Bas has had a deep passion for mental health and helping others, especially women, with eating disorders. In 2021, she was featured in TEDx Talks, sharing her anorexia nervosa experience.
Looking back, Bas explained that her eating disorder developed when she first realized that she did not have much control in her life. At the time, she was disinterested in hobbies, disliked school, and had broken up with her boyfriend. The only parts of her life that she thought she could control were the number of calories she consumed and the hours of exercise she completed.
Initially, Bas did not want to seek help after she told one of her close peers who did not take it seriously. She unwillingly sought recovery at 16 when she experienced a series of frightening symptoms in her body. At the hospital, she discovered the state of her health was even worse than expected. Her heart rate and bone density were so dangerously low that she had to be hospitalized. She was experiencing extreme hair loss and had missed her period for a long time.
Bas suffered from anorexia not only physically, but mentally as well. She felt completely numb most of the time. Socially, she had lost many of her friends because all of her attention was directed toward her eating disorder.
Commitment to recovery did not start until Bas was 17. She began to actively seek help when she realized that she felt more energetic and passionate about new interests. Her life completely changed when her therapist questioned where she saw herself in 10 years. That was the first time Bas heard from someone that she should recover not simply because she needed to get better, but rather to accomplish her goals in life.
“Full recovery is accepting yourself where you are at, knowing that food is fuel and community, not a demon,” Bas said. “I believe that the whispers of eating disorders derive from the desire to protect yourself. For me, it was food and control. We need to tackle the origin of the problem and put that energy into other areas of our lives in a healthy manner.”
One of the challenges Bas had to overcome during her recovery was body dysmorphia. Because there were many so-called fitness influencers posting pictures of their slim bodies, she did not feel satisfied with her own body every time she looked in the mirror. She felt the societal pressure to fit into ideals set by the online community.
A body-affirmative concept that Bas introduced is “body neutrality.” According to her, body neutrality is not only limited to people recovering from an eating disorder, but rather all women throughout the world.
“Body neutrality is really about respecting your body, period,” Bas said. “Regardless of how it looks, be grateful for all the things it does for you.”
Bas urges everyone to enjoy themselves and have confidence in their own skin. For her, wearing outfits that made her feel confident, journaling about her emotions, and dancing to music helped her feel good about herself in her own body.
To those struggling to confront a close friend or family member actively going through an eating disorder, Bas advised to first prepare for a bit of bitterness from them. They might distance themselves and deny their eating disorder. In these situations, she stressed the importance of patience and staying beside them without pushing them beyond their limits.
For young women and men across the world grappling with various eating disorders themselves, Bas strongly recommended going to see a professional therapist and a nutritionist.
“Please be kind and gentle to yourself,” she said. “It is a lot. You feel numb, you feel intense, but practice tapping into your self-potential. I often see people with eating disorders thinking they have no joy in life. Find little things that make you not even happy, but just feel okay, and you will slowly see how much better your life could be if you leave this disorder behind.”