Will 'To the Bone' accurately portray anorexia?

This week, Netflix will release their newest original movie, To the Bone, which stars Lily Collins as a 20-year-old named Ellen who is in treatment for anorexia nervosa. The film, which aims to give viewers a realistic glimpse into the life of someone with an eating disorder, follows her and others as they seek unconventional treatment methods for their eating disorders. 

As psychologists at The Ohio State University Wexner Medical Center who often treat men and women suffering from eating disorders, we have mixed emotions about this movie’s release.

It’s possible that this movie could be seen as “glorifying” the disorder, especially since the extreme thinness aspect is so shocking to see. The risk of being irresponsible comes into play when a movie is so focused on weight loss and extreme thinness, which can detract from other symptoms that can be more damaging to one’s relationships and life. 

Many individuals we work with believe their eating disorder is not as “severe” if they aren’t extremely thin – which couldn’t be further from the truth. 

In addition to severe food restriction, there are symptoms that can be even more dysfunctional and damaging to the individual, such as binge eating, purging, preoccupation with food, weight, and shape, food rituals, compulsive exercise, and low self-worth. Many people of “normal” weight struggle just as much as those who may fall below the cutoff weight for anorexia nervosa.

The causes of eating disorders are complex, but graphic images and disordered behaviors like those depicted in the trailer can be a visceral experience for those at risk and can trigger all kinds of upsetting feelings. We often see portrayals in TV and film that focus on weight loss or extreme thinness, which can encourage the misconception that eating disorders are lifestyle choices, instead of serious biological illnesses.

When movies focus on psychological and emotional aspects, rather than just on low weight, it can result in a more accurate depiction of eating disorders.  Anorexia Nervosa is probably the most recognizable eating disorder due to the obvious and often extreme physical changes one goes through; however, more patients suffer from bulimia nervosa, binge eating disorder and OSFED (Other Specified Feeding and Eating Disorders).

On the positive side, it’s possible that this movie could be helpful with people understanding the struggles that patients with anorexia nervosa experience. Many people believe that it’s just about food and hopefully, this movie will provide more insight into the underlying psychological, emotional, and neurobiological aspects. The movie may spur individuals suffering from eating disorder symptoms to seek treatment. Additionally, it may help loved ones – especially parents – gain insight into the mental workings of someone who struggles with anorexia nervosa or any other eating disorder.

Eating disorders are life-threatening illnesses that will affect 30 million Americans at some point in their lives, but myths and stereotypes are everywhere. It's important that portrayals of eating disorders address the fact that these illnesses affect all kinds of people and make it clear that help is available. We hope that the film communicates that eating disorders are serious but treatable illnesses, and that Netflix and all those involved in To the Bone will make support resources available to those in need.