Is 'To The Bone' An Accurate Portrayal Of Life With An Eating Disorder? Experts Explain
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The Netflix original To The Bone, which follows the life of a young woman receiving treatment for her eating disorder, won't premiere on the streaming service until July 14 — but the film has been the subject of major discussion online since the June release of its trailer. Many who have dealt with eating disorders, as well as specialists in ED therapy, have spoken out about the film, worrying that despite its attempts to depict the disease realistically, it both doesn't provide sufficient protection for people with ED who might be triggered by the film and also fails to go far enough, falling into the familiar trap of glamorizing or simplifying ED while trying to show the damage it causes.

Media representation of disease and illness can often be a benevolent force; accurate portrayals of illnesses can spread awareness, raise funds for cures, garner empathy for sufferers and dispel myths about their condition. Tom Hanks' role in Philadelphia as an HIV/AIDS sufferer, for instance, has been lauded as pivotal in shifting public perceptions about the disease in the 1990s.

However, depicting eating disorders on screen often becomes a minefield of issues. As a representative from eating disorder foundation BEAT told Bustle, “We very much support the media in raising awareness of eating disorders, as the more we talk about these serious mental illnesses the better we can break down stigma and, in turn, encourage individuals to seek treatment as soon as possible. Equally, we know that when eating disorders are glamorized or trivialized by the media, this can trigger negative behaviors in people who are affected by these complex mental health issues." In short, media representations of ED must try to find the delicate and difficult balance between increasing public knowledge of the illness and potentially fueling the triggers of those who already battle with disordered eating — and no matter what positive intentions a film or show has, an irresponsible depiction of ED can have catastrophic real-world consequences.

Bustle spoke with several eating disorder awareness organizations, as well as N., 29, a recovering ED sufferer (who has not seen the film and has been advised against it by her medical professional), about the right and wrong ways to depict eating disorders in entertainment.

The Problem With Trying To Slap A Happy Ending On An Eating Disorder

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To The Bone is at times a distressing viewing experience. The fictional film is rooted in reality — it is based on the real-life experiences of writer/director Marti Noxon, and star Lily Collins has spoken publicly about her struggles with her eating disorder, too — but it doesn't get especially graphic.

And in N.'s opinion, it doesn't go nearly far enough.

To The Bone also smoothes over the real difficulties inherent in suffering from an eating disorder by attempting to create a simple arc — problem, resolutions, darker problem, more significant resolutions — that is conventional to dramatic films.

"It's f*cked. It's so fu*cked," she told Bustle of what she'd heard about the film from fellow sufferers and ED treatment professionals. "It glorifies eating disorders. [The media] don't talk about what a f*cking ugly and awful disease it is. In my experience alone, [eating disorders involve] vomit clogging the pipes and overfilling the bathroom, buying $100 worth of groceries for the week and eating them all in one night; it's not as 'clean' as it's portrayed." The film mentions hitting "rock bottom" — but for the heroine, this takes the form of fainting and hallucinations. While To The Bone does noble work in attempting to show the harsh side of eating disorders, for some people, including N., it doesn't look or feel like their lived experience.

To The Bone also smoothes over the real difficulties inherent in suffering from an eating disorder by attempting to create a simple arc — problem, resolutions, darker problem, more significant resolutions — that is conventional to dramatic films. The difficulty with this, N. says, is that eating disorders are not only brutal — they're more complex than that. The problem with trying to fit the story of one person's eating disorder into a film, she explained, is that "it ignores the lifelong vulnerability of anorexia sufferers because of brain physiology." Significant research has shown that people with ED have unique brain chemistry, which makes recovery far from an open-and-shut affair. N. spoke of her own experience with the "anorexia switch," saying, "Any hunger or unintentional weight loss will trigger it... I had a stomach virus earlier this year, triggered. Ramadan fasting, triggered." The idea of resolution or a "turnaround", even if in To The Bone it's simply referenced offscreen, is worrying to N. as it creates the fallacy of a simple and permanent "cure" for the illness — which simply does not exist.

Why Saying Eating Disorders Are Just About Food Misses The Point

To The Bone treads the line between avoiding the potential glorification of the extremely thin body, and making the ramifications of the disease properly clear to the audience. It's a film acutely aware of the power of images (Collins' character is an artist with a history of pro-ana art), but, perversely, it also tries to use Collins' body as an attempt to emphasize its point — which many experts agree can be dangerous for sufferers. “We particularly recommend media not to report on specific low weights, amounts of food eaten, or show pictures of people at very low weights, as these can be harmful to viewers who are vulnerable," BEAT told Bustle.

