​What Netflix’s ‘To The Bone’ Gets Right And Wrong About Eating Disorders

Women's Health |

By Alexandria Gomez

The film, starring actress Lily Collins, has been the subject of heated debate.

Depictions of eating disorders in film and television have been consistently met with criticism for their misrepresentation and glamorisation of what is considered a serious mental illness. Netflix’s latest offering on the subject, To The Bone, follows Ellen, played by actress Lily Collins (herself an eating disorder survivor), and her complicated road to recovering from anorexia.

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There’s been a very polarising reaction to the film in the eating disorder treatment community, says Bonnie Brennan, senior clinical director of adult services at the Eating Recovery Center in Denver, USA,  and a certified eating disorder specialist. For one, Brennan acknowledges that the movie could be triggering or emotionally arousing for those who have experienced eating disorders—a sentiment reflected by many on social media when the trailer was released:

Since the film’s release, responses from survivors and experts have become even more complex. Here’s what the film gets right and what it could’ve done better, according to Brennan:

What It Gets (Sort Of) Right: Diversity

Despite the fact that eating disorders effect a wide range of people, on-screen subjects are typically young, female, beautiful, white, relatively affluent, and thin.

While the main character in To The Bone is a young, white woman, what’s different about this film is that it does touch on other versions of eating disorders—one patient is a male, one is pregnant, and another black, lesbian patient suffers from overeating issues. However, their stories are only glazed over. “Now, I would challenge the community to put forth another piece of art that focuses on stories we haven’t seen before,” says Brennan.

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In reality, “eating disorders do not discriminate,” says Brennan. It’s estimated that 25 and 36 percent of those with anorexia and bulimia, respectively, are men, a number that is believed to be underreported, according to the USA’s National Eating Disorder Association. Additionally 16 percent of transgender college students have reported suffering from an eating disorder, according to National Association of Anorexia Nervosa and Associated Disorders (a group that wasn’t represented in the film at all).

What It Gets Wrong: Treatment

After going through several treatment centres, Ellen is given a final shot when she’s admitted to a residential treatment centre where she’s monitored by a live-in nurse along with a group of other patients. There, we see her continue to do sit-ups in her bed and push food around her plate between intermittent visits from a doctor played by Keanu Reeves.

Patients in To The Bone are allowed to see their weight at initial weigh-ins—but in reality, Brennan says patients typically do an initial blind weigh-in and are assigned a goal weight range so they won’t be able to fixate on specific numbers. “For folks who struggle with the scale, many are obsessed and it’s completely dysfunctional,” Brennan says. “Their entire day is based around where the scale is.”

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This residential centre in the film more closely resembles a transitional living community that one might go to after making it through treatment, says Brennan. There, patients are shown watching movies on the couch, participating in group therapy, and sharing meals.

Overall, the tone at the treatment centre feels a bit off, as Brennan points out, noting that socialisation and finding oneself outside of the disorder is important, but that the film’s depiction of treatment puts a bit too much emphasis on the fun. While events and outings happen, that’s hardly all treatment is, says Brennan. Most in-patient care facilities would look more like a hospital setting, says Brennan. Furthermore, patients in To The Bone have no supervision at meals, which Brennan says is very unconventional. Most treatment facilities practice strong supervision at mealtime until out-patient care, she says.

Should You Watch It?

As for the debate of whether or not the film is triggering, Brennan says of course it is—for victims and families. That’s because the depiction of an eating disorder’s effect on family and vice versa rings so true, says Brennan. “They did a great job of showing an unconventional family and all their alternative reactions,” she says. In To The Bone, viewers see Ellen’s sister’s loving and frank honesty, her father’s avoidance, and her stepmom’s imperfect, but ultimately vital, support. This part of the film was important in that it speaks to the vast diversity of what a family’s role is in this process, says Brennan.

READ MORE: “I Overcame Anorexia By Stepping Out Of My Comfort Zone”

However, she’s quick to point out that a trigger is simply a moment of pain that you get to choose a reaction to. So yes, To The Bone might remind those who have struggled with eating disorders of their past, but it won’t necessarily throw them into relapse. If you’re considering watching the film and are worried about its triggering nature, talk with your support system, says Brennan. Ask yourself, “Is this a good time for me to watch this or should I at all?” If it’s not, Brennan says to remember that the film isn’t going anywhere, so it’s okay to wait until you’re in a better place if you’re still eager to watch it. And if and when you do watch it, don’t watch it alone, take notes on how it makes you feel, and make an appointment to discuss your reactions with your therapist.

This article was originally published on www.womenshealthmag.com

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