Pro-ana

Pro-ana (pronounced pro-anna)

(1) Of or relating to the position anorexia is a legitimate lifestyle choice.

(2) The on-line community advocating this view.  The most uncompromisingly pure among the community actively deny anorexia nervosa is a clinical condition.

(3) A movement for the promotion of behaviors related to anorexia nervosa. 

(4) A member of this movement or one of the related communities.

Circa 1998-2001:  The construct is pro + ana.  Pro was from the Classical Latin prō (in favor of, on behalf of), from the Proto-Italic por-, from the primitive Indo-European pr- & pro.  Ana is a clipping of of anorexia (an(orexi)a), a phonetic diminutive of the 1957 scientific term anorexia nervosa, the construct being the Ancient Greek ἀν (an) (without) + ὄρεξις (órexis) (appetite, desire) + the Latin nervōsa (nervous).  The clipping of "anorexia" was created both as verbal shorthand and coded language (so the matters of diet and related matters could be discussed without the risk of "outsiders" understanding.  "Ana" was thus a form of personification and a "cover", the outsiders hopefully assuming a young lady named Anna was being spoken of.  Pro-ana is a noun; the noun plural is pro-anas.

Only a matter of time: Lonaniana.

Ana in this context is thus obviously unrelated to the suffix -ana (familiar in forms such as “Victoriana” (of the era of the rein of Victoria (1819–1901; Queen of the UK 1837-1901)), “Americana” (of matters specific to US culture, politics etc), Holmesiana (memorabilia or writings related to the fictional detective Sherlock Holmes created by Sir Arthur ConanDoyle (1859–1930)) etc) that became popular after being adopted in continental literature.  It was from the Latin -āna (neuter plural of –ānus (feminine -āna, neuter -ānum) and was applied to create formations meaning “of or pertaining to”.  In English the specific sense originally was “a collection of things that relate to a specific place, person etc”; the suffices -ic & -ica now fulfil a similar function.  All formations created by appending –ana are pluralia tantum (from the Latin plūrāle tantum (plural as such; plural only); the term describes a noun (either in certain or all its senses) that does not generally have a singular form.  In his A Dictionary of the English Language (1755), Samuel Johnson (1709-1784) defined the suffix thus: “Books so-called from the last syllables of their titles; as Scaligerara, Thuaniana; they are loose thoughts, or casual hints, dropped by eminent men, and collected by their friends.”  An early exemplar was Thraliana, something of a gallimaufry of diary entries, jokes, poems and anecdotes, complied between 1776-1809 by Dr Johnson's dear friend by Mrs Hester Thrale (1741-1821) although those wanting something meatier will more enjoy the two volume Addisoniana (1803), a two-volume biographical and anecdotal anthology of the writings and conversations of the English essayist politician Joseph Addison (1672-1719), compiled and edited by Sir Richard Phillips (1767–1840); it’s a fine relic of a troubled time.

Palindromic elements: A collection of material relating to pro-ana would properly be titled “Pro-anaiana”.

Dr Johnson’s notion of “loose thoughts, or casual hints, dropped by eminent men, and collected by their friends” is familiar also as “table talk”.  Table talk literally is conversation (especially if informal or gossipy) among a group seated together for a meal or other social activity.  The point about table talk is it’s held to represent an individual’s “true” thoughts in unvarnished form (ie not “sanitized” for public consumption and for that reason the table talk of the illustrious or infamous often attracts interest when assembled and published.  However, such collections rarely are true transcripts and even if not deliberately misleading in that what can appear can be a verbatim account of what was spoken and an accurate summary of views and opinion, much can be lost in the transcription.  Classic examples of the difficulties historians encounter in the absence of audio recordings are the several editions of Tischgespräche im Führerhauptquartier (Table Talks at the Führer's Headquarters), published between the 1950s and 1980s, containing what were alleged to be transcriptions of (mostly) monologues delivered by Adolf Hitler (1889-1945; Führer (leader) and German head of government 1933-1945 & head of state 1934-1945) to guests at his lunches or dinners between 1941-1944.  As well as being edited at the time they were written, Albert Speer (1905–1981; Nazi court architect 1934-1942; Nazi minister of armaments and war production 1942-1945) pointed out the printed copy omits so much of the repetition, pauses and linguistic stumbles that could make meals with Hitler “stiflingly boring” for “the regulars who’d heard it all, many times before”.

Etymologists are inclined insist the correct form can be only "pro-ana" and there are traditions in English which supports this but the community itself uses ana, pro ana and proana interchangeably, the most common form the short-form ana, following the practice with anorexia nervosa which is truncated to anorexia in all but formal academic or clinical work.  Over two-odd decades, pro-ana has also spawned words such as thinspiration (often clipped to thinspo) and thinology, used to describe specialized editorial content of the calling; the much less-used term pro-mia referring to bulimia nervosa.  Pro-anas are purists who maintain high-standards; those who aspire to the anahood but in some way fail are dismissed as wannarexics.

