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To The Bone: A Film Review From A Mental Health Professional

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Content warning: This post deals with eating disorders and may be triggering for some readers.


To The Bone is a new Netflix original movie about a 20-year-old woman, Ellen, who suffers from anorexia nervosa and ends up in a group recovery home for individuals with eating disorders. The official  trailer is included at the very end of this post.

Just like with 13 Reasons Why, there is a ton of controversy surrounding the appropriateness of this film. Many individuals, including many mental health professionals believe that this movie is very dangerous because they believe it will glamorize eating disorders. Some are even calling for Netflix to take the movie down.

Once again, just like with 13 Reasons Why, the majority of these individuals have not even seen the movie yet. Their fears however have some legitimacy.

Research suggests that it’s triggering for those who already have an eating disorder or who are  struggling with unhealthy thoughts surrounding eating, body image and weight issues to watch other people displaying eating disorder behaviors, even if it’s a story of hope and recovery.

With that said, I do not think that those individuals should watch this movie.

If you are someone or you are the parent of a child or friend of someone who is suffering from an eating disorder, I do not think this is a movie you should watch with them. Watch it yourself for sure, as I believe the movie gives some great insight into what it’s like to suffer from an eating disorder, but do not watch it with them  in hopes this will be a great conversation starter between the two of you. It could possibly do more harm than good.

There are definitely some images and events in the movie that can be triggering to certain individuals, such as the main character herself who is scary thin, to the calorie counting and food avoiding behaviors displayed throughout the movie.

Banning this movie however I do not agree with because it is just that, a conversation starter. It’s a movie that needed to be made.

My Issue With The Movie

My only issue with the movie is that Ellen, played by British actress Lily Collins is scary thin. This in itself can trigger individuals who already have issues with their body weight or have an eating disorder.

The real issue is that Lily Collins herself struggled with anorexia nervosa and bulimia nervosa at some point in her 27 years of life and writes a chapter about it in her book, “Unfiltered: No Shame, No Regrets, Just Me.”

For the movie she had to lose a lot of weight to look the part of a very unwell young woman. Although she reports that they did it in a healthy way with the help of a dietician, I still found it alarming that anyone would subject someone who already has a history of struggling with eating disorders, to losing so much weight and then this almost skeletal person is the main character that millions of viewers, some of who will be susceptible to triggers, have to watch on-screen for two hours.

As I watched the movie, before I did my research, I couldn’t tell if she was really that thin or if it was some tricks of the camera or make-up, but upon learning that she actually had to lose such a large amount of weight to play her character, it was just a bit unsettling.

I’m not sure if this film could have been done any other way.

Anorexia Nervosa Versus Bulimia Nervosa

Unless I missed it, the one thing I don’t think the movie did a good job on was differentiating between anorexia nervosa and bulimia nervosa. People tend to think that the only difference is that those with anorexia nervosa severely restrict their calories while those with bulimia nervosa eat and then purge (vomit) in order to control their food intake.

However, there are two types of anorexia nervosa.

One is the restrictive subtype that is more of what people are familiar with. They rarely eat, count calories religiously and may use laxatives, but usually do not purge. The second subtype is the bingeing and purging subtype. These individuals are more like those with bulimia nervosa as they will binge (over eat) and then purge their food.

The main difference between the two is that individuals with anorexia nervosa have a difficult time maintaining the minimal amount of weight considered healthy and individuals with bulimia nervosa are usually at a healthy weight or even overweight.

While anorexia nervosa and bulimia nervosa are the two eating disorders people are most familiar with, other common eating disorders include pica, binge eating disorder, and avoidant/restrictive food intake disorder.

Most eating disorders last 6 to 8 years which is a large part of someones life.

While body image, food and weight loss are generally the focus of an eating disorder, they usually aren’t the underlying causes.

Issues that may trigger eating disorders include a history of abuse or trauma, bullying, parent relational problems, low self-esteem, personality disorders, substance abuse, difficulty dealing with conflict, genetics and feeling as if they have no control over their lives.

Millions of Americans suffer from disordered eating and they’re not all thin, young white girls. People who suffer from eating disorders come in all shapes, sizes and ethnicities from the rail thin to the morbidly obese.

I worked with a 10th grade Haitain-American girl, along with another therapist who specialized in eating disorders as well as a dietician for two years. She struggled with anorexia and it was some of the most difficult work I have ever done.

Eating disorders, just like most mental health disorders, are always hard and uncomfortable topics to discuss and many people would prefer to act like they simply do not exist or are something they never will have to deal with. That is why 13 Reasons Why faced such backlash and why To The Bone is as well. Avoiding these issues will not make them go away.

If people want to be angry with Netflix for making movies such as To The Bone then we also need to be angry with our media in general because it glamorizes weight-loss and thinness. Girls as young as elementary school have started engaging in unhealthy diets and calorie counting due to the images they see on a daily basis through our media.

Marti Noxon, the writer and director of To the Bone says that the movie is based on her experience of struggling with an eating disorder and that the film is intended as “a conversation starter about an issue that is too often clouded by secrecy and misconception”.

So with some warning I recommend this film to anyone interested in learning more about what it is like to struggle with an eating disorder, but not to anyone who is already struggling with body image issues or unhealthy issues about food and weight.

The hope is that this film increases the conversation without increasing the risk of triggering others, but honestly I don’t know if it’s possible to have these type of conversations without anyone ever being triggered. It’s the nature of the beast.

If you or anyone you know are struggling with an eating disorder, please contact The National Eating Disorder Association (NEDA)at http://www.nationaleatingdisorders.org

 

 


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