d purging techniques. The researchers also found that pro-eating disorder site visitors tended to have a longer duration of disease, spent less time on schoolwork and spent significantly more time online each week than did those who never visited the sites.

Even those sites ostensibly dedicated to helping people recover from eating disorders (pro-recovery sites) aren't harmless. Nearly 50 percent of patients visiting such sites reported learning about new methods to lose weight or to purge.

"Parents and physicians need to realize that the Internet is essentially an unmonitored media forum," said Peebles. "It's just not possible to completely control the content of an interactive site."

While about 50 percent of parents were aware of the existence of pro-eating disorder sites, only 28 percent had discussed these sites with their child. Fewer still, only about 20 percent, reported placing limits on either the time their child spent online or on the sites they visited.

Parents aren't the only ones who may not recognize trouble brewing. Peebles and Wilson found in their second study that younger eating disorder patients may be at risk for more rapid weight loss than adolescents and frequently have atypical presentations that may make diagnosis more difficult.

"We were very surprised and concerned to find that younger patients lost weight significantly faster than adolescent patients," said Peebles, who pointed out that growth before puberty is critical to future development. "Children should be growing rapidly during pre-adolescence. But these kids had not only stopped gaining, they'd even lost weight."

Adult-specific diagnostic criteria for such eating disorders as anorexia and bulimia muddy the issue, said Peebles, by referring to missed menses and ideal body weight percentages, neither of which are applicable to prepubescent girls who may have already stunted their height by denying themselves ne
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