Lindsay Lohan wearing (non-ana) red wrist-string.

The ana's standard means of social identification is a simple, beaded red bracelet, the beading of some significance because variations of red bracelets, some as simple as a wrist-string, have long been used by many cultures, usually with some sort of link to the idea of a good-luck charm.  Famously, a חוט השני (the khutt hasheni, a thin scarlet or crimson string) is sometimes worn as Jewish folk custom as a way to seek protection from those misfortunes which may be aimed at one by the עין הרע (evil eye).  It's most associated with the Kabbalah sect and Kabbalic scholars say there's nothing in ancient Jewish texts about wrist-strings of any color and the "tradition" is a recent folk practice which seems to have begun in the north-eastern United States early in the twentieth century.  Anas thus need always to check for beading before reaching out.

Notes

Although at the time it never reached the critical-mass needed to coalesce into a movement, the pro-ana concept actually pre-dates the web.  Among the bulletin boards the nerdiest connected to with 1200 or 2400 baud modems in the 1980s and early 1990s were both anorexia support boards and those which celebrated the condition but, once the indexed www (world-wide-web) was "bolted-on" to the internet the spread was rapid and, by the mid-late 1990s, pro-ana was global.

Pro-ana content tends to be (1) victim stories, (2) images & clips where ribcages & shoulder blades are often seen and clavicles much admired and (3), lists of helpful tricks and techniques.  Politically, the accepted pro-ana world view is they are not suffering from an illness; ana is a human right, an essential part of their identity and just another lifestyle choice.  As pieces of design, the sites tend to use pre-defined templates and in that are unremarkable although the preponderance of monochromic (in gray-scale) imagery is noted.  The pro-ana sites began to attract wider attention early in the twenty-first century, the irony being that much of the criticism came from the very publications many suggest contribute to eating disorders.  Off and on since then, pressure from the public and anti-ana organizations has compelled many hosts to shut down pro-ana sites although these efforts are Sisyphean, the relocations usually quick.

Sixteen Pro Ana Tips & Tricks for Beginners

Role model skinnytoker Trindalyn Mackenzie.

If followed with sustained rigor, what's in this list should result in weight-loss and the ability to maintain a lower mass.  If adhered to, there should be no need to resort to using the new generation of GLP (Glucagon-Like Peptide) receptor agonists which, while effective, are (1) expensive, (2) introduce often novel chemicals to the body and (3) don't in all cases mean weight loss will be sustained once the course of treatment stops.  The GLPs should be regarded (like the various surgical options available) as "last resorts" because D&E (diet & exercise) is the better path to follow and the pro-ana path, though demanding, is straight, narrow and well-lit.  For thinspiration, on TikTok, a place spiritually pro-ana is the SkinnyTok community.  According to some modern conventions, the expected form would be “SkinnyTok” but typically they eschew the CamelCase (partial capitalization), preferring “skinnytok” because letters have a physical character, lower case denoting “thin” and upper case “fat”). An illustrative example of content is skinnytoker Trindalyn Mackenzie skinnysplaining: “skinny isn't owned, it's rented”.  Her concept is right, the phrase encapsulating the pro-ana world view.

(1) Keep track of your calories.  Set an absolute number and NEVER exceed it while trying always, gradually, to lower the number.  Within the calorie limit, aim for a diet which is 75% leafy-green vegetables & legumes, 20% tart fruit (as the whole item but NEVER just the juice) and 5% seeds & nuts.  Added sugar should be zero because enough is in the fruit but, if absolutely necessary (feelings of weakness or cravings), one daily barley-sugar boiled sweet (preferably early in the day) is OK.  After finishing barley sugar (don't chew, just let it gradually dissolve), brush teeth  as well as good oral practice this will diminish the possibility of the appetite being stimulated.  However do NOT brush teeth within about an hour of eating or drinking (especially acidic (citrus and such) or with a sugar content) because such things soften the teeth's enamel and brushing before the surface recovers can "scrub away" the weakened enamel.  What's recommended is rinsing with water or chewing sugar-free gum.  This diet mix can at the margins be varied but must stay vegan.  Nothing should be fried and while most vegetables can be eaten raw (carrot & celery sticks the preferred pro-ana snack), there are advantages in cooking some with steaming usually the best method; steam only to the point necessary (it will vary) and at that point there should still be crunchiness.  In most cases, don't peel vegetables because some of the most valuable nutritional content lies just under the skin and one highly recommended technique is to base your selection of fruits & vegetables on skin & flesh color; eat a variety of colors.  Herbs & spices add much flavor and if you use the ones you most enjoy, they will tend to train the yearnings of your taste buds away from fat, salt & sugar.  Salt intake is essential but the daily requirement is little more than a teaspoon, much of which will be obtained from food.  If adding salt, stick to the terms in the cookbooks: sprinkle & pinch.

