by Mary K. Walstrom
The deadly and pervasive nature of eating disorders has recently been acknowledged by United States government and public health officials. This awareness has led to the creation of eating disorder prevention materials for use by health care providers and school personnel (http://www.4woman.gov/bodyimage/Bodywise/bodywise.htm). However, these materials have limited scope and impact. To eradicate the nation's eating disorder epidemic, large-scale education and prevention campaigns, spanning diverse populations, will be needed. Fortunately, the Internet offers a vast, widely accessible array of educational, research, and advocacy resources on eating disorders. While this availability may offer rapid, affordable help to many eating disorder sufferers and concerned individuals, the quality of information retrieved is often a concern.
Critical analysis of web-based health information is vital since we are likely to be influenced by the web-based health materials we locate. For example, according to a May 2001 report from the Journal of the American Medical Association (JAMA), 70% of the 100 million Americans who search for online health information use it to make treatment decisions (http://www.jama.ama-assn.org/issues/v285n20/abs/joc02274.htm). With this trend in mind, imagine a troubled teen seeking web-based eating disorder information who encounters a site promoting anorexia nervosa. Clearly, it is essential to be able to identify accurate, recent, and credible eating disorder information online.
This review summarizes eight eating disorder websites that meet strict evaluative criteria. Each site features timely, research-based, well-organized, and reader-friendly eating disorder information. Sites are divided into four categories: metasites, education/prevention, professional, and academic/research. Given the expansive inspection of websites completed for this review, I believe that those below offer some of the finest web-based eating disorder resources currently available. These sites highly appeal to the interests of eating disorder sufferers, researchers, professionals, students, activists, and other concerned individuals.
Ask Noah
URL: http://www.noah-health.org/english/illness/mentalhealth/eatingdisorders.html
Developed/maintained by: Mary Jo Dorsey, M.L.S., Weill Cornell Medical Center
Last updated: August 8, 2001
Reviewed: October 1, 2001
New York Online Access to Health (NOAH) began in 1995 as the brainchild of four institutions: City University of New York (CUNY), the Metropolitan New York Library Council, the New York Academy of Medicine, and the New York Public Library. NOAH's mission is to provide high-quality bilingual information on a wide variety of health topics. Site content selection and evaluation criteria are viewable in the section called "About Noah." Subject matter for each topic is researched, organized, and maintained by a volunteer contributing editor. A link to all NOAH editors appears on the main health topic pages. Moreover, the name of the contributing editor responsible for a given page appears at the bottom. All editors hold advanced degrees, suggesting the accuracy and reliability of page content. The quality of page information is further ensured given that it is reviewed by NOAH's content committee.
The "Ask Noah About: Eating Disorders" page features three main categories: "What are Eating Disorders?" "Care and Treatment," and "Information Resources." Approximately two dozen links are available under the first category, all connecting to documents on eating disorders from reputable sources (e.g., the American Psychiatric Association, American Academy of Pediatrics, American Academy of Family Physicians, American Psychiatric Association, and American Anorexia and Bulimia Association). The "Care and Treatment" and "Information Resources" sections contain far fewer links (at this time, three each); however, the quality remains high. Navigation among topics is quick, since all links are on the main page. Also, one may easily search for information on topics related to eating disorders by clicking the "Health Topics" or "Subject Index" links at the top of the main eating disorder page. The primary strength of this metasite is the wide variety of research-based sources it bridges. Also notable is the disclaimer on the front page, wisely advising readers that information is not to be taken as medical or professional advice.
Something Fishy Website on Eating Disorders
URL: http://www.something-fishy.org/
Developed/maintained by: Amy Medina
Last updated: July 26, 2001
Reviewed: October 1, 2001
Amy Medina's creation of this site in 1995 coincided with the beginning of her recovery from a ten-year battle with anorexia nervosa. Amy details the history of her full recovery and the development of her site, illuminating the personal passion and commitment to excellence behind the site content. The amount of eating disorder material available on Something Fishy seems to be the broadest of any site on this issue. Some of the major site topics include definitions, signs, and associated dangers of eating disorders, keys to helping loved ones, doctor-patient issues, locating treatment, online support, sufferers' personal stories, and memorials to lives lost to eating disorders. Material for these topics appears to be developed by Amy, and references and disclaimers are at times provided. Site-related news is also available, such as results of informal reader polls, upcoming chatroom announcements, and opportunities to subscribe to a newsletter. Especially impressive are the links to material on cultural issues (e.g., men, women of color) and the trilingual nature of most parts of the site (English, French, and Spanish).