While the film does address the underlying psychological complexities beneath disordered eating, from problematic families to desires for control, it still uses the shorthand of eating a candy bar to symbolize healing.

But for N., the low-weight fetishization of people with ED is only part of the problem with films like To The Bone. "It needs to be more than just about the food and thinness," she said. While the film does address the underlying psychological complexities beneath disordered eating, from problematic families to desires for control, it still uses the shorthand of eating a candy bar to symbolize healing. That, says N, is a common misconception, the "'it's just about the food, if they just eat something they're fixed' myth".

CEO of the National Eating Disorders Association Claire Mysko agreed, telling Bustle, "[A] common mistake we see in films and TV is an over emphasis on weight, numbers, and depictions of extreme thinness. The causes of eating disorders have both biological and environmental underpinnings and they affect all kinds of people, regardless of size, gender, ethnicity, sexuality, or background."

Why We Need Diverse Representations Of Eating Disorders

Though there are more film and TV depictions of eating disorders than there were a few decades ago, those depictions generally haven't gotten any more diverse: the face of ED in the media is still typically thin, female, and white. To The Bone doesn't break from that — which, N. highlighted, is a problem. "It's perpetuating the idea that people with EDs are [always] skinny," she said. "When I first struggled to eat at 15, I remember telling people something was wrong, but because I was overweight, they dismissed it and told me to 'keep doing what you're doing.' I'd go to GPs who told me I was a healthy BMI, so to 'come back when you're underweight'."

The problem with the thinness paradigm, N. explained, is that "it's not just a stereotype; it has real ramifications for treatment."  "I didn't believe I had a 'real' ED until I was 25 because I was 'normal' weight. I'm actually thinner in a recovered body than I was in a disordered body. That doesn't fit the glorified narrative."

The film does have diverse secondary characters, from a boy to a girl of color who isn't thin, but they're all largely positioned as foils or background to Collins' character; this is her character's film, about her illness. To N., that represents a weakness in entertainment's treatment of EDs in general. "Right now," N. explained, media depictions focus on the "cis-white female pixie quaint young girl, highly educated". But "EDs affect all body types, ages, genders or lack thereof."  

The misconception that eating disorders only affect young, affluent, white women can discourage people from getting help and inadvertently undermine the complexities of these illnesses.

It's a position reflected by those who are part of therapeutic communities. Mysko told Bustle, "Films and TV shows about eating disorders often play into stereotypes and fail to address the many experiences of those affected. The misconception that eating disorders only affect young, affluent, white women can discourage people from getting help and inadvertently undermine the complexities of these illnesses...I would like to see the diversity of experiences reflected in the media. Folks in LGBTQ communities, members of the military, people of color, athletes, and many more are at increased risk for eating disorders and yet we rarely see their stories told. It's also important to reflect size diversity in the stories. Many people don't seek help because they aren't underweight or 'sick enough' to deserve professional treatment."

So What Should Films About Eating Disorders Look Like?

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Is it possible to find depictions of ED that illuminate without glamorizing or otherwise Hollywood-ifying the disease? "There's a documentary called Thin," said N. "Whether it should or shouldn't be a recommendation, I'm not sure, but it's based in an inpatient ward. It's incredibly real and diverse in experiences and outcomes, and I watched that and was the opposite of triggered. It motivated me to want to get better. It shows what f*ckery it wreaks on your life. And yes, [it contains] different body types."

Thin's real distinction from To The Bone, aside from the fact that it is a documentary rather than a fictional film, is two-fold: one is that it gives equal screen time to four different women; the other is that it provides updates on their continuing struggles after the documentary ended — and shows that only one story contained a real, traditional recovery narrative.

That said, harmful media portrayals, even when well-intentioned, can go very wrong, Mysko told Bustle. "When the public perception of eating disorders is that they're about vanity or that they only affect certain kinds of people," she said, "many individuals and their families feel less comfortable sharing their experiences and reaching out for help. Eating disorders are at epic proportions with 30 million Americans who will suffer at some point in their life. The more we speak out, share our stories, raise awareness, and send the message that recovery is possible and support is available, the more lives we can save."

If you're dealing with an eating disorder, you can find NEDA's website here, and contact their helpline at 1-800-931-2237