(2) Drink lots of water; try to aim for seven litres a day but anything over five is OK.  Being hydrated is anyway healthy and drinking water before taking food helps fill your stomach faster so you’ll eat less.  Remember to not drink a lot of water at once; instead keep hydrated by drinking little amount after every few minutes.  Always drink it as cold as possible, it forces the burning of more calories to restore body temperature.  Unless operating in extreme conditions with high fluid loss, do not go over eight litres a day; water can in extreme case be toxic and death has been reported among those who have ingested around 20 litres (less may be fatal in certain individuals, especially those with a lower body mass, hence the 5-7 litre recommendation). 

(3) Place a full-length mirror in your bedroom and evaluate yourself on daily basis. This is one of the best ways to stay motivated and remember, you’re there to be critical as well as admire.  If you can arrange multiple mirrors to provide for a 360^o view that's even better because it makes it easier to focus on problem areas (these can persist even as overall weight is falling).  Hanging a thinspiration photograph next to the mirror is recommended.

(4) Have small meals.  It’s easier for the body to burn three 100 calorie meals than one of 300 and lends your body the illusion you’re eating enough to keep the stomach full, whereas you’re eating less.  Always eat slowly and chew thoroughly, it will hasten the digestive process.  After every meal, brush teeth (after waiting an hour!); again, this is good dental hygiene but with freshly brushed teeth, you'll be less inclined to eat.  

(5) Find an ana-buddy.  The pro-ana routine can be a harsh mistress so an ana-buddy with whom you can talk about your problems and diet-related stuff can be helpful but only if they're a kindred spirit.  This works not only by keeping each other motivated but you'll also teach each other new tricks or exercise routines.  You both must be 100% committed to the system and such noble souls are rare so, if need be, replace them with someone wholly committed.  You're in a war with weight so be harsh and accept only allies who will help in the fight.

(6) With the aggressive pro-ana diet, it’s very important to take vitamin pills.  Research suggests that for most people on what is the orthodox "balanced diet", vitamin supplements are probably unnecessary (some researchers suggest they can even be counter-productive) but because pro-ana doesn't include certain food groups, a daily multi-vitamin is recommended and usually adequate so resist the temptation to take two and do so only if you become light-headed or faint with any frequency; you may need specific additional supplements.  The most publicized deficiency associated with pro-ana is iron and it may thus be necessary greatly to increase the intake of leafy greens like spinach or peas, broccoli & string beans; seeds high in iron include pumpkin, sesame, hemp and flaxseeds.  One's family physician can obtain the tests to determine specific deficiencies and these should be dealt with by adjustment to diet.  Remember though that doctors are inclined to be dictatorial and the recommended technique to deal with their negativity is just to agree with whatever they say.  Try to appear sincere and be deferential; they like that.   

(7) Avoid butter and oils.  Treat them like sugar or drugs of dependency.

(8) Resist the temptation to smoke or vape.  While it's true some short-term weight loss often is achieved by smoking cigarettes, (1) in the medium-long term weigh-gain is the typical consequence, (2) the nicotine in cigarettes is addictive making it difficult to use tobacco as a short-term or occasional "quick-fix" and (3) it's a carcinogenic product which, on average, appears to reduce life-expectancy by around a decade.  Not enough is yet known about vapes but there are many reports of adverse outcomes, presumed to be a consequence of inhaling that many chemicals.       

(9) Sleep at least eight hours a day, preferably more.  Less sleep means tiredness and hunger and you can’t eat while asleep.  Try to avoid eating in the four hours before going to bed and ideally aim for at least twelve hours of fasting prior to the first food of the day (which may happen at a time later than a traditional "breakfast").  Pro-ana endorses the 4:3 diet plan (an intermittent fasting protocol in which each seven-day cycle includes three (non-consecutive) days of fasting) and there are many recommendations covering the composition of food intake on the non-fasting days (many with an emphasis on high-protein foods).  It's difficult to be prescriptive about the specifics of intake because, by definition, food interacts with human physiology and in that there's much individual variation, thus pro-ana recommending those adopting the 4:3 regime experiment to determine the most effective mix.  Individual experiences are likely to vary.