Although Something Fishy contains numerous main and sub-topics, navigation of the site is extremely easy and efficient. A frame at the left indicates to readers where they are positioned in the site hierarchy at any time. Readers may also jump to any page of the site from the one being viewed. Overall, the site offers exceptionally valuable material for eating disorder sufferers, healthcare practitioners, and students investigating eating disorder conditions.
Lucy Serpell's Eating Disorder Resources
URL: http://www.serpell.com/eat.html
[Editors note: new URL, per email from Luch Serpell, March 4, 2004: http://edr.org.uk/]
Developed/maintained by: Lucy Serpell*
Last updated: July 4, 2001
Reviewed: October 1, 2001
Lucy Serpell launched this site in 1994, and it has grown to a comprehensive metasite useful for eating disorder sufferers, researchers, students, and healthcare practitioners. Lucy holds a Ph.D. from the Institute of Psychiatry (King's College, London), which explains the focus on professional and academic resources in her site. A general information section begins the site, containing an array of metasites, online recovery sites, commercial pages, and personal websites (of those struggling with or recovered from eating disorders). The remaining topics include academic resources, treatment, national associations, physical problems, overeating/BED (binge eating disorder), newsgroups, recommended books, and related issues. Navigation and topic location could be improved by increasing the number of site categories, allowing for more focused topic searches. Researchers will find useful links to grant funds, eating disorder conferences, and professional associations. Other impressive features include links to fat/size acceptance and antidieting sites. Lucy offers readers the opportunity to receive email notices of site updates. She also includes a warm personal note, welcoming feedback on her site and offering correspondents alternative sources of information in lieu of personal replies.
[*Editor's note: Lucy Serpell reviewed eating disorder sites for Feminist Collections v.18, no.4 (Summer 1997), p.17-18.]
Anorexia Nervosa: Judy's Story
URL: http://www.angelfire.com/ms/anorexianervosa/index.html
Developed/maintained by: Judy Sargent
Last updated: Unknown
Reviewed: October 1, 2001
A successful, engaging blend of personal and professional eating disorder information appears in Judy Sargent's meta-website. A large photo and self-introduction greets readers who visit Judy's home page. Judy's background includes a long, near-death battle with and recovery from anorexia nervosa and a completed M.A. degree in Psychiatric-Mental Health Nursing. She draws on this wealth of experience in a book she recently published, The Long Road Back: A Survivor's Guide to Anorexia. The book's touching photos are included on her immense website, which features reliable, accurate, and moving resources for eating disorder prevention.
The majority of the site seems geared toward those struggling with eating disorders. Judy vividly documents her anorexic and recovery life stages, offers a frequently-asked-questions page that elaborates on these stages, and extends a warm personal note offering support and hope for full recovery. Online support options, treatment centers, and recommended books offer further assistance to those dealing with eating disorders. Students and concerned others may gain rich insight into the lived experience of eating disorders through Judy's descriptive revelations.
For those wondering if they are at risk for an eating disorder, a helpful link to the DSM-IV diagnostic criteria for these conditions is provided. All readers will find the site easy to navigate, as one main home page contains all major site links. This page appeals to both the hearts and minds of readers seeking eating disorder information, supplying an important alternative to the many information-laden, clinically oriented eating disorder sites on the web.
The sites featured in this section represent two of the most prominent, well-developed nonprofit organizations dedicated to eating disorder research, education, prevention, and advocacy.
National Association of Anorexia and Associated Disorders (ANAD)
URL: http://www.anad.org/
Developed/maintained by: Unknown
Last updated: Unknown
Reviewed: October 1, 2001
Founded in 1976, the National Association of Anorexia and Associated Disorders (ANAD) claims to be the oldest national nonprofit organization dedicated to offering free resources and services to eating disorder victims and their families. These audiences will benefit from links to free hotline counseling, eating disorder information, guidelines for creating community support groups, and advocacy materials (e.g., for fighting insurance discrimination, fat testing in schools, and negative media messages). Researchers, educators, and healthcare practitioners will find useful links to professional organizations and national conferences. ANAD membership is open to all. Activism is a key, welcome feature of this site, clearly demonstrated by a (presumably annual) candlelight vigil/protest meant to affirm positive body image, recognize eating disorder victims, and promote eating disorder prevention. (The 2002 vigil will be held at the National Mall in Washington, D.C., as well as on college campuses and in local communities around the country.) Surprisingly, ANAD's board of directors and website developers are not listed. A biography of ANAD's founder is accessible on the "About ANAD" page. Navigation is smooth, as major site topics usually remain visible in a left-justified frame, allowing readers to jump to a desired site section most of the time. The site's two-color format and minimal graphics enhance readability.
