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‘Written in these scars are the stories I can’t explain’: A content analysis of
pro-ana and thinspiration image sharing on Instagram

Article in New Media & Society · January 2017

DOI: 10.1177/1461444816687288

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DOI: 10.1177/1461444816687288
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content analysis of pro-ana and journals.sagepub.com/home/nms

thinspiration image sharing on

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Debbie Ging and Sarah Garvey

Dublin City University, Ireland

Abstract
Since pro-anorexia websites began to appear in the 1990s, there has been a growing
body of academic work on pro-ana and thinspiration communities online. Underpinned
by a range of (inter)disciplinary perspectives, most of this work focuses on websites and
blogs. There is a dearth of research and, in particular, gender-aware research on pro-ana
practices and discourses in the context of newer mobile social platforms such as Instagram.
Using a dataset of 7560 images, this study employs content analysis to ask whether, to
what extent and how pro-ana identities and discourses manifest themselves on a more
open, image-based platform such as Instagram. We demonstrate that, by mainstreaming
pro-ana, Instagram has rendered visible pro-ana sensibilities such as abstinence and self-
discipline in the broader context of distressed girls’ lives and Western culture more
generally. We conclude that this increased visibility may in fact be a positive development.

Keywords
Anorexia, eating disorders, girls, Instagram, memes, postfeminism, pro-ana, self-harm,
social media

Introduction
Pro-anorexia, also referred to as pro-ana or simply ana, is a collective response to ano-
rexia that became visible on the Internet in the early 1990s. Pro-anorexics reject the

Corresponding author:
Debbie Ging, School of Communications, Dublin City University, Glasnevin, Dublin 9, Ireland.
Email: Debbie.ging@dcu.ie
2 new media & society 

medical diagnosis of eating disorders (EDs), claiming instead that extreme food restric-
tion is a valid lifestyle choice (Rouleau and Von Ransom, 2011). Thinspiration refers to
the same phenomenon but also covers more mainstream dieting practices, in itself an
indication of how the boundaries have become blurred between pro-ana and more accept-
able regimes of food restriction. While some scholars contend that pro-ana has no offline
precedent, having evolved exclusively post-Internet (Giles, 2006), others argue that pro-
ana sensibilities were already present in Western culture and that their existence and
expression are logical responses to a society that valorises thinness (Bordo, 2003;
Knapton, 2013; Malson and Burns, 2009; Schott and Langan, 2015). In recent years, the
pro-ana community has migrated from websites, which tended to be static, heavily mod-
erated, password-protected and exclusively focused on anorexia, to social media plat-
forms such as Instagram, which is more visual, less hierarchical, more open due to the
high number of public accounts and more difficult to moderate due to large volumes of
cross-tagged images.
Bans imposed in 2012 by both Tumblr and Pinterest have not succeeded in deter-
ring pro-ana activity on these platforms (Gregoire, 2012). Meanwhile, significant
numbers of pro-anas have turned their attention to Instagram, a strongly visual appli-
cation that was originally designed for editing and sharing photos but which quickly
evolved into a social networking platform. According to Kenny (2013), ‘the innately
“creative” nature of the app means users engage with what might even be described
as a quasi-art form, applying filters and edits that glamorise a life-threatening illness’.
At the time of data collection (25 August 2014), posts tagged with #ana stood at
5,527,788 and posts tagged with #anorexia stood at 3,286,391. At the time of writing,
these figures are 7,611,122 and 5,150,917, respectively. Banned hashtags such as
#thinspiration and #thinspo either reappear or are constantly being modified (e.g.
#thinsp00), while a vast amount of pro-ana content also flourishes under less obvious
tags such as #bodycheck, #collarbones, #thighgapp, #bonespo, #anamia, #size00,
#needtobeskinny, #brokenana, #secretsociety123 and #wanttobeskinny. Like
Facebook, Instagram provides users with instant feedback in the form of likes and
comments, encouraging both regular users and ‘Thinstagrammers’ to measure their
impact and popularity in numerical terms.
Using a dataset of 7560 images harvested from the hashtags #ana, #starve and #fast-
ing, we sought to explore how pro-ana manifests itself on Instagram, primarily by ana-
lysing the types of images posted and, to the extent possible, by considering how these
images are shared and received. Given that the vast majority (90–95%) of people with
anorexia and bulimia are women (Boero and Pascoe, 2012: 33), our analysis is theoreti-
cally underpinned by a feminist perspective, which is attentive to the gender-specific
experiences of teenage girls. In addition to this, while sceptical about technological-
determinist frameworks, we also asked whether and how the specific affordances of
Instagram – openness, meme-style visuality,1 hashtagging and peripheral governance –
are influencing the construction of pro-ana identities and support networks in this space.
Our findings prompt us to suggest that while Instagram’s visualisation and mainstream-
ing of pro-ana may serve to normalise disordered eating, these features also work to
reveal the normality of body dissatisfaction in young women’s lives as well as to contex-
tualise food restriction as part of broader patterns of ‘gender distress’ (Dobson, 2015)
Ging and Garvey 3

linked with depression, anxiety and self-harm. Before discussing the findings in detail,
we consider below the key theoretical perspectives that informed our study.

