A reliability and content analysis of Italian language anorexia nervosa-related websites

Objective: Internet represents a major source of information related to health issues, increasingly used by providers. Indeed, there are numerous websites concerning eating and weight disorders, such as anorexia nervosa. The aim of the current investigation was to systematically perform a reliability and content analysis of Italian language anorexia nervosa-related websites. Methods: Reliability of the anorexia nervosa website pages was assessed using the Health on the Net Foundation Code of Conduct Standards (HonCode (R)) certification mark. A comprehensive content analysis (thematic cluster analysis, correspondence analysis of emerging themes and topics, density and degree-centrality analysis, and co-word analysis) was performed using the commercial software T-Lab. Results: 402 unique website pages were included and analyzed in the current study. Statistically significant differences related to the accomplishment or less to the items of the HonCode (R) certificate mark were found for all items, except for confidentiality and webmaster/additional contact. From the thematic cluster analysis, four clusters were identified: namely, treatment (26.6%), vomiting (24.7%), weight (24.4%) and onset-age (24.3%). Treatment (in particular, cognitive-behavioral psychotherapy) was the most represented theme (with a frequency of 97.76%, recurring in 393 websites). Pro-ana content characterized 147 website pages (with a frequency of 36.57%). Conclusion: The quality of Italian language anorexia nervosa-related websites was rather moderate-poor, being generally inconsistent with the principles of the HonCode (R) certification mark. Therefore, physicians and health authorities should be aware of such findings to provide their patients with proper answers and education.