This condition of faking illness online has a name: “Munchausen by internet,” or MBI. It’s a form of factitious disorder, the mental disorder formerly known as Munchausen syndrome, in which people feign illness or actually make themselves sick for sympathy and attention. According to Marc Feldman, the psychiatrist at the University of Alabama at Tuscaloosa who coined the term MBI back in 2000, people with the condition are often motivated to lie by a need to control the reactions of others, particularly if they feel out of control in their own lives. He believes that the veil of the internet makes MBI much more common among Americans than the 1 percent in hospitals who are estimated to have factitious disorder.

Dawn Branley-Bell, a psychologist at Northumbria University who studies extreme online behaviors, agrees that digital life can encourage deceptive behavior. “The internet makes it easier to portray ourselves as something we are not,” she says. “Trolls often justify their actions by saying the online world is not ‘real life,’ so it doesn’t matter what they do or say online. It is possible some users refuse to believe their [actions] online have real, psychological effects upon others.” Once the lie is told, she notes, it can be difficult to backtrack.

Those with factitious disorder can use a variety of techniques to induce actual sicknesses, including poisoning and planting fecal matter in IV drips. Online, though, people especially appear to feign cancer.