Theoretical perspectives on the pro-ana community online

Scholarship on the pro-anorexia community online generally derives from three main
disciplinary fields, namely, the clinical or medical approach, the socio-cultural perspec-
tive and feminist analysis (Ascari, 2013; Casilli et al., 2012), although the latter two
frequently overlap. The medical community is steadfastly opposed to pro-anorexia
groups on the grounds that the movement is ‘distinctively accepting of the desire to not
recover … [and] there is a fear it might then lead to a normalisation of the behaviours and
decrease the chances that individuals will seek professional help’ (Ascari, 2013: 4).
Much of the medical and psychological scholarship (Bardone-Cone and Cass, 2007;
Curry and Ray, 2010; Rouleau and Von Ransom, 2011) is preoccupied with establishing
a correlation between exposure to pro-ED websites and increases in disordered eating
behaviours, resistance to clinical intervention and susceptibility to relapse. These
approaches generally assume a hypodermic-needle effect, whereby the key functions of
online pro-ana communities are considered to be glorification, normalisation and aggre-
gation of the disorder. It is unsurprising, therefore, that medical and psychological schol-
arship has also attributed considerable agency – and danger – to the technological
specificities of new platforms. For example, Haas et al. (2010) posit that anonymity and
the invisible but interactive audiences of sites such as MySpace, Xanga and Livejournal
allow ‘weak-tie’ support to be perceived as ‘strong-tie’ networks, thus further alienating
pro-anas from their families. Tiggemann and Miller’s (2010) and Tiggemann and Slater’s
(2013) findings suggest that profile identity construction and speed and ease of connec-
tion with peers on Facebook increase social comparison and appearance concerns, while
Mabe et al. (2014) contend that Facebook use may maintain body size preoccupation and
state anxiety due to ease of image sharing and photoenhancing technology.
By contrast, social, cultural and transdisciplinary perspectives, while they acknowl-
edge the dangers of the pro-ana phenomenon, generally focus on the positive aspects of
online communities. Many contend that pro-ana websites compensate for a lack of or
negative offline therapeutic resources (Tierney, 2006: 186), and can provide eating-dis-
ordered individuals with an outlet for safe self-expression (Dias, 2003), non-judgemental
support (Williams and Reid, 2007), a feeling of inclusion and belonging within a special-
ised community of likeminded individuals (Brotsky and Giles, 2007; Schott and Langan,
2015; Smith et al., 2015) and the de-stigmatisation of the condition (Ferreday, 2003:
277). Feminist analyses of pro-ana adopt a similar approach but overtly acknowledge
and seek to address the fact that anorexia is a gendered condition (Bordo, 2003; Schott
and Langan, 2015). For Burns (2004), the problem is not merely one of pressure to con-
form to idealised feminine norms set by the fashion and diet industries but also to a
broader set of expectations imposed upon women, whereby ‘the dangerous idealization
of abstinence and restriction … have become exemplars of feminine control and strength’
(p. 290). According to Dias (2003), because anorexic women’s bodies are under constant
scrutiny, the Internet is ‘a space in which women who are struggling with anorexia can
potentially find sanctuary from the surveillance and regulatory mechanisms of control of
4 new media & society 

the public sphere’ (p. 31). She is critical of attempts to censor pro-ana spaces as she sees
this as a further silencing of the female voice. In a similar vein, Schott and Langan (2015)
have argued that Tumblr’s 2012 censorship of pro-ana content serves to extend the patri-
archal control of women, who use the platform to communicate, connect and potentially
resist dominant social constructions of their identity and motivations.
While such forms of resistance are not necessarily successful, feminist scholars con-
vincingly argue that they must be considered in wider contexts of gender and power. As
Bordo (2003) has noted, ‘… eating disorders, far from being “bizarre” and anomalous,
are utterly continuous with a dominant element of the experience of being female in this
culture’ (p. 57). For Day (2010), pro-ana online spaces both conform to and rebel against
patriarchal ideals. On one hand, pro-ana women enact resistance towards outside agents
of control such as medical professionals and therapists; on the other hand, these sites
promote excessive ‘self-control, self-discipline and self-surveillance, often in line with
culturally dominant ideals of femininity… and patriarchal constructions of female bod-
ies and desires as requiring control’ (Day, 2010: 245). The value of feminist analyses is
that they regard pro-ana expressions in the wider context of girls’ everyday gendered
experiences. This is particularly pertinent in relation to the contradictions of living in a
postfeminist culture, whose Girl Power rhetoric extols vocal assertiveness, while bio-
logical-essentialist mantras posit assertiveness and taking up space, whether physical or
vocal, as male traits (Ging, 2009). Amy Dobson (2015), for example, interprets girls’
pain sharing memes on You Tube as an articulation of ‘gender distress’. According to
Dobson, these silent, visual narratives of suffering eclipse pro-ana sensibilities in that
they are motivated by a desire for reciprocal self-disclosure, solidarity and affirmation
and, through their refusal to talk, reject the pressure on girls to adopt the vocally asser-
tive posturing of Girl Power. Dobson cites McRobbie (2009: 116), who interprets such
contemporary ‘female’ conditions as pro-ana, dieting and self-harm as ‘illegible rage’ at
a culture which tells them they have it all, yet puts unequal pressure on them to look
sexy and then slut-shames them when they do assert sexual equality (Ringrose and
Renold, 2012).
The feminist literature thus questions the technological-determinist positions that
inform medical discourses, namely, those which insist that harmful behaviours are cre-
ated exclusively by the Internet. boyd’s (2007) work is especially useful here as she
argues that, although the risky or harmful behaviours that some young people engage in
are more visible in the digital age, they are not necessarily more prevalent. According to
boyd et al. (2009), ‘We’re giving agency to the Internet so that we can blame it for what
it reveals, rather than forcing us to contend with what we see’ (p. 414). This concept of
technology as rendering visible (as opposed to creating) a problem is particularly perti-
nent in the case of pro-ana, which is often framed as a new and dangerous phenomenon
created by technology rather than a community made up of individuals with pre-existing
‘gender distress’, who proactively use technology to seek out one another in a bid – how-
ever successful or unsuccessful – to express or alleviate their pain.
Finally, while it is important to be sceptical about the ways in which technological
determinism can obscure complex social factors, it is equally impossible to dismiss the
role played by technology in this communicative environment. Given that pro-ana is a
truly digitally networked public (boyd, 2007), it is unlikely that the technological
Ging and Garvey 5

