I’d like to talk to you about To the Bone, a movie which was released on Netflix this July. To the Bone deals with eating disorders (“EDs”) and has caused quite a stir across social media ever since its trailer was released.

Though I won’t go into much detail in this article, note that there will be a few spoilers ahead. You should also note that To the Bone contains potential triggers — as do the heated responses to it on the social media. So check in with yourself regularly, as I ended up needing to do, if you decide to watch the film and participate in those debates afterwards.

To the Bone stars Hollywood actress Lily Collins. Collins, herself having struggled with an ED in her teens, plays Ellen, a 20-year-old woman with anorexia. After not making progress with yet another inpatient program, Ellen comes home once again to her stepmother Susan (Carrie Preston) and younger sister Kelly (Liana Liberato). Of Ellen’s original family, we also see her biological mother, Judy (Lili Taylor) later during a family meeting in an inpatient setting, but not her father, who remains mysteriously busy and absent.

The drama starts to unfold after Ellen is encouraged to go see Dr. Beckham, a controversial specialist played by Keanu Reeves — yes, you read that right, Keanu Reeves! She eventually joins Dr. Beckham’s residential treatment program, meeting and forming relationships with some of the other patients there, in particular with a young man named Luke (Alex Sharp).  

Not to give too much away, To the Bone is about how Ellen tries to handle a series of ups and downs in her work in the program, and simultaneously in her old and new personal relationships, including a potential romantic one. To the Bone ends on a vaguely hopeful note, the possibility that something may be different this time, that Ellen may stick with the treatment and get better; that she may recover.

To the Bone is engaging and entertaining. I also found myself caring for the lead and several other characters. The background story of the movie is of interest in itself: First consider the difficult task the filmmaker, Marti Noxon, faced, when she set out to create and share with viewers a film based on her own struggles and imbued with her own private pain. Collins faced something similar, playing a role that must have brought back some strong feelings — that of her own experiences with EDs. Aside from entertainment, the movie also does a decent job of educating the public about some of the behaviors associated with EDs, such as calorie-counting, purging, exercise obsession, etc.

Having said that, it might surprise you that I give To the Bone a very qualified recommendation. Why? Because the movie is not without its shortcomings.

To the Bone has been criticized on several fronts, for instance that it is not representative enough. EDs come in a variety of forms, and the people affected by them are of all colors and races, shapes and weights, and come from all walks of life. In other words, there is more to EDs than anorexia, and anorexia itself is also not limited to middle- or upper-class thin white girls either.

This is a valid criticism because although the movie does contain other representations of ED, To the Bone revolves around Ellen and her anorexia. There is a dearth of movies that focus on other eating disorders, such as bulimia, and in particular, binge eating disorder, even though their prevalence is comparable to that of anorexia.1  

Even if we stick to the portrayal of anorexia, however, the movie falls short. Sure, To the Bone can be educational sometimes, in its portrayal of behavior associated with anorexia, such as Ellen’s perfect memory for calories contained in different foods, her obsessive sit-ups, her preoccupation with the circumference of her arm, the food chewing and spitting out ritual… But it’s Ellen’s pallid face and emaciated body that is primarily how the viewer is made to understand her illness. As though anorexia is merely a body size or a shape; or a kind of look.

Which reminds me how a few years ago in the local library, I overheard two young women talking about a mutual friend who had anorexia, and one telling the other she was jealous because the friend looks so skinny. This is where education is badly needed, but films like To the Bone hardly counter the limited understanding of anorexia as a body type or a fashionable look, but as a disease that is among the most fatal of all psychiatric illnesses.2

What is worse is that even if we were to think of anorexia as merely a body size, even in this respect To the Bone fails to show the true monstrosity of the disease; anorexia is not the loss of excess weight but a mental illness that is associated with extensive deterioration in one’s health but also loss of beauty. But in Ellen we get Hollywood’s version of anorexia… not real anorexia; we get what heroin-chic aesthetic of the ’90s was to an actual heroin user.  

But so what, one might ask, what if the movie makes the disease appealing? Then the only thing To the Bone provides those struggling with weight and mental health issues, would be a manual of new tricks for secretly losing dangerous amounts of weight, and a new role model in the hip and beautiful skinny Ellen.   

Writer-director Marti Noxon must have been aware of such criticisms because in the film there is also a reference to Ellen’s art having played a role in a fan’s suicide. From what Noxon has said in her interviews, however, I have gotten the impression that in To the Bone she intended to share a fictionalized account of EDs inspired by her own struggles and experience, and not a comprehensive description of the variety of EDs; nor did she intend to portray how such illnesses should be managed or treated.

But responsibility does not depend only on intent. Movies are seen by many, and in acting as metaphorical loudspeakers, they amplify and spread their messages and views, countering individual voices and private encounters with illness. It is a wish, for some like myself, and a demand for others who have been hurt, that filmmakers dealing with the agonies of human condition, respect the subject matter and people affected by it; that the power and freedom of the medium gets balanced by responsibility born of desire for understanding the suffering of fellow human beings.   

But there is hope. At one point in a therapy session, Ellen says to her therapist that it’s “so weird that you know everything about me, and I don’t know anything about you.” This used to be true of the one-sided nature of the relation between movies and their viewers, but these days the social media presence has allowed a greater input from viewers. If people with EDs and their friends and loved ones are willing to speak their mind over and over again, filmmakers and producers will have to take notice sooner or later. This here is me trying to do my part.

References

  1. Smink, F. R., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414
  2. Chesney E, Goodwin GE, Fazel S (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 13, 153–160.