Women with anorexia may experience a positive release from destructive weight-loss behaviors.
Anorexia, a disorder that has a mortality rate of up to 20 percent, is often associated with low self-esteem and perfectionism. But the popularity of "pro-ana" web forums, featuring "success stories" and "thinspiration," indicates that at least some sufferers feel pride and other positive emotions -- which may prevent them from wanting to get better.
"Some women at least, with anorexia, are getting some positive feelings from this," clinical psychologist and researcher Dr. Edward Selby told The Huffington Post in a phone interview. But why?
A research team led by Selby analyzed data from 118 women aged 18-58 who were in outpatient treatment for anorexia. Participants were trained to use a PalmPilot, which prompted them to answer questions about their feelings, food intake and weight-loss behaviors five times a day for two weeks.
The data, published in a recent issue of Clinical Psychological Science, showed that many of the women had trouble differentiating between positive emotions -- which may be motivating them to engage in weight loss. Patients' pride about losing weight may be confused with other positive emotions such as confidence or accomplishment.
"We found that this essentially put women at risk from feeling positive emotions from these [weight-loss] behaviors," Selby told HuffPost. "Things like a vomiting episode, misuse of laxatives, exercise."
Previous studies have shown that eating disorder patients may have trouble "making sense" of their emotions, but they commonly focused on negative emotions and not positive ones. Selby explained that an inability to differentiate between positive emotions has implications for eating disorder treatment, by turning towards "a major focus on building a new identity by finding positive emotions through other things."
"[We don't intend to] downplay the role of stress and negative emotion involved in anorexia," Selby said. "A lot of women have very problematic, stressful lives, and then they find positives through the anorexia behavior."
So, finding those who struggle with disorders like anorexia a new source of positive feelings may be a place to start.
CORRECTION: A previous version of this article stated that an estimated 30 million Americans suffer from anorexia. In fact, 30 million Americans will suffer from a clinically significant eating disorder at some time in their life. We regret the error.
Need help? Call the National Eating Disorder Association hotline at 1-800-931-2237.
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