affordances of social media do not play a role in (re)shaping its communicative patterns
and discourses. As Massanari (2015) has demonstrated in her analysis of anti-feminist
technocultures on Reddit, ‘Disentangling the community’s norms from the ways those
norms are shaped by the platform and administrative policies becomes difficult in a
space such as Reddit, as they are co-constitutive of one another’. Similarly, Boero and
Pascoe’s (2012) work shows how the social, interactional and performative functionality
of MySpace is used by pro-anas to engage in rituals of authenticity and embodiment such
as sharing photos, weigh-ins and group fasting. Although the current study focuses pri-
marily on image content and thematic categorisation, we are also attentive to the ways in
which these images are shared, tagged and ‘re-grammed’. Our approach is best described
as techno-social (Massanari, 2015) in that we consider both the gender scripts that inform
teenage girls’ lives and the ability of social media’s technological affordances to (partly)
shape the social.

Methodology
It is difficult to determine what constitutes a coherent dataset on a platform such as
Instagram. While its hashtag and follower features make it easy for the individual user to
locate and connect with similar people, there is no uniform way for the researcher to
generate a representative volume of subject-specific material. Several weeks of search-
ing and observation indicated that the hashtags #ana, #starve and #fasting were most
frequently attached to pro-ana content2 and so we decided to use these as the basis for our
dataset. Pinsta.me, an Instagram web browser, was used to assemble a constructed week
sample over a period of 1 month, whereby sample dates were stratified by day of the
week to generate a more representative sample. Images were generated directly from
Instagram in real time in pages of 10. A total of 36 screen captures (360 images) were
screenshot and saved in Excel for each hashtag on each day of the constructed 7-day
week, resulting in 1080 images per day, adding up to a total dataset of 7560 images. Data
collection also took place at different times on each day of compilation to allow for a
more representative overview by including time periods when Instagram users across the
United States and in other time zones were highly active.
The data were categorised using mutually exclusive categories as they arose from an
initial overview of the dataset, and was therefore an inductive process. Using random
subsamples of the data, 9 categories were identified and a codebook was drawn up,
detailing the criteria for each category (these are outlined in the findings). The data were
coded by one author only, but we conducted a reliability test by having the second author
code a random sample of images, which produced almost identical categorisation.
Ambiguous images, that is, those which could have fitted into more than one category,
were coded on the basis of the most dominant hashtags used to tag the image. The indi-
vidual hashtags were then broken down by these categories to determine any hashtag-
specific trends. Our immersion in the three hashtags #ana, #starve and #fasting over a
period of many weeks also involved general observation of practices of cross-tagging,
liking and commenting, as well as occasional visits to individual posters’ pages. These
observations partly inform some of our findings, even though a systematic capture and
analysis of these data were beyond the scope of the study. This is a limitation of the
6 new media & society 

research that could be addressed in both smaller scale qualitative analyses and larger
scale network analyses in future. All images collected were publicly available as they
were shared from public and searchable Instagram accounts. Although almost all pro-ana
Instagram users have separate accounts with a fake (usually eating disorder related) user-
name, we have cropped these and the comments out of the sample images to protect
users’ identities.
The ‘other’ category emerged primarily because some Instagram users used anorexia-
specific hashtags to tag images that had no relevance to anorexia. This is partly attribut-
able to users named Ana using the hashtag, but it also appears that many Instagram users
are aware of the popularity of anorexia-related hashtags and may tag their selfies with
#ana and so on in order to gain a wider audience and more attention, as is the case with
tags such as #love, #happy, #beautiful and #TagsForLikes. We did not perceive this as
skewing the data but rather as a finding in its own right, indicative of the increasing
mainstreaming of pro-ana that Instagram affords and discussed in more detail below.
Some skewing of the data did occur, however, due to the fact that the Friday of the con-
structed week used for sampling fell on the Christian holiday of Good Friday, which
resulted in unusually high volumes of religious images being uploaded with the #fasting
hashtag. This explains the higher number of images in the ‘other’ category under this
hashtag.