Eating Disorder Awareness and Prevention (EDAP)
URL: http://www.edap.org
Developed/maintained by: Unknown
Last updated: Unknown
Reviewed: October 1, 2001
Eating Disorder Awareness and Prevention (EDAP) asserts itself as the largest national nonprofit organization dedicated to eating disorder education and prevention. Since its founding in 1987, EDAP has annually sponsored Eating Disorder Awareness Week, reportedly the largest national event dealing with eating disorder concerns. The site is highly geared toward training and advocacy, seen in the wide range of teaching materials and activist events it makes available. This focus well mirrors the organization's mission--to eliminate eating disorders and body dissatisfaction through education, advocacy, training, and research. The voluminous amount of educational materials (displayed and for purchase) and public awareness events could be better organized within the website. For example, the home page contains three separate columns of information and links, displayed in four different colors, various text styles, and several different graphics. Information about the board of directors and content creators is not immediately obvious, although some educational material does contain references and author/researcher names. EDAP seems most successful at creating innovative and effective events for generating public awareness and concern about eating disorders, and for recruiting both professionals and lay persons to join its mission.
Academy for Eating Disorders
Developed/maintained by: Unknown
Last updated: Unknown
Reviewed: October 1, 2001
The Academy for Eating Disorders website creates opportunities for professionals to collaborate in treating eating disorders. The organization began as an association in September of 1993, and establishment as an academy soon followed in 1995. The home page of this site displays the Academy's eight-part mission, which is undergirded by a philosophy that views eating disorders as best treated by professionals from various disciplines. Site content is accessible through ten major links: "Mission," "Public Links" (which includes a generous list of links to professional eating disorder-related organizations), "Membership," "Conferences," "Newsletter," "How to Help," "Email Us," "Media Inquiries," "Members Only," and "Special Interest Groups." Five categories of membership are available, all including a valuable subscription to the International Journal of Eating Disorders. The Academy's online presence asserts an important message about the complexity of eating disorder treatment and the need for venues to make such efforts successful.
MEDLINEPlus: Eating Disorders
URL: http://www.nlm.nih.gov/medlineplus/eatingdisorders.html
Developed/maintained by: Unknown
Last updated: September 21, 2001
Reviewed: October 1, 2001
MEDLINEPlus offers current, research-based healthcare information, drawn from the world's largest medical library, the National Library of Medicine at the National Institutes of Health. Other reliable site information includes medical dictionaries and encyclopedias, as well as drug information. The "Eating Disorder" component of the site is easily accessible through the search engine on the main site page (http://www.nlm.nih.gov/). The home page content includes "Latest News" (e.g., Reuters), "From the NIH" (links to an eating disorder educational booklet), "Clinical Trials" (sponsored by the National Institutes of Health), "Specific Conditions/Aspects," "Treatment," "Organizations," "Teenagers," and "Women." The last two topics present specialized information for young and midlife eating disorder sufferers, respectively. The "Clinical Trials" links offer crucial updates for researchers and potential options for those with eating disorders seeking alternative treatment forms. Links to MEDLINEPlus topics related to eating disorders also appear automatically on the main site page (e.g., "Weight Loss/Dieting" and "Food, Nutrition, and Metabolism"), enhancing searches for students. With few but well-organized topics, simple layout, and bilingual capabilities, this site provides readers considerable navigation ease and high readability.
Until the eating disorder epidemic in the U.S. is tackled through major public health drives, eating disorder websites are certain to increase. Many of these sites provide a critically needed reality check and source of help--involving accurate, recent, first-person, and research-based eating disorder facts--amid a culture that increasingly rewards eating-disorder-like appearances and behavior. One last website helping to reverse eating disorder trends is the home page of the National Eating Disorders Screening Program, at http://www.nmisp.org/eat.htm. As a part of Screening for Mental Health, Inc., the program has been testing college students for eating disorders since 1996 (during Eating Disorder Awareness Week). The program has expanded to include the general public, and in 2002 it will encompass high schools. Site visitors can preview screening questions and format and obtain various information sheets (e.g., tips, fact sheets, and special issues). Such a program offers hope for the increased public action and awareness that are needed to reverse and prevent all eating disorder conditions.
[Mary K. Walstrom, Ph.D. (University of Illinois-Urbana-Champaign), is an adjunct instructor in the Women's and Gender Studies Department at Sonoma State University in Rohnert Park, California. Her specializations include the study of online eating disorder support group communication and the ethics of Internet-based research. She also facilitates a support group in an outpatient eating disorder program in Santa Rosa and gives public presentations/seminars that build positive body image and self-esteem.]
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