(10) Keep setting a target weight.  Because of fluid retention and other cyclical variations, it’s probably counter-production to set daily targets and a weekly goal is better although true obsessives will monitor at least once and maybe several times a day; this is not discouraged.  To stay motivated, hang on the wall thinspiration photographs of slender models to observe while weighing-in.  Many non-ana diet sites suggest avoiding weighing-in daily and clinically they may be right it achieves little but they just don't understand the nature of obsessions.  Record the weigh-ins so you can chart progress over weeks and months; this requires nothing more demanding than the most basic open-source spreadsheet but math nerds who enjoy such things can do it with pen & paper.  Although for most purposes pencils are better than pens, ink is permanent so it's harder to cheat.  You will be tempted to cheat but you must not; pro-ana does often demand you lie to others but you must never lie to yourself.

Example of a thinspiration photo: Model Lululeika Ravn Liep (b 1998), Cover magazine, February 2015.  Although the use of this image was condemned by the thought police, a true pro-anaite should think: “She could lose a few pounds.”

(11)  Do NOT drink any alcoholic beverages; for variety only soda-water or carbonated mineral water are acceptable.  Coffee and tea are good appetite suppressants so drink only black coffee or tea and NO milk or sugar.  Avoid caffeine drinks; they’ll contain either sugar or chemicals about which there exists no reliable research on how they affect the appetite.  Avoid the inherently sweet herbal teas; they do tend to stimulate the appetite in a way black tea and coffee don't.  Black tea and coffee are also useful in training the palette away from sweetness and towards the tart.  After a while, this will start to influence your choice of fruits and vegetables; as a general principle the darker and more bitter in taste, the better.  Care must of course be taken.  In its pure form, caffeine can be fatal in tiny quantities although in the form usually enjoyed (coffee), one would need to drink dozens of cups in a day to approach toxicity.  The French philosopher Voltaire (François-Marie Arouet; 1694–1778), often at the Café de Procope in Paris, drank a reputed 40-odd cups a day, enjoying it so much he ignored the advice of his doctors to stop.  He lived to 84 but there’s no evidence the often attributed quotation: “It may be poison, but I have been drinking it for sixty-five years, and I am not dead yet” was his.  The more likely source is French author Bernard Le Bovier de Fontenelle (1657–1757) whose actual words were: “I think it must be [a slow poison], for I’ve been drinking it for eighty-five years and am not dead yet.”   Fontenelle died a month short of his hundredth birthday.  The sensible approach is to restrict yourself to one strong (ie short black and such) coffee at the start of the day and otherwise just have cups of weak (even decaffeinated) instant coffee; think of it not as a stimulant but a companion.

(12) Wearing short or revealing clothing can be very motivating and definitely such garments are helpful when looking in mirror because it will be obvious there's still work to do, something often disguised by what's worn in public.  Wear in private clothes you'd never dare to wear in public and make it a goal to be able to wear them without looking fat.    

(13) Drink the juice of a squeezed lemon in hot water first thing each morning and last thing each evening; it has the general effect of adding to the stomach acids which break up food.  Because of this acid, always brush teeth afterwards (allowing the essential 60 minute delay).

(14) If you have to eat in company (it can be unavoidable), wear baggy clothes with big pockets able to be lined with plastic bags.  Then, when no one is looking, you can dispose of food and people will think you eat normally.  It sounds a difficult thing surreptitiously to manage and to start with it will be but you’ll learn to adopt techniques like always sitting in a corner or at the end of the table and soon become an expert.  It's easier than it sounds.  However, prevention being better than cure, there are plausible excuses for NOT being able to eat (fasting prior to a blood test, having "upset tummy" etc) and that means social activities can still be enjoyed with intake restricted to water, black tea or black coffee. 

(15) Exercise every day.  Gyms are optional because you can do even better with ana-specific routines such as running up stairs or hills, both of which have an extraordinary multiplier-effect on whatever distance is achieved.  Unlike gyms, it's also free and never forget the goal is weight-loss, not abstractions like fitness or muscle tone; success is not looking fit & toned, success is looking thin & frail.  If possible, exercise in darkness to avoid sun exposure; if this is not possible (and there may be good reasons to restrict this to daylight hours) cover as much skin as possible with protective clothing and use the highest available SPF (sun protection factor) sun-block lotion, wear a wide brim hat and never forget the sunglasses.  Never use elevators and escalators; always take the stairs.  Wherever possible, replace travel by cars, trains and busses with walking or biking.  This is also good for the planet which is the only one we have.

(16) Eat ice; ice can be an alternative to a meal, it really works.  Shaved ice is best because it avoids dental damage; there are many things to consider when eating ice and curiously, sometimes it's advantageous to take more, sometimes less.  For a discussion on the mechanics of ice-eating: The eating of ice

Anorexia nervosa was included in the (1952) first edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) as a psycho-physiological reaction. The DSM-II (1968) moved it to Special Symptoms–Feeding Disturbances and in 1980, a new eating disorders section was created for the DSM-III.  The most significant structural change came in 1994 when in DSM-IV the condition was afforded its own section.  The DSM-5 (2013) relaxed some of the diagnostic criteria including, for the first time, rendering it all entirely gender-neutral, a gesture to conform with practices elsewhere rather than anything suggesting clinical experience was noting a greater gender-spread in the patient count.  Announcing DSM-5, the board noted it wished to reduce the number of patients in the former EDNOS (Eating Disorder Not Otherwise Specified) category, now reclassified as the OSFED (Other Specified Feeding or Eating Disorder) group.  Thus the psychiatrists staked their claim in this low-cal demarcation dispute by capturing the wannarexics.