Results and analysis

Pro-anorexia images accounted for 74% of the total dataset. The nine categories that
emerged from our dataset were thinspiration, gamified and interactive, text-based quotes,
pro-anorexia linked with depression, pro-anorexia linked with self-harm and suicide, tips
on maintaining and concealing an ED, pro-recovery, selfies and other. To date, the litera-
ture on ‘traditional’ pro-ana websites has identified some similar content categories:
‘thinspiration’ material, tips on maintaining and concealing an ED, mutual support and
encouragement, the personification of ana as a friend (Sharpe et al., 2011) and the con-
struction of ana as a religion (Knapton, 2013). Thus, while we encountered some overlap
with the categories identified in other studies (Boughtwood et al., 2007; Brotsky and
Giles, 2007; Davis, 2008; Giles, 2006), we did not find images that suggested mutual
support and encouragement (although this was strongly evident in the comments), the
personification of ana as a friend or the construction of ana as a religion. Additional cat-
egories that emerged in our study, which have not been identified in the literature, were
depression, self-harm and suicide, gamified and interactive, pro-recovery and ‘other’.
The image categories we identified are outlined and explained below:

Category 1: Thinspiration (25%) included images of underweight or extremely thin

female bodies, images of protruding hipbones and/or collarbones, images of slim
thighs or ‘thigh gaps’ and images of protruding ribs or extremely flat stomachs and
before-and-after weight-loss transformations (Figure 1).
Category 2: Gamified and interactive (4%) included images which imply that the user
will engage in fasting or excessive exercise in return for ‘likes’, posts that display
Ging and Garvey 7

Figure 1. Examples of thinspiration images/memes.

Source: Instagram.

Figure 2. Examples of gamified and interactive memes/images.

Source: Instagram.

countdown clocks detailing the amount of time since the user last ate, posts that
request the audience to name a food that the user will agree not to eat for a set period
of time; posts displaying users’ weight on the scales and any memes that request other
users to interact with the poster of the image (Figure 2).
Category 3: Text-based quotes (26%) included memes that discourage eating, memes
that express feelings relating to one’s ED and poetry or lyrics relating to sufferers’
feelings on how they are treated by society (Figure 3).
Category 4: Pro-anorexia linked with depression (3%) included memes detailing users’
feelings of sadness, isolation, depression, worthlessness and unattractiveness; and images
of ‘fat’ body parts that cause users feelings of depression and anger (Figure 4).
Category 5: Pro-anorexia linked with self-harm and suicide (6%) included memes
detailing user’s suicidal thoughts and/or desires to self-harm, graphic images of self-
harm and/or cutting, and memes and poems that refer to self-harm and/or suicide
(Figure 5).
Category 6: Tips on maintaining and concealing an ED (10%) included images of
low-calorie meals, dangerous and unhealthy diet and exercise plans, tips and advice
8 new media & society 

Figure 3. Examples of text-based quotes.

Source: Instagram.

Figure 4. Examples of pro-anorexia images/memes linked with depression.

Source: Instagram.

Figure 5. Examples of pro-anorexia images/memes linked with self-harm and suicide.

Source: Instagram.

on excessive exercise, disordered eating and hiding an ED from friends, family and
doctors (Figure 6).
Category 7: Pro-recovery (8%) included images and text that promote recovery and/
or encourage seeking professional help, images of healthy and balanced meals and
quotes that encourage recovery and hope for the future (Figure 7).
Ging and Garvey 9

Figure 6. Examples of tips on maintaining and concealing an eating disorder.

Source: Instagram.

Figure 7. Examples of pro-recovery images/memes.

Source: Instagram.

Category 8: Selfies (6%) included images of the account holder taken of herself, typi-
cally with a smart phone. This category included only head/face shots. We have not
included examples as they identify the poster. Category 9: Other (12%) included any
images tagged with the hashtags under analysis (#ana, #starve and #fasting) that did
not fit into any of the other stated categories (Figure 8).

The table below shows the total dataset broken down by category and percentage, and
further broken down by hashtag.
The thinspiration and text-based quote categories were the most common overall,
with pro-ana linked with depression occurring least frequently. We can infer that the
most extreme images were associated with the #starve hashtag in that it produced the
highest number of images classified as thinspiration (42.8%) as well as the highest num-
ber of images classified as text-based quotes (43.6%). Perhaps most importantly, it also
produced the highest number of images in the pro-ana linked with depression category
(44.2%) as well as in the pro-ana linked with suicide and self-harm category (41.6%).
The #starve hashtag also produced the lowest number of pro-recovery posts, selfies and
other images, and was therefore less diluted in terms of pro-ana content than the other
two hashtags under analysis. The #fasting hashtag contained the highest level of
10 new media & society 

Index Table.

