You may have heard some buzz around the upcoming Netflix movie To the Bone , which tells the story of a young woman with anorexia . In the movie, Lily Collins plays Ellen, a sarcastic teenager who struggles with the eating disorder and eventually seeks in-patient treatment despite being unconvinced that she can get better.
The Netflix original debuts on July 14, and its trailers offer a revealing look at the story: Ellen obsessively sticks with her disordered weight-loss methods and is urged by her mother to eat more, often in misguided ways. (In one scene, Ellens mom hands her a cake made to look like a cheeseburger with the words, Eat Up, Ellen! iced on top and laughs about it while her daughter just stares.) Ellen eventually falls under the care of the straight-shooting Dr. William Beckham, played by Keanu Reeves, who attempts to help her and other patients see that recovery is possible.
There's no doubt that anorexia is a difficult, delicate topic for a movie to cover, especially when it's seemingly trying to be funny, heart-wrenching, and bold all at once. So it's no surprise that early reactions to the movie have been mixed, especially among eating disorder experts.
Collins, 27, has been candid about her history with anorexia as a teenager and the fact that she lost weight to play Ellen."It was something that I thought is risky, because theres a fine line between facing something head-on and succeeding, or falling back into it," she told Refinery29 . "But I knew that, this time, I would be held accountable for it. I would be [losing weight] under the supervision of a nutritionist and surrounded by all these amazing women on set. So, I knew that I would be in a safe environment to explore this.
No matter how safe it may seem, some experts allege that it was irresponsible to have someone who has struggled with the condition in the past lose weight for the role, whether under supervision or not.
"Anorexia is a very serious mental illness , and there is the chance that someone can relapse during or after recovery," Heather Senior Monroe, L.C.S.W., director of program development at Newport Academy , tells SELF. "Putting Collins in the position where she needed to lose weight for the role, and essentially relive the disease to an extent, crosses a boundary that is not in alignment with healthy recovery."
Jennifer Carter, Ph.D., a psychologist at The Ohio State University Wexner Medical Center, who specializes in eating disorders and sports, agrees. This aspect of the film is "dangerous," she tells SELF. "Some individuals have risk factors that kick in when they lose weight, and obsessive/addictive [behaviors] can begin."
While it's impossible to be inside Collins' head and know how the weight-loss aspect of the movie affected her, many people with eating disorders will always be in recovery , so the concern is valid.
There's also worry about how Collins' weight loss for the film may impact viewers. Many people with eating disorders think if they dont become extremely thin, then they dont have a real problem, Sarah Altman, Ph.D., a clinical assistant professor in psychiatry and behavioral health at The Ohio State University Wexner Medical Center, tells SELF.
This couldnt be further from the truth, Dr. Altman says, adding that many patients who have a medically normal weight struggle just as much as those who may fall below the cutoff weight for anorexia. Damaging habits like purging, preoccupation with weight, food rituals, obsession with exercise , and food restriction don't always lead to intense weight loss, but it doesn't mean someone doesn't need help. In that sense, having Collins take on the role without losing weight may have been more responsible and been a teachable moment.
Ellen is a beautiful white teenager whose family can apparently afford to get her top-line treatment. "Eating disorders have historically been associated with young, white women of privilege," says the National Eating Disorders Association . "However, this is a mytheating disorders do not discriminate."
On a related note, some critics point out that the movie may be the latest of many that doesn't address how expensive treatment can beand how, even when someone overcomes stigma around seeking treatment, cost may make it impossible to access the kind of recovery center featured in To the Bone . There may be missed opportunity here to talk about the financial challenges of treatment and the challenge of reaching racial minorities and men, Dr. Altman says.
As she notes, Ellen is treated alongside at least one woman of color and a man, according to the trailer. And it's true that minorities are disproportionally less likely to seek help, according to NEDA, and that the film is set in a recovery clinic. The deliberate narrative choice to center the story of a young white woman whose family can apparently afford treatment still allows the movie to gloss over these important racial and financial conversations.
If the movie skims over these subjects, it can serve to exacerbate stereotypes and leave those who do not fit into any narrow parameters represented feeling [isolated], eating disorder expert Lori Ciotti, L.I.C.S.W., assistant vice president of the Northeast Region of The Renfrew Centers and site director at The Renfrew Center of Boston , tells SELF.
Monroe applauds Netflix and Marti Noxon, the films director, who has a history of anorexia and bulimia , for trying to raise awareness about such an important issue. However, I predict that those suffering with anorexia, or who have suffered from anorexia, will agree that there are points in the film where the disease is unfortunately romanticized and sentimentalized, she says.
Monroe worries that the movie may serve as a trigger for people who are vulnerable. Those who suffer from an eating disorder often strive to reach unhealthy goal weights, and the films main character is someone a vulnerable person could potentially look up to, she explains, adding that the film may inadvertently give people tools to lose weight in an unhealthy way .
In addition to showcasing different methods Ellen uses to lose weight, the trailer is full of graphic images of her thinness. It's possible that the movie could be seen as glorifying the disorder, and possibly motivating for some people who use thinspiration and other forms of social media as a network of support for their behaviors and disorder, Dr. Altman says, explaining that this calls for a warning at the beginning of the movie that informs viewers that what theyre about to see may be triggering.
Any discussion or destigmatizing of eating disorders is something Ciotti is "willing to give a chance. If done well, it can help those suffering feel less isolated and encourage them to reach out for treatment, she says. Collins' and Noxon's personal experience with disordered eating may help translate into a more responsibly told story.
Dr. Altman says that she, too, sees potential pros. She points out that many people think anorexia is just about food, and the movie may help provide insight into the underlying psychological and emotional aspects of the disease.
Dr. Carter says that also its important to highlight the fact that families can struggle with how to help a loved one who has an eating disorder, which the movie seemingly does. Some parents may be in denial for a period of time or blame themselves (even though, Dr. Carter says, there is no evidence that families are often to blame for eating disorders), while others may become more controlling or angry in response to a loved one developing an eating disorder. Eating disorders are not logical and can be so frustrating for the family, Dr. Carter says. Family members often feel helpless.
No doubt everyone involved in To the Bone is aware of this fact. Like anything else, people who have been personally affected by an eating disorder will likely respond to the movie in different ways, Anne Buffington, R.D., C.S.S.D., nutrition program coordinator at Michigan State University who specializes in counseling for people with eating disorders, tells SELF.
"Some may relate to the film and appreciate the voice it can give to this important issue that many are facing, while others may be triggered by what they see depending on where they are at in their own recovery," she says. "Some may be somewhere in between." She advises that anyone who is currently seeking treatment for an eating disorder discuss potential triggers with their treatment team or support system before watching the movie.
Ciotti says she always has concerns that people who are suffering will struggle after seeing something like To the Bone , but that doesnt mean movies on this topic should be avoided altogether. Those who have eating disorders, whether diagnosed or not, can be triggered by so many antecedents on a daily basis, she says. The message of this film seems to be that help is out there.... In my estimation, that should be lauded as an honorable intention.
If you or someone you know is at risk or experiencing an eating disorder, resources are available through NEDA or contact their phone helpline at 1-800-931-2237 or their text crisis line by texting "NEDA" to 741741. You can also visit http://www.eatingrecoverycenter.com to speak to a clinician.
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