A Clinician’s Criticism of Netflix’s “To The Bone”

There is no doubt that Netflix’s To The Bone featuring lead actor Lily Collins was well intentioned. As both director Marti Noxon and lead actor Lily Collins have suffered from anorexia, it was paramount to them that they use their platforms to share this story in an attempt to spread awareness. Raising awareness about this disease is crucial for the identification, recovery and wellbeing of so many. Though despite the film’s good intentions, much controversy exists within the eating disorder treatment and recovery communities around the way anorexia is depicted in the film’s trailer and in the press that followed.

A Clinician’s Criticism of To The Bone

To portray the lead character -- an adolescent female in the throes of anorexia -- Collins lost a significant amount of weight to appear emaciated on screen. When asked by the press about how she was able to accomplish this transformation, given her history of anorexia, Collins referenced her dramatic weight loss as being carried out in "the most healthy way possible."

A Maryland-based eating disorder clinician writes that, for an individual with a history of anorexia, "'losing weight in a healthy way' is akin to sharing that an individual with a history of alcoholism is able to 'drink in a healthy way.' It’s just not possible, and frankly, it’s an incredibly irresponsible message to share, as it could be highly triggering to someone in recovery from an eating disorder."

A Dangerous Message for Those in Recovery

Collins’ reassurance of a healthy weight loss could serve to confuse or motivate others, suggesting a controlled weight loss is not dangerous for someone in recovery. Considering science has informed us that with rapid weight loss comes energy deficiency, a process which can muddle the brain’s decision-making capacity, this was a risky move for Collins -- regardless of the films “good intention” and a dangerous message to send.

Additionally, given anorexia is noted to be a competitive illnesses, clinicians fear the trailer itself may have served as a “how to” manual for those who are already struggling. The trailer clearly depicts calorie counting, emaciation, over-exertion, and exercise. These visuals paired with triggering messaging such as Collins’ character stating "I’ve got it under control" may have unintentionally reinforced those who feel similarly about their restrictive and ritualistic behaviors.

Perpetuating Myths About Eating Disorders

So often the mainstream media perpetuates existing myths about eating disorder. The film has come under fire for its unintentional reinforcement of some of the most widely-accepted myths. As per the Huffington Post, "It’s depiction of an individual with anorexia as an emaciated, Caucasian, young female who is starving herself to 'feel in control,' is not representative of the variety of people impacted who struggle with this disease."

Let’s debunk some of these myths.

• While a desire to gain control may be one aspect of the larger picture, it is important to remember that eating disorders are caused by genetic, temperamental, and psychological factors, which are then triggered by stressors in the environment. Depicting anorexia as a desire to be “in control” or to “look like a model,” perpetuates the myth that people are simply “making a choice,” rather than struggling with a serious mental illness.

• As so often portrayed in the media, the lead actress is a young, caucasian female. This may inadvertently fuel the myth that eating disorders only plague this population. We know that is simply not the case.

• The emphasis on the lead’s emaciated figure fails to acknowledge that eating disorder may impact people across the weight spectrum. It’s important to note that you do not have to appear emaciated, like the lead actress in the film, to be struggling with anorexia. If this myth persists, such individuals may not be identified by their peers or family members, or deemed “sick-enough.” This greatly lessens the likelihood that this individual would be suggested for life-saving treatment.

To The Bone: How Columbus Park Can Help

Despite the shortcomings of this film, we commend Noxin and Collins for their work and dedication to eating disorder prevention, awareness, and education. With education comes treatment. Speak to your loved one about To The Bone to determine if this film would be helpful or hurtful to them. Remember: When in an appropriate care setting, such as Columbus Park, individuals with anorexia can experience full, successful and happy lives. Early intervention is the single best predictor of recovery.

Contact us today for more information about our programs and services.