To The Bone: Proceed With Caution

My fascination with eating disorder movies developed suddenly one day years ago, when I had a free afternoon and access to YouTube. For example, Growing Pains actress and anorexia survivor Tracey Gold played someone named Nancy in a Lifetime movie that is one of the most cinematically horrendous things I’ve seen.

Did these stories perpetuate my already severe eating disorder symptoms by including numbers, behavior details, and images of thinness? Yes, probably. However, I watched movie after movie, memoir followed by documentary, for another separate reason: I wanted to feel understood.

In the isolated pain of anorexia, I had shut out all my friends. I had stopped going to treatment appointments. Cold and alone in a prison that became unmanageable, I wanted someone to take my hand. I wanted someone to tell me, “I get it.” I wanted to connect with stories that made me feel safe and validated.

So, I turned to YouTube.

These films did not “heal” me. They did not constitute treatment. However, years later, these narratives stick with me. Nowadays, I am not seeking “tips” or numbers; I seek understanding.

I want eating disorders to be understood.

So many films have broached the difficult subjects of schizophrenia, addiction, and bipolar disorder, to name a few. But eating disorders? People are primarily directed to Lifetime movies and documentaries so corny, outdated, and ridiculous they can barely be taken seriously.

Cue my excitement when I learned about To The Bone months ago. Perhaps this would be a good movie about eating disorders. My high hopes were based on the fact that lead actress Lily Collins and director Marti Noxon struggled with eating disorders in the past. In addition, Project HEAL, a recovery organization I respect very much, provided consultation during filming and has endorsed the movie.

The conversation began to shift when the trailer premiered last week. Controversy spread across the opinion spectrum. Many eating disorder sufferers are infuriated (understandably) that the already small lead actress lost weight for the movie, as well as the trailer’s triggering images of empty plates and protruding collarbones. Project HEAL founder Liana Rosenman released this statement:

It’s a challenge to make a truthful movie about eating disorders that sheds light on their severity and complexity — capturing the patient and family experience of this real mental disorder — without glamorizing the disease ‘To the Bone’ tows this line beautifully. While the movie has the possibility to be triggering to some, I strongly believe that it will make a huge difference of raising public awareness of this silenced disorder.

In this post, I will be giving a layered critique of To The Bone by highlighting some key issues at play.

While I have not watched the movie, both the trailer and my understanding of the social and psychological factors of eating disorders will equip me to preemptively raise some questions and critique aspects of the upcoming film.

The Power of Eating Disorder Narrative (For Good and Bad)

Let me preface what I am about to say by noting that I will be watching To The Bone when it premiers.

I believe in the power of narrative.

When harnessed for good, the power of story can bring peace, hope, and understanding to the weary. Eating disorders are complex, misunderstood illnesses that have not captured adequately in film. Dozens of movies embrace plot lines surrounding alcohol and drug addiction, but eating disorder themes are often swept under the rug.

Historically, movies that cover eating disorders are truly awful.

I cannot say that more emphatically.

The level of cinematic creativity and diversity can be represented by me describing one scene that is inevitably in all these movies: Brooding teenage girl staring at the mirror with a bra on feeling like she is fat.

Is that the best we can do?

Elementary school-aged children have body image issues, dorm bathrooms have clogged drains from vomit, and the American diet industry is worth billions, but let’s look at a white, upper-class girl looking in the mirror with disdain?

American film is better than that. Eating disorder research is farther along than that.

It’s treacherous territory making a movie about an eating disorder. To accurately depict the hell and pain of these clusters of symptoms, while promoting recovery versus the pro ana/ mia communities, is like tiptoeing on a cliff.

“Honest” depictions of eating disorders such as Wasted and Thin have done much harm in inadvertently exacerbating a pro-eating disorder mindset. Included in these films are details that have served as “how to” tips for those who are very much embedded in an eating disorder mindset.

What can be most triggering for eating disorder sufferers in film is mention of numbers, images of grotesquely thin people, and vivid descriptions of ED behaviors.

This brings us to To The Bone.

To The Bone is advertised to be a movie that doesn’t “hold back,” in terms of showing a woman out of control in her life, with a sunken face and empty plate. Lily Collins is emaciated in the movie, a role for which she lost weight from her already small frame, despite having an eating disorder history.

I have no doubt that the movie will promote full recovery for Collins’ character, nor do I doubt the film’s intentions. I also believe it will be a great conversation-starter for the general public surrounding the secrecy of eating disorders.

However, the trailer is disturbing. 

