Religious and Spiritual Dimensions of Pro-Ana Discourse on X: A Linguistic Analysis for Counseling Practice

Anorexia nervosa is among the most lethal psychiatric conditions. Online pro-anorexia ("pro-ana") communities may frame starvation and restriction in moral or spiritual terms. This study explored how pro-ana discourse on X (formerly Twitter) encodes values, spirituality, and identity through language, with attention to clinical practice. A dataset of 2396 English-language tweets (2020-2025) was collected using dual criteria (pro-ana hashtags plus eating-disorder keywords). Only U.S.-based English tweets were included to maintain linguistic and cultural coherence with LIWC-22 norms and counseling frameworks developed in U.S. contexts. Tweets were separated into three corpora (full, hashtags, and tweet bodies) and analyzed using Linguistic Inquiry and Word Count 2022 (LIWC-22), supplemented with custom spirituality and pro-ana dictionaries, and keyword/keyness analysis against a 36-billion-token web reference corpus. Religious language appeared consistently higher in hashtags compared with tweets and Twitter norms. Tweets contained more authenticity and self-disclosure, while hashtags functioned as collective markers of identity and practice. Body and food terms were strongly elevated, and affiliation terms appeared comparatively suppressed. Keyness analysis identified distinctive items such as <i>prayer fast</i>, <i>fasting prayer (Luke)</i>, <i>OMAD fast</i>, <i>hunger hurt</i>, and <i>I'm punching</i>, illustrating how sacred, cultural, and diet-related slogans were combined within pro-ana discourse. Pro-ana rhetoric may function as a sacralized identity frame that can provide existential meaning to disordered practices. These findings contribute to behavioral science by highlighting how online communities linguistically construct health-related identities and values. They also suggest that effective clinical interventions should address eating disorders not only at behavioral and cognitive levels but also at the level of values and spirituality.