Category No. of images Percentage

of total
Thinspiration 1884 25%
#ana (20% of all #ana images were - 504 (26.8% of all thinspiration
classed as thinspiration) images occurred under the #ana
hashtag)
#starve (32% of all #starve images
were classed as thinspiration) - 806 (42.8% of all thinspiration
images occurred under the #starve
#fasting (22.8% of all #fasting
hashtag)
images were classed as thispiration)
- 574 (30% of all thinspiration images
occurred under the #fasting hashtag)
Gamified + interactive 297 4%
#ana (2% of all #ana images were - 47 (15.8% of all Gamified +
classed as Gamified + Interactive) Interactive images occurred under the
#ana hashtag)
#starve (3.2% of all #starve
images were classed as Gamified + - 82 (27.6% of all Gamified +
Interactive) Interactive images occurred under the
#starve hashtag)
#fasting (6.7% of all #fasting
images were classed as Gamified + - 168 (56.5% of all Gamified +
Interactive) Interactive images occurred under the
#fasting hashtag)
Text-based quotes 1951 26%
#ana (24% of all #ana images were 605 (31% of all text-based quotes
classed as text-based quotes) occurred under the #ana hashtag)
#starve (33.7% of all #starve 850 (43.6% of all text-based quotes
images were classed as text-based occurred under the #starve hashtag)
quotes)
496 (25.4% of all text-based quotes
#fasting (19.7% of all #fasting occurred under the #fasting hashtag)
images were classed as text-based
quotes)
Pro-ana linked with depression 267 3%
#ana (4% of all #ana images were 94 (35.2% of all pro-ana linked with
classed as pro-ana linked with depression images occurred under the
depression) #ana hashtag)
#starve (4.7% of all #starve images 118 (44.2% of all pro-ana linked with
were classed as pro-ana linked with depression images occurred under the
depression) #starve hashtag)
#fasting (2.3% of all #fasting 55 (20.6% of all pro-ana linked with
images were classed as pro-ana depression images occurred under the
linked with depression) #fasting hashtag)
Ging and Garvey 11

Figure 8. (Continued)

Category No. of images Percentage

of total
Pro-ana linked with self-harm + 437 6%
suicide
159 (36.4% of all pro-ana linked with
#ana (6% of all #ana images were self-harm + suicide images occurred
classed as pro-ana linked with self- under the #ana hashtag)
harm + suicide)
182 (41.6% of all pro-ana linked with
#starve (7.2% of all #starve images self-harm + suicide images occurred
were classed as pro-ana linked with under the #starve hashtag)
self-harm + suicide)
96 (22% of all pro-ana linked with self-
#fasting (3.8% of all #fasting harm + suicide images occurred under
images were classed as pro-ana the #fasting hashtag)
linked with self-harm + suicide)
Tips on maintaining and hiding 737 10%
ED
208 (28.3% of all tips on maintaining
#ana (8% of all #ana images were and hiding ED images occurred under
classed as tips on maintaining and the #ana hashtag)
hiding ED)
172 (23.3% of all tips on maintaining
#starve (6.8% of all #starve images and hiding ED images occurred under
were classed as tips on maintaining the #starve hashtag)
and hiding ED)
357 (48.4% of all tips on maintaining
#fasting (14.2% of all #fasting and hiding ED images occurred under
images were classed as tips on the #fasting hashtag)
maintaining and hiding ED)
Pro-recovery 616 8%
#ana (12% of all #ana images were 311 (50.5% of all pro-recovery images
classed as pro-recovery) occurred under the #ana hashtag)
#starve (2.8% of all #starve images 72 (11.7% of all pro-recovery images
were classed as pro-recovery) occurred under the #starve hashtag)
#fasting (9.2% of all #fasting 233 (37.8% of all pro-recovery images
images were classed as pro- occurred under the #fasting hashtag)
recovery)
Selfies 469 6%
#ana (11% of all #ana images were 269 (57.3% of all selfie images
classed as selfies) occurred under the #ana hashtag)
#starve (1.9% of all #starve images 48 (10.3% of all selfies occurred under
were classed as selfies) the #starve hashtag)
#fasting (6% of all #fasting images 152 (32.4% of selfies occurred under
were classed as selfies) the #fasting hashtag)
(Continued)
12 new media & society 

Figure 8. (Continued)

Category No. of images Percentage

of total
Other 902 12%
#ana (13% of all #ana images were 323 (35.8% of all other images
classed as other) occurred under the #ana hashtag)
#starve (7.6% of all #starve images 191 (21.2% of all other images
were classed as other) occurred under the #starve hashtag)
#fasting (15.4% of all #fasting 388 (43% of all other images occurred
images were classed as other) under the #fasting hashtag)
TOTAL 7560 100%

Figure 8. Total dataset broken down by categories and percentages (of the total dataset, of
each hashtag and of each category).
ED: eating disorder.

gamified and interactive images (56.5%). These findings suggest both continuities with
and differences from previous online pro-ana communities. These are discussed in more
detail below under three key headings, namely, the aestheticisation and mainstreaming of
pro-ana, overlap with self-harm, depression and suicide and the emergence of gamified
and interactive pro-ana content.

