Movies can be a wonderful tool to help teens understand a topic that is perhaps hard to talk about. However, when it comes to eating disorders – a topic that is already deeply misunderstood by the general topic – To the Bone may not be the best tool.
Netflix’s To the Bone
The movie is about a 20 year old anorexic girl named Ellen who spends the majority of her adolescence in recovery programs for eating disorders, but each time they turn out to be unsuccessful. Finally, her family agrees to send Ellen to a group home for youth with eating disorders. What makes the group home different from the previous recovery programs Ellen has tried is the non-traditional doctor played by Keanu Reeves. The group home experience ultimately helps Ellen come face to face with her illness.
Ellen is played by Lily Collins (daughter of the famed singer Phil Collins) who apparently also struggled with an eating disorder at one point. In addition to Collins, the film’s writer and director, Marti Noxon, also struggled with an eating disorder.
Anorexia and Other Eating Disorders
In To the Bone, Ellen has Anorexia Nervosa, a life-threatening illness that is characterized by a strong desire to control the intake of food. What might at first start out as a diet turns into a need to remain thin. On some level, Anorexia Nervosa can turn into an illness about power and control. This eating disorder has both a psychological and medical component.
Psychological: Those with Anorexia Nervosa tend to have many thought patterns, obsessions, beliefs, and ideas that keep the dysfunction of the disorder in place. Part of treating the control of eating in teens and adults is the exploration of those thoughts and beliefs.
Medical: Severely controlling food intake leads to physical consequences. For instance, with too little food in the body, the muscles and the tissues start to break down. An adolescent with Anorexia Nervosa moves through cycles of self-starvation, denying the body essential nutrients it needs to function normally. The body is forced to slow down all of its processes in order to conserve energy. For instance, with Anorexia Nervosa:
- The heartbeat reduces to a very slow rate, causing low blood pressure and an increased risk for heart failure.
- Lack of nutrients leads to a weakening bone density which in turn can lead to Osteoporosis.
- There is muscle loss and weakness.
- Severe dehydration can cause kidney failure, dry hair and skin, and excessive hair loss.
- Because of overall weakness, there may be fainting and fatigue.
- There may be the tendency to get cold easily.
- Hair might begin to grow on the body, a condition called lanugo, which happens as a way to keep the body warm.
There are other types of eating disorders that don’t necessarily fit into neat categories. However, in addition to Anorexia, there is also:
Both of these illnesses are characterized by eating large amounts of food in a short amount of time. Unlike Anorexia, a person with these disorders has a lack of control when eating.
There is a difference between these illnesses however. With Bulimia Nervosa, a person often feels guilty after binging and will turn to laxatives or excessive exercise to compensate for overeating. This process of binging and then compensating for it eventually becomes a method of mood regulation. On the other hand, Binge Eating Disorder, does not involve any compensatory behavior despite a person feeling guilty after a binge eating episode.
What To the Bone Missed
As reviews from the Guardian and Teen Vogue point out, To the Bone doesn’t say anything new about eating disorders. It appears to tell the same story that most people are already familiar with – a young middle class teen who struggles to stay thin develops Anorexia – and possibly only further glamorizes eating disorders. Here’s what’s missing from the movie:
- eating disorders can come in many forms, including Pica, Rumination Disorder, and other types of disordered eating
- eating disorders can affect anyone from any socioeconomic class and any age
- those who are overweight also struggle with eating disorders (yet, a movie about being thin has more appeal to the American public than a movie about being overweight)
- there are few, if any, hopeful images regarding Anorexia
- there is little that helps to raise awareness about eating disorders
Furthermore, for an illness that can have some severe consequences, this movie remains too lighthearted. The Guardian calls it “squeamish”. The truth is that 20 million women and 10 million men will suffer from an eating disorder at some point in their lives.
Treatment for Eating Disorders
It’s important to point out that although eating disorders are serious illnesses that can be life threatening, they are treatable. As mentioned above, there are both physical and psychological aspects to an eating disorder. This requires then that treatment address both.
Psychological: To address the psychological aspect to eating disorders (dysfunctional thought patterns and beliefs), various psychological treatment forms are used including:
- individual therapy
- group therapy
- support groups
- psycho-educational groups
These methods also aim to teach individuals about the disorder so that they are familiar with the ways it is dysfunctional. Learning about an illness can help a teen make different choices.
Medical: To address the physical conditions that result from eating disorders, a teen typically will work with a doctor as well as a nutritionist. Together, both professionals can assess the body to be sure it is functioning in a healthy way and getting all the nutrients it needs. Part of treatment is restoring the body and finding its optimal level of equilibrium and health.
There are many resources, treatment centers, and education that parents, caregivers, teachers, and teens can access online and in their communities. As mentioned above, there is much that remains misunderstood about eating disorders. However, with enough education and awareness about these illnesses, perhaps over time, fewer and fewer individuals will experience them.