Upbeat music and triggering imagery are paired with colorful sayings like, “I am in control,” and, “I am strong.” There is a scene of a friend joking that Collins has “calorie Asperger’s.” Snap shots of group therapy and psychiatrist Keanu Reeves indicate that the movie will have a “happy ending.” The treatment center is led by a cool, hot, “unconventional” doctor (Keanu Reeves) who takes the residents to a waterfall, I guess. Sunken faced Collins asked a fellow sufferer, “How do you just eat?” The boy replies, “I’m not going to lie. I’m really f%&#ing hungry.” Cue the upbeat music and bold colors.

Let’s start with the obvious emotional disconnect between the cheerleader music that could as easily introduce Bring It On, paired with disturbing words, phrases, and images. It’s obvious the movie is trying to promote an upbeat, “pro recovery” vibe in the weirdest way.

I’m also fixated on the hot doctor thing. There is nothing realistic about a doctor somehow going on treatment outings with clients. Sorry, been to treatment, and they have mental health techs do that kind of stuff. Usually people are lucky if they see psychiatrists once every 90 days. They’re billed at way too high of a rate to take treatment residents to waterfalls. In real life, that treatment center would cost at least $100,000 per month.

I get that the upbeat attitude of the trailer intends to foreshadow a happy ending, but it doesn’t fit. There is nothing sexy or upbeat about an emaciated girl with a protruding spine in a doctor’s office, or having “calorie Asperger’s,” whatever that means. How do any of these movie clips warrant the musical equivalent of high fives and bubble gum?

This trailer had me shaking my head as a once-enthusiast of this movie. I will still be watching To The Bone, but my concerns about this narrative are seismic, especially after the trailer. If this movie opens up the conversation about eating disorders and helps sufferers feel understood, I will celebrate. At the same time, this trailer depicts the sad reality of the lack of eating disorder education to the larger public and highlights persisting stereotypes.

Oh Look, Another Young, Upper Class White Girl With Anorexia

It’s a tale that is unfortunately the plot line of almost every eating disorder movie. A white, cisgender, upper-class, long-haired, intelligent, already-thin girl who needs control develops an eating disorder. She has issues with her family, probably. At the end, she gets better or dies.

To The Bone uses these same demographics with the main character.

Groundbreaking.

The reality is that eating disorders affect those in any ethnic group, socioeconomic status, religion, sexual orientation, age, and geographic location. Moreover, the rates of eating disorders are rising in other key demographic areas: males (especially gay males), younger children, and middle aged women.

Director Marti Noxon defended this story choice, “It’s important to remember EDs is unique and To The Bone is just one of the millions of ED stories that could be told in the US at this very moment.”

Noxon is correct in that millions of ED stories could be told, but this is the one being told in the film. This cinematic choice has broad implications. Many who watch this movie might not be familiar with eating disorders, so the choice to feature a thin, white, young female will shape the way others view what an eating disorder looks like.

The problem with a white, emaciated woman of privilege being the heroine of this movie is two-fold:

  1. It does not represent the reality of eating disorders, nor does it accurately portray the significant crossover between disorders across a lifetime (e.g. shift from bulimia to anorexia to binge eating back to anorexia). I’m not going to lie, Lily Collin’s emaciated frame and overdone sunken-eye makeup makes me roll my eyes. Many people with eating disorders are not underweight. It certainly doesn’t represent the physical “norm” of someone with an eating disorder.
  2. These demographic choices of the main character highlight existing stigma. Sadly, Lily Collins’ emaciated frame will draw in viewers. I wonder what would happen if Lily Collins had gained 50 pounds for the role rather than losing weight, or if the heroine of the film was another beautiful, but overweight, actress, such as Melissa McCarthy or Queen Latifah. What about James Corden? I don’t think a film like this would be popular. Starving is the most culturally sanctioned eating disorder behavior. Do I think a story needs to be told of someone who binges and is obese as a result, for instance? Absolutely!! But it won’t be, for a long time, anyway. I’m not surprised that the dominant narrative of this movie plays into societal fascination with anorexia and the cultural thinness ideal.  I have been disgusted by interviews discussing Collins’ weight loss. “How Did an Already Thin Girl with an Anorexia History Lose More Weight to Play Someone with Anorexia?” might be a popular headline, but it’s nonsensical for those in recovery.

The problem with this one story fitting the predominant cultural narrative is that it makes us more likely to miss someone who doesn’t fit the physical “type” of Lily Collins but is displaying eating disorder behaviors. We are more likely to overlook an older female who is always in the gym or a young male who sneaks off to his car and comes back hours later smelling of food and vomit.