Thinspo

Thinspo (pronounced thin-spoh)

(1) Material created, curated or used (distributed almost exclusively in digital form) to inspire thinness or weight loss.

(2) A sub-set of the pro-ana community which exists to support those on a spectrum ranging from obsessive dieters to those who have chosen as a lifestyle a managed form of anorexia nervosa.

2005–2010: The short form of thinspiration, the construct being thin +‎ (in)spiration.  Thin was from the Middle English thinne, thünne & thenne, from the Old English þynne, from the Proto-West Germanic þunnī, from the Proto-Germanic þunnuz (thin) (and related to þanjaną (to stretch, spread out)), from the primitive Indo-European ténhus (thin), from ten- (to stretch).  It was cognate with the German dünn, the Dutch dun, the West Frisian tin, the Icelandic þunnur, the Danish tynd, the Swedish tunn, the Latin tenuis, the Irish tanaí, the Welsh tenau, the Latvian tievs, the Sanskrit तनु (tanú) (thin) and the Persian تنگ‎ (tang) (narrow). A doublet of tenuis, it was related also to tenuous.  Inspiration was from the Middle English inspiracioun, from the Old French inspiration, from the Late Latin īnspīrātiōnem (nominative īnspīrātiō), from the Classical Latin īnspīrātus (past participle of inspīrō).  It displaced the native Old English onbryrdnes (literally “in-pricked-ness”).  Thinspo inspired others forms such as fitspo (encouraging fitness) and blondespo (advocating being blonde) and between thinspo and fitspo, critics noted some overlap, suspecting that in at least some cases the later identity is assumed as an attempt at disguise.  Thinspo & thinspiration are nouns; the noun plural is thinspos.  Derived forms like the nouns thinspirationist & thinspirationism do appear but are non-standard.

Thinspo's idealized bone definition.

The companion term ribspro (the short form of ribspiration (known also as bonespo)) is a particular genre within thinspo.  Whereas thinspo material can be long or short-form text, diagrams or images, ribspro is almost exclusively visual, the text limited to perhaps a few admiring or encouraging words and, as the names suggest, the focus is on ribcages or other bones proximately defined against taut skin.  Backbones, ribs, clavicles and hipbones seem the most favored, presumably because they tend to provide the most definitional contrast but there’s also the suspicion they're the particular aesthetic construct the thinspo community finds most attractive (unlike a knee or elbow which, however boney, seems not to be thought photogenic).  Another genre (a kind of applied thinspo) within the community is meanspo (the short form of mean inspiration), from the “tough love” or “cruel to be kind” tradition of weight loss and this school of thought advocates issuing critical and insulting comments to those considered “insufficiently thin enough”, the rationale being this will convince them to reduce intake, exercise more, purge and thus lose weight.  The thinspo ecosystem has also proliferated thematic variations such as “vegan thinspo” although that seems at least to some extent opportunistic given the most extreme of the thinspo operatives had long since banished animal products, regarding recommendations like “lean meat” or “chicken strips” as just so much fat.

Thinspo images often are rendered in grayscale, and that may have stated in in a nod to the aesthetic of art-house photography or simply because in monochrome the bone definition is more pronounced, a function of the contrast of light & shadow exploited by artists working with the chiaroscuro technique.  Whatever the origin, "black & white" became a thinspo motif although the B&A (before & after) posters appear to stick to original, full-color images. 

Like much in the pro-ana community, thinspo sites exist on a spectrum, those thought innocuous left to continue while any judged to be encouraging eating disorders subject to being shutdown although the efforts undertaken by (and sometimes imposed on) the platforms is a Sisyphean struggle, content shifting between hosts as required.  It’s also organic in that thinspo, like all that’s curated by the pro-ana community, is just another function of the supply & demand curve.  The supply of pro-ana content exists because of demand and in a manner familiar to behavioral economists, the ecosystem is symbiotic, the two forces acting upon and encouraging the growth of the other.  Like much that is on-line, some of the material blatantly is fake, something most obviously detected in the dubious B&A photos which appear with frequent duplication.  