The aestheticisation and mainstreaming of pro-ana

Traditional sites have tended to be dominated by thinspirational material, pro-ana quotes
and slogans and tips (Sharpe et al., 2011). These categories have clearly migrated onto
Instagram in visual form, and continue to be the most popular types of images shared. As
with pro-ana websites, the Instagram images depict almost exclusively white females,
thus reinforcing the stereotype of the anorexic as a white western female. However, some
noteworthy differences emerge, both in terms of the images themselves and the ways in
which they are shared. In addition to its function as a social network, Instagram is a
photo-editing software that offers attractive filters and other editing options. As a result,
the types of images posted tend to be more stylised and aesthetically sophisticated than
on other platforms, with a lot of thinspiration material appearing in black and white or
bleached out colours. This not only accentuates bone protrusion but also references art
photography and the kind of aesthetic frequently associated with high-end or designer
fashion. It arguably also ‘tones down’ images of self-harm (discussed in more detail
below), which appear more gruesome when blood is red.
This development has coincided with the rise of meme culture (Shifman, 2013), in
which text and images are juxtaposed, often to communicate complex perspectives and
sentiments that are not easily expressed through exclusively text-based communication.
These trends have consolidated and formalised the aesthetic and formulaic conventions of
pro-ana images, which are easily and rapidly understood, replicated and shared across a
vast number of hashtags every day. According to Robards and Bennett (2011), following
Ging and Garvey 13

stylistic conventions may offer opportunities for a sense of belonging, while Dobson
(2015) argues that the meaning of a meme is ‘located in its relationality, in the sense of
shared cultural experience and understanding produced through its consumption and cir-
culation’ (p. 8). However, while the images in this category are clearly the result of the
creative affordances of Instagram, it is noteworthy that large numbers of users operating
these pro-ana hashtags do not post filtered images of themselves but rather share or
‘regram’ canonical images of pro-ana girls with captions and tags such as ‘goal’ and
‘notme’. Unlike the more closed pro-ana communities on websites and in private Facebook
groups, therefore, this much looser network appears to include many non-anorexics or
‘wannarexics’ who also admire and aspire to the ana aesthetic. This aestheticisation and
formulisation of pro-ana content means that these images no longer appear so niche or
disturbing but rather share instantly recognisable qualities with both mainstream fashion
and art photography and Internet meme culture. Our data cannot tell us whether the popu-
larity and open circulation of this type of body imagery among both anorexic and non-
anorexic women is likely to encourage the incidence of disordered eating. What it does
reveal, however, is the continuity that exists between pro-ana and mainstream ideals of
femininity (Bordo, 2003) and the fact that a pro-ana sensibility (‘not me but goals’) is by
no means restricted to those who are unhealthily underweight.
This mainstreaming of thin body imagery is also facilitated by the much more public
nature of Instagram, its easy searchability and the speed at which large volumes of
images are shared across multiple hashtags of varying relevance. Although we collected
data under only three hashtags, large numbers of tags are attached to pro-ana images,
often linking them to ana-unspecific topics such as #followme, #tagforlikes and #dieting
as well as to emo, depression and suicide-related tags. As boyd (2007) points out, digi-
tally networked publics are more interconnected, with less defined boundaries than web
1.0 platforms. As a result, pro-ana images circulate alongside more conventional images
of female thinness and beauty, and the boundaries are increasingly blurred. These images
also overlap with selfie culture, thus creating visual and discursive online contexts that
are much more socially acceptable than conventional pro-ana websites.
This synergistic integration of pro-ana content across Instagram’s visual landscape
may also explain why there appears to be much less hostility displayed towards ‘wann-
rexics’ than was the case with website-based pro-ana communities, which have typically
been exclusive and inward-looking rather than inclusive. On Instagram, pro and anti-
recovery comments, memes and quotes sit side by side, both under hashtags and on
individual profiles and, while there are sometimes emotional appeals made to pro-ano-
rexics to stop starving or posting trigger images, there are no real boundaries or controls
by which the community can manage the inclusion or exclusion of others. Moreover,
there is little or no evidence of the kind of policing of potential wannarexics (‘wanna-
baiting’) described by Boero and Pascoe (2012: 40). In this sense, the pro-ana Instagram
community is considerably more inclusive than its website-based antecedents.

Overlap with self-harm, depression and suicide

Instagram’s propensity for cross-fertilisation via multiple tagging has also facilitated
considerable overlap with suicide, depression and self-harm related tags and images. A
significant number of users share an array of content from a single account that includes
14 new media & society 

Figure 9. Example of an image tagged with eating disorder specific as well as suicide/
depression related hashtags.
Source: Instagram.

material depicting EDs, self-harm, depression and suicide with hashtags specific to (at
least) all four afflictions (Figure 9). It is worth noting that, since data collection, this
trend appears to have become considerably more common, although further quantitative
analysis is needed to support this. Consequently, any user searching for ED or ana-related
content is likely also to generate a mixture of self-harm, depression and suicidal content.
In this sense, Instagram’s openness both dilutes and amplifies the ability to successfully
locate ‘extreme’ content on the platform. On the one hand, the search function is hin-
dered by people tagging images with both related and irrelevant hashtags, which in turn
diminishes its capacity to generate purely ED-specific content. On the other hand, the use
of multiple hashtags reveals that most pro-ana content is posted in conjunction with and
in relation to a range of other problems affecting young people (e.g. #sad, #selfharmmm,
#anxiety, #depressedgirl, #bullied), thus enabling us to gain more contextualised insights
into the various emotions and problems they are experiencing.
This cross-fertilisation occurs not only at the level of cross-tagging but also in the
visual content of the memes themselves, which often combine themes of anorexia,
depression, self-hate, self-harm and suicide, most frequently by featuring images of
excessively thin and freshly cut or scarred arms and legs (Figure 10). In addition to this,
a number of other sub-themes are evident in these memes, which resonate strongly with
Dobson’s (2015) work on pain memes on You Tube and McRobbie’s (2009) ‘illegible
rage’, namely, a recognition of the pain inherent in performing happiness, the pressure to
be perfect, tiredness, loneliness, a feeling of being ignored or invisible, a desire to escape,
a desire to be weightless and anger at society. These images thus exemplify pro-ana
meme sharing not merely as means of communicating experiences of disordered eating
but as a way of tying to articulate the causes of pain, of which disordered eating is a
Ging and Garvey 15

