| Summary: | Previous research has indicated that pro-eating disorder websites are forums where participants discuss and share tips to maintain unhealthy behaviours, but other authors claim that they are just digital places where stigmatized people seek emotional support and share experiences. This study aimed to conduct a systematic review to examine the role of these social interactions in the onset and maintenance of disordered eating behavior, and how they may hinder recovery. Studies exploring social interactions in pro-ED websites were sought after in PsycINFO, PsicoDOC and PsycArticles databases. Inclusion criteria were i) primary studies that ii) collected data from pro-ED websites or experiences in pro-ED platforms and iii) analyzed social interactions, iv) in English or Spanish. Sixteen studies were identified. Findings revealed that social support and affect are a fundamental part of the activity within these websites, and that they can hamper treatment in two ways: through the sharing of tips and tricks to hide starvation and promotion of group dieting, but more subtly they can also be an obstacle because these websites are seen as “safe refuges” associated with pleasant feelings that patients refuse to leave. Although we admit limitations in the analysis, as little similarities across studies and problems with external validity, we conclude that online social interactions are important enough in ED treatments to be better adressed in clinical research.
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