Whether there were statistically significant differences in the nature of the content of thinspo and fitspo (a clipping of fitspiration (the construct being fit + (in)spiration) sites (featuring images and other material designed to trigger a motivation to exercise and enhance physical fitness) attracted academic interest and there were studies, the results differing in detail (there were widely divergent results depending on the platform analyzed which was thought to be a reflection more of the degree of success a platform achieved in enforcing its policies than any difference in the collective user profile) but displaying the same general trends: Thinspo sites portrayed body parts with more than twice the frequency of fitspo and posts highlighting bony body features and references to mental illness were overwhelmingly almost specific to thinspo.  Interestingly, the differences between fitspo & thinspo relating to sexually suggestive images, appearance comparison and messages encouraging restrictive eating were striking and almost wholly correlated with the platform on which they were posted.  The more extreme of the forks such as self harm (such as the cutter subset) also appear on thinspo sites.

Thinspo Rules

Thinspirationism: A blonde Lindsay Lohan during thinspo pin-up phase, 2005.

(1) Never eat something just because you want to finish it.  Eat only enough to stop the worst of the hunger pangs and don’t eat until sated; those extra bites add up.

(2) Don’t let emotions take over and eat only if hungry.  Stop yourself once you start eating if you know it’s for the wrong reasons.  The right reason is pangs of hunger; there is no other reason.

(3) If you catch yourself in a binge, stop the moment you realize.  Don’t forgive yourself for screwing up; it will only permit you to screw up again.  If you have binged, it must in some way be atoned for and than can be an increased energy burn (ie more exercise) or intake deprivation (eg skipping next meal).

(4) Every calorie counts so review every recipe and remove as many calories as possible.  Where available, choose the low cal version (but study nutritional-content labels because tags like "diet" or "97% fat-free" can be deceptive and misleading) and drink water (unmodified soda water is fine), black tea or black coffee instead of other beverages.  Avoid zero-cal sweeteners because (1) they’re a chemical cocktail and (2) the thinspo goal is completely to cure the body’s natural sugar addiction.  Artificial sweeteners may be equated with opioid substitutes such as methadone and while clinically there may be good reasons for a patient seeking to cease using heroin to be proscribed methadone, sugar is like nicotine: highly addictive but weak and able (chemically) to be withdrawn from within days.  Some will find the psychological addiction lingers longer but often that's associative (as it is with the social link between drinking alcohol and smoking).  The general principle is it's not good to replace one addiction with another so with added sugar the answer is "cold turkey", not packets of powdered chemicals.  The body does of course need sugar (it works essentially by converting intake into sugars the muscles, brain and other organs can use) but your intake should be exclusively in natural (unprocessed) sugars like those in green apples.    

(5) Don’t feel guilt about wasting food.  The undesirability on environmental grounds is noted but the sooner you change yourself, the better and as you hone your techniques, losses can be reduced to close to zero.  Set a goal always not to eat everything you’re served and gradually increase this quantity.  Before long, you’ll be throwing away food without barely a thought and if you have a garden or outdoor pot-plants, most organic waste can be chopped up or mushed to be mixed with water and added to the soil (plants will use the nutrients and eventually, the residue become soil).

(6) Eat slowly, savoring each bite.  Thinspo does not mean ceasing to enjoy food; it means the opposite because it makes every bite a rare and valued treat.  Thinspo life is like a rugby test in which only one try is scored but it is celebrated whereas "normal" life is like a rugby sevens game in which there may be two-dozen trys: after the first few they cease to be exceptional.  We evolved quickly (in biological terms) from creatures which had to hunt or gather every bite of the fat, salt & sugar we craved to survive but, with the same biology, we now live often sedentary lives among shelves laden with fat, salt & sugar, all within reach and sometimes packaged conveniently for instant consumption.  It is the curse of plenty. 

(7) Drink water during meals, as much as you can manage but, as a general principle, don't go beyond 6 litres (1.3 gallons (UK) 1.6 (US)); this is well short of of water's toxicity threshold but there's both a law of diminishing returns and a point at which water-intake becomes counter-productive.  Water curbs hunger, is filling, aids in digestion and maintains hydration which has many benefits.  Water has zero calories and can be taken as ice.

(8) Chew food more, taking at least one full breath after every bite.  While it will vary according to what’s being eaten, as a guide, chew 20-30 times for each mouthful. This not only assists digestion but slows the pace of eating, reducing consumption.

(9) Cut food into smaller pieces which (1) slows the process of eating, (2) can make you think you’re eating more (there's nothing wrong with fooling yourself if self-aware) and (3) it will make other people think you ate more (in some circumstances it can be helpful to fool others).

Thinspirationist: Actor Lily Collins (b 1989) in a semi-sheer white Calvin Klein ensemble, the cropped spaghetti-strap top and knee-length pencil skirt, both embellished with scale sequins, New York Fashion Week, New York City, September, 2025.  Note the pleasing definition of the sinews (arrowed, centre).  The hair-style is a chin-length bob.