Figure 10. Examples of images that combine pro-ana, self-harm and depression related
themes.
Source: Instagram.

symptom, as well as the difficulties inherent in everyday social interaction and survival.
This is in keeping with Juarascio et al. (2010: 405), whose content analysis of pro-ana
groups on Facebook and MySpace revealed that ‘The emotional content was varied and
deep, and often focused on content such as family trouble, boyfriends, school and work’.
The images analysed in our study also revealed rich insights into posters’ affective and
communicative intentions. Although, as Dobson claims, they may be representative of a
kind of catatonic resistance, they are not wordless. Indeed, there appears to be a strong a
desire within these memes to render rage legible, and many of them articulate the quin-
tessentially anorexic concept of the body as the last resort of protest by showing scars
and words literally etched into human flesh, bearing out Boero and Pascoe’s (2012)
claims that ‘Rituals of online embodiment are employed as community-building and
sustaining strategies’ (p. 49).
The popularity and resonance of this type of memetic shorthand for complex and
otherwise unarticulated pain makes even more sense if we consider the many contradic-
tions girls face in a postfeminist society (Ging, 2009). Across a range of cultural dis-
courses, low self-esteem is taken for granted through persistent suggestions that women
need to make themselves feel better – though the cause of their pain is never acknowl-
edged – and simultaneously disavowed by Girl Power discourses, insisting that young
women are brash, confident and self-fulfilled (Dobson, 2015). Moreover, while post-
feminist discourse pays lip service to sisterly solidarity, its emphasis on competitive
individualism, whereby women must compete with one another for ‘hotness’ status
(Levy, 2005), severely limits its potential for meaningful political solidarity (Ging,
2009). As Boero and Pascoe (2012: 33–34) claim, ‘Expectations of femininity are con-
tradictory, and anorexia represents both resisting and acquiescing in normative feminin-
ity’. In this way, social control is ‘etched’ on the anorexic body’.
Viewed in this context, the railing against society that is evident in many pro-ana
memes is an understandable reaction to a society which places high demands on young
women (to be successful, beautiful, thin and confident) and promulgates the myth that
gender equality has been achieved, yet has no vocabulary for the feelings they might
experience when they encounter power inequities and double sexual standards in their
everyday lives. Expressing and sharing pain is likely to perform a cathartic function in
16 new media & society 

this scenario, and may explain the appeal of cross-over tagging, which enables girls to
perceive and express their suffering from a variety of discursive and aesthetic perspec-
tives, rather than restricted exclusively to pro-ana. In order to explore this in more
detail, future research is needed, which focuses on the community aspects of pro-ana
on Instagram and, in particular, on the comments generated by images. We can, how-
ever, identify a distinct sensibility in Instagram pro-ana image sharing, which is less
about the defensive and secretive maintenance of pro-ana as a lifestyle or closed com-
munity and more about ‘coming out’ or self-disclosure, not only to other pro-anas but
also to girls who identify as depressed, emo and suicidal as well as to girls who are
pro-recovery.

Gamified, interactive and competitive content

Instagram encourages high levels of interactivity, with the result that its pro-anorexia
content has become more competitive and gamified than was the case on older forums
and websites. Although gamified and interactive posts made up only 4% of the dataset,
this is a significant new development in pro-ana communicative formats. Whereas inter-
action on traditional pro-ana sites entailed conversation between members and the shar-
ing of advice and personal stories, pro-ana users can request their followers or indeed
anyone who sees their image postings to compete and involve themselves in weight-loss
‘games’. This gamification most commonly presents itself in the form of users request-
ing ‘likes’ or comments in return for excessive exercise sessions or lengthy periods of
abstinence from food. Users also invite others to engage in competitive fasts and ask
followers to ‘name a food’ that they should no longer eat. Some users also demand
‘body-checks’ from one another, whereby they must post their weight and body measure-
ments so that others can comment on their updates, praising further weight loss and criti-
cising any weight gain. The #AnaBuddy hashtag, which was attached to many of the
images captured in our dataset, also appears to be used by pro-anas to seek out others
who will motivate them to lose more weight.
Thinstagrammers thus proactively use the technological affordances of Instagram as
a means of self-motivation through public commitment to fasting goals. Unlike with
password-protected websites, gamified pro-ana memes appear on public accounts and
are therefore available to all Instagram users. On the one hand, this might be perceived
as a dangerous new development, particularly given that anyone (from ‘wannarexics’ to
curious ‘randomers’) can engage or pretend to engage in competitive fasting with pro-
anas, potentially putting them in an even more vulnerable position than when communi-
cating with others who are genuinely anorexic.3 On the other hand, this mainstreamed
gamification also serves to reveal how abstinence and restriction have become normal-
ised and idealised as ‘exemplars of feminine control and strength’ (Burns, 2004: 290),
not only in these spaces but also across the diet and fitness industries generally. Tiggemann
and Zaccardo (2015), for example, claim that exposure to fitspiration imagery on
Instagram has negative effects on women’s body image and self-esteem. Thus, while
these gamified strategies may be both ill-conceived and unhealthy, they are arguably
motivated by the same logic as weight-loss mobile apps and competitive fat-shaming
programmes such as Operation Transformation.
Ging and Garvey 17

