the phenomenon. But Mysko said experts believe that "exposure to online images of extreme beauty standards and the drive to compare does increase the risk of developing eating disorders."
Sara, a 22-year-old Castlewood client, said thigh-gap sites were a contributing factor in her struggle. She spoke on the condition that she be identified only by her first name to avoid the stigma associated with eating disorders.
Always a high achiever, Sara was captain of her high school swim team in Minnesota and a straight-A student. In college, she graduated near the top of her class, even while hiding her secret.
It was in high school that Sara developed anorexia. By college, she was purging and excessively exercising. She was a frequent visitor to thigh-gap sites.
"It helped to normalize what I was doing to myself," Sara said. "I never knew before that I wanted a thigh gap. It felt like it was some type of accomplishment that people would want to achieve."
The sites offered photos of slender-legged models, testimonials on how to achieve the gap and tips such as chewing food but spitting it out before swallowing.
Grotesquely, some of the sites showed pictures of Holocaust victims "for motivational purposes" or martyred those who died from eating disorders. It seemed to make her own struggle OK, Sara said.
"I would say, `Well, I'm not that bad.'"
Her therapist, Kim Callaway, said she often encourages clients to avoid social media and even delete their Facebook pages.
"It's not uncommon for people to be on Facebook talking about what they ate today, posting pictures of their meals or writing about how they're 10 pounds lighter than they were a month ago," Callaway said.
"The ability to be instantly connected to everybody and see what they look like and see them blog or talk about what they are eating and what they do for exercise - this makes it a lot more difficult for those with eating disorders," Callaway said.
The National Eating Disorders Association is fighting back with its own site, which promotes positive body image and encourages healthy attitudes about food and weight.
Sara is getting better after about four months of treatment at Castlewood. She's moved out of the treatment center to an apartment, though she still gets outpatient therapy.
"I want to recover," she said. "And I don't want this to be my life anymore."