(10) Associate unhealthy food with something else: ice cream with saturated fat, bread with carbs, juice with sugar etc.  Concrete visual examples are also helpful: imagine cake as fat sitting in and adding bulk to your thighs, chips as a permanent lining adding mass to the stomach etc.

(11) Learn from other people eating because while there are individual variations, overall, the patterns should be consistent.  Watch skinny people and apply their principles to your own diet; watch fat people with disgust and revulsion, avoiding what they do.

(12) Decide beforehand how much you are going to eat and never eat more.  If cooking, cook only one serving, so you can’t eat anymore.  The ideal model is to have no food in the house and each day buy only what you’re that day allowed.  It can at first be difficult but can be done and if stuck to, it’s a foolproof diet because you cannot eat what's not there.  If on the day you've not been able to buy food, you must fast and take in only water or black tea and coffee.  You won't enjoy it but it's good for you and may inspire you to add one or two "fast days" to the weekly cycle.

Lindsay Lohan shopping on Melrose Avenue, Los Angeles, 2009.  Her thinspo pin-up career long out-lasted her blonde phase.

(13) Always remind yourself of your goals and rewards.  Keep track of daily nutrient and food goals (some use a diet minder journal or tracking app but the best method is whatever works for you).  Weigh yourself twice a day (before morning coffee and just before going to bed), the goal being always to see a lower number than previous weigh-in.  If you have achieved a target weight and operate within a daily variation of +/- 100g, that is acceptable although that's also technologically deterministic: if your digital scales report in 50g increments, reduce your acceptable variability to that level for if God has given us such scales, She's trying to tell us something.

(14) Don’t eat 2½ hours before bed.  This time window can be increased but not reduced.

(15) You’ll be sometimes compelled to eat with friends or family so develop techniques surreptitiously to dispose of food.  You’ll get good at knowing where to sit so one hand can always be unseen and a good trick is to wear clothes with big pockets you can line with plastic bags.  Sit somewhere which makes disposal simple (open windows ideal, large pot plants can work) and develop a suite of reasons to ask to sit in certain spots.

(16) Don't be tempted to take up smoking or vaping.  While it can't be denied smoking often works as an appetite suppressant (all those commendably slender catwalk models can't be wrong), inhaling a known carcinogen is unwise because not only does it shorten lifespan (it seems on average by about a decade although the numbers do bounce around) but even while one remains alive it can induce or worsen many illnesses and other conditions.  While in the long run we're all dead and one should die thin, the object is to live thin for as long as life remains enchanting and what smoking does is tend to reduce life expectancy.  The numbers need to be understood because while dying at 75 rather that 85 may not (vied from decades afar) sound that bad, smoking directly can kill those in their twenties or thirties.  There are better ways (see 1-15 above) to lose weight and the evidence on vaping is mixed.  It's too soon to tell what the long-term health outcomes will be but there is anecdotal evidence flavored vapes can stimulate one's appetite and that makes sense because so many use tastes the mind associates with "sweet".  There's only one acceptable form of addiction: diet & exercise.     

Pagophagia

Pagophagia (pronounced pag-off-faghia)

(1) The excessive and constant eating of ice, often as part of extreme dieting.

(2) A craving to eat ice, sometimes associated with iron-deficiency anemia.

Pre 900: A compound word, the construct being págo(s) + -phagia.  Págos is from the Byzantine Greek, the perfective stem of ἔφαγον (éphagon) (I ate; I devoured), singular first-person aorist active indicative form (by suppletion) of ἐσθίω (esthíō) (I eat; I devour).  Phagia is from the Ancient Greek πάγος- (phag-) (stiff mass; frost; ice) from pēnunai, (to stick, stiffen), from the primitive Indo-European root pag.  It was used also in a derogatory, figurative sense to describe a cold, unfriendly person (in the sense of one metaphorically cold like ice).  The nouns pagophile & pagophily and the adjective pagophilic reference species which prefer (ie are adapted to) ice as a habitat.  Pagophagia is a noun and pagophagic is a noun & adjective; the noun plural is pagophagics.

Ice, diet and the DSM

Pagophagia (the excessive consumption of ice or iced drinks), is often regarded as a recent phenomenon and a novel manifestation of pica (a disorder characterized by craving and appetite for non-edible substances, such as ice, clay, chalk, dirt, or sand and named for the jay or magpie (pīca in Latin), based on the idea the birds will eat almost anything) but in texts from Classical Greece are warnings in the writings of both the physician Hippocrates (circa 460–circa 370 BC) and the polymath Aristotle (384–322 BC) concerning the dangers of the excessive intake of cold or iced water.  The cause of the death of Theophilus (Byzantine (Eastern Roman) Emperor 829-842) was officially dysentery but, based on the original texts of Byzantine historians and chroniclers of the era, modern researchers speculate the cause of death may have been related to Theophilus' pagophagia (snow eating), a long-time habit he indulged to relieve the symptoms of gastric inflammation.  In the medical literature, from the sixteenth century on, there are discussions and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of eating disorders, another range of conditions with a long history.