Conclusion
This study demonstrates that thousands of pro-ana images are shared on Instagram on a
daily basis. The proliferation of pro-ana hashtags as well as the use of multiple tagging
ensures that the images can be easily searched and found both by the pro-ana audience as
well as by other users, whose interests span a range of topics from dieting and fitness to
self-harm, suicide and depression. The overlaps that we observed with selfie culture,
depression- and self-harm-related content and pro-recovery material challenge many of
the stereotypes about pro-anorexics’ desire to hide themselves away, to be secretive or to
communicate only with other pro-anas. As Boero and Pascoe (2012: 38) report, the
groups they studied on MySpace revealed a diversity of behaviours and identities at odds
with the monolithic image of the anorexic presented in medical, psychological and some
second-wave feminist accounts. They claim that ‘The pro-ana anorexic does not seek to
hide her body or her disorder, often acts aggressively, actively searches out membership
in a pro-ana community, and shows ambivalence about both anorexia and recovery’
(Boero and Pascoe, 2012: 38).
Indeed, the merging of pro-ana and pro-recovery images and discourses in the same
spaces, pro-ana users’ acceptance of kindness and support from both camps, and the
apparent lack of ‘wanna-baiting’ all strongly support the claim that not all pro-anorexics
object to recovery, and many people who involve themselves in the pro-ana community
do so solely to gain support, understanding and a feeling of belonging (Ascari, 2013;
Boero and Pascoe, 2012). There are at least two ways in which we can interpret and
respond to the increased openness, fluidity and hybridity of this digitally networked pub-
lic. On one hand, some might see the overlap with self-harm, depression and suicide as
introducing pro-anas to even more potentially harmful or ‘triggering’ content. It might
also be surmised that the aestheticisation of photos, the use of widely accepted formats
(memes) and the fluidity of tagging and sharing practices signal a dangerous normalisa-
tion and mainstreaming of EDs, self-harm and indeed of young girls as damaged and
depressed.
On the other hand, these complex visual expressions of girls’ pain and the ways in
which they are shared invite more holistic and contextualised understandings of pro-ana.
Unlike static websites and blogs, the more overlapping, fluid and multi-tagging nature of
Instagram provides a more ‘joined-up’ and multi-layered perspective of pro-ana behav-
iours and discourses online. These overlaps suggest that pro-ana self-disclosure on
Instagram should be of interest not only to healthcare practitioners but also to those
concerned about (cyber)bullying, depression and self-harm and gender equality.
Meanwhile, the mainstream popularity of pro-ana imagery reported here should serve to
remind us that the ‘tyranny of slenderness’ (Chernin, 1981) is not antithetical to but
rather continuous with Western culture’s idealisation of femininity. If, as Fox et al. (2005)
claim, pro-ana is ‘a way of coping and a damage limitation that rejects recovery as a
simplistic solution to a symptom that leaves the underlying pain and hurt unresolved’, it
is arguably the underlying pain and hurt that require the most serious attention in the long
term (p. 967). This is especially urgent in light of a recent UK survey (Lessof et al.,
2016), which shows that girls are experiencing significantly higher levels of anxiety,
worthlessness and depression than boys.4 Viewed in this way, the mainstreaming of
18 new media & society 

pro-ana on Instagram could help to force debates about disordered eating and self-harm
out of the discursive confines of pathology and technological determinism and into
broader, more contextualised discussions about gender, new media and society.

Funding
The author(s) received no financial support for the research, authorship and/or publication of this
article.

Notes
1. The memes under analysis here are exclusively static images overlaid with text.
2. Since the time of data collection, these hashtags have fewer posts and far less pro-ana content,
while the number of other, new pro-ana related hashtags has increased. At the time of writ-
ing, those with the highest number of posts are #mia (7,860,491), #ana (7,608,824), #skinny
(6,198,735), #anorexia (5,148,877), #thin (2,730,674), #anorexic (2,507,986) and #eating-
disorder (2,452,895), although the pro-ana content of these has also become somewhat more
diluted. In the meantime, new, more pro-ana specific hashtags such as #size00, #bonespo and
#palethinspo have appeared.
3. The 4chan community’s #bikinibridge hoax in 2014 is a particularly sinister example of how
eating-disordered women can be encouraged by non-supportive users to engage in competi-
tive rituals of self-disclosure.
4. In all, 37% of girls had three or more symptoms of psychological distress, for example, feel-
ing worthless or unable to concentrate, compared to 15% of boys.

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Author biographies
Debbie Ging is a Senior Lecturer in Media Studies at Dublin City University. Her current research
is concerned with articulations of gender on social media, and addresses issues such as cyberbul-
lying, online misogyny, men’s rights politics, eating disorders and the sexualisation of children.
Sarah Garvey is a research student and graduate of the Masters in Social Media Studies at Dublin
City University. Her research concerns the discursive construction of pro-anorexia on social media
platforms.

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