A noted feature of the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5 (2013)), was the more systematic approach taken to eating disorders, variable definitional criteria being defined for the range of behaviours within that general rubric.  What may have appeared strange was including the ice-eaters within the psychological disorder Pica which is characterized by the manifestation of appetite for non-nutritive substances including sharp objects (acuphagia), purified starch (amylophagia), burnt matches (cautopyreiophagia), dust (coniophagia), feces (coprophagia), sick (emetophagia), raw potatoes (geomelophagia), soil, clay or chalk (geophagia), glass (hyalophagia), stones (lithophagia), metal (metallophagia), musus (mucophagia), ice (pagophagia), lead (plumbophagia), hair, wool, and other fibres (trichophagia), urine (urophagia), blood (hematophagia (sometimes called vampirism)) and wood or derivates such as paper & cardboard (xylophagia).  DSM-5 also codified the criteria for behaviour to be classified pica.  They must (1) last beyond one (1) month beyond an age in infancy when eating such objects is not unusual, (2) not be culturally sanctioned practice and (3), in quantity or consequence, be of sufficient severity to demand clinical intervention.  Interestingly, when the text revision of DSM-5 (DSM-5-TR, 2022) was released, the sentence “individuals with atypical anorexia nervosa may experience many of the physiological complications associated with anorexia nervosa” was added to the description of the atypical anorexia nervosa example to clarify that the presence of physiological consequences during presentation does not mean that the diagnosis is the (typical) anorexia.  However, it must be remembered the DSM is a tool for the clinician and, while it can be a useful source document for the lay-reader, there are other publications better suited to those self-diagnosing or informally assessing others.  An individual for whom the only symptom of pica is abnormally high and persistent ice consumption doesn’t of necessity need to be subject to the treatment regime imposed on more undiscriminating consumers.

One of the reasons pagophagia is one of the more-researched and better-documented examples of pica is its strong association with iron deficiency anemia (the word in modern use unrelated to ischemia (local disturbance in blood circulation) which well into the twentieth century was sometimes a synonym), something which manifests especially in women as one of the consequences of the menstrual cycle.  The research has established there’s a high prevalence of pagophagia in patients with iron deficiency which tends to disappear once treated although the mechanism isn’t fully understood.  One theory is chewing ice temporarily increases alertness in those with iron-deficiency–related fatigue, possibly by improving cerebral blood flow or nerve conduction.  Pagophagia is thus unusual among the picas in that it’s a “red-flag symptom” in hematology whereas the others tend to be of interest to nutritionists and the psychiatric community.  The correlation is not absolute because not all pagophagics suffer an iron deficiency; for some it’s the pleasure or the crunch, the oral stimulation or merely a habit but if the craving is strong or compulsive, the usual recommendation is the use of supplements (ferritin, serum iron, transferrin saturation, hemoglobin).

One cube at a time.

The pro-ana community does recommend the eating of ice, not merely as a food substitute but because the body needs to burn energy both to melt the ice and subsequently restore the body to its correcting operating temperature.  With frozen water, this effect is greatest in negative calorie terms but the discount effect applies even to iced confections.  If a frozen confection is listed as containing a calorie content of 100 (25 grams of carbohydrate @ 4 calories per gram), this does not include the energy the body expends to melt the ice and the net consumption is actually around 72 calories.

All things in moderation: Lindsay Lohan enjoying ice-cream and (an allegedly virgin) iced mojito, Monaco 2015.

Pro-ana does NOT however approve of frozen confections, the preferred one litre of frozen water containing zero calories yet demanding of the body a burn of around 160 calories to process, the energy equivalent of running one mile (1.6 km).  The practical upper limit per day appears to be between 3-5 litres (.67 / .8-1.1 / 1.3 (US / Imperial) gallons) depending on the individual and it’s speculated a daily intake much over eight litres may approach toxicity, essentially because the localized symptoms would be similar to hypothermia and some organs fail optimally to work when body temperature drops too much.  Paradoxically, pro-ana also notes, ice shouldn’t be eaten when one is too hot.  After running, the body actually exerts energy through the active effort of dissipating excess heat and if one were to ingest large amounts of ice as one was cooling off, some of the heat generated would be neutralized by the coolness of the ice, minimizing some of the energy burning benefits.  There’s also the need to avoid dental damage; pro-ana recommending it be allowed to melt in the mouth or consumed as shaved ice.