Moreover, those who don’t fit the mold To The Bone sets forth might feel even more shame. These are things I’ve heard or said dozens of times:

“Someone like me shouldn’t have an eating disorder.”

“I don’t look like I have an eating disorder.”

“My insurance company denied me treatment because my symptoms weren’t severe enough. I think if I lose weight they’d pay for it.”

“What if my church/ friend group/ school/ ethnic community found out I have an eating disorder? I’ll disappoint everyone.”

I am not knocking stories of women in privilege. In fact, my story is in some respects that story– white, small girl in a seemingly normal, upper-middle class environment with straight A’s develops anorexia. I had access to health care, even when my insurance refused to authorize treatment. This is not to say that I fit the standard mold entirely. There is no “normal” eating disorder story. People are dimensional, complex beings. Those of any religion, race, cultural group, age, and sexual orientation can develop an eating disorder.

My concern is that To The Bone will fall into a category of story of a woman in privilege, stifling and silencing other narratives. To the third grader chewing gum instead of eating popcorn with her friends as an attempt to reduce “baby fat,” to the male model who drinks and smokes to avoid daytime meals, and to the middle-aged housewife who finds herself needing inpatient treatment, I say this: Your story is valid. Just because To The Bone features an unrealistic, seriously emaciated young actress doesn’t mean your pain is less valid.

Eating disorders are eating disorders. They don’t discriminate.

The Mundane Reality of Eating Disorder Recovery

Keanu Reeves apparently plays an “unconventional psychiatrist” in the movie and seems both hot and cool. I worry that these unconventional methods will serve as the vehicle of healing in the movie. As if meeting a cool doctor and coming to a profound understanding of the “why” of symptoms leads to recovery.

For years, I expected when I found out the “why,” perhaps through lots and lots of digging during therapy, I would stop my eating disorder. Maybe would no longer be necessary. I was trying to find the elusive “it,” which often doesn’t come. 

I never found out why I have an eating disorder.

Does it matter, at the end of the day? To really, truly know why I developed an eating disorder, I would have to dissect my brain with the science of 200 years from now and look at every single circumstance in my first 13 years of life. I would have to look at my family history, get data from my mom’s pregnancy and my prenatal care, etc. It is impossible to know exactly why. 

I did not find recovery from talking about my family background for years or going to restaurants with my therapist in treatment. Yes, I have done these things, and to an extent, they helped, but they never got me “there,” to the elusive “it.” 

The reality of eating disorder recovery is a secret, but I’m going to tell you it anyway:

It is boring.

There, I said it. Eating disorder recovery is choosing to sneak a mid-day snack between meetings because my stomach is grumbling. It is paying the damn $100 every few weeks to check in with my dietitian. It is filling my medication on time. It is grocery shopping on Sunday night because I am tired.

It is ongoing, and it is not fun. Well, sometimes recovery is fun. Eating ice cream on a warm night is a fun part of recovery. Most parts are not fun. I hate having to wake up, knowing that the extent to which I restrict will guide my body’s well-worn path of switching to starvation mode. I hate forcing myself to eat lunch when my stomach is in turn due to anxiety, knowing that I have to eat anyway.

Boring is not Hollywood. Boring will not gain ratings. And so, I assume To The Bone will be filled with exaggerated moments of truth and insight, as well as dramatic sensational images and numbers. Showing a protruding spine is extreme, so it’s better for ratings. Getting weighed when you’re bloated and haven’t taken a shit in 2 weeks is gross and not sexy, so it will not be included.

Most of us don’t have the luxury of having a hot, cool psychiatrist taking us to waterfalls in treatment.

Real eating disorder recovery is boring and regular. It isn’t sexy or worthy of a red-carpet Netflix debut, but it is so worth it. 

Proceed with Caution

As I said before, I will be watching To The Bone on July 14th. I hope my concerns will be unfounded and that others will benefit greatly from this film. I hope I’m not going to be on the couch eating sour candy rolling my eyes because of unrealistic “aha” moments, too many protruding spines, and calorie-counting.

I know the film will open up conversation about what eating disorders are like.

I just hope it opens up good, informed conversation, conversation that heals rather than shames and stigmatizes.

Eating Disorders Kill, But Relationships Heal

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Fall 2009

Charlotte: Five years ago, the story was much different. Numbness and deprivation had drained my body of life, and vacancy replaced life in my eyes. Every night, I would pray that my heart would keep beating another night. I was spiraling into darkness, snowballing so fast that I wondered when and where I would crash. I eventually did crash, and landed on a ranch in Arizona, of all places. I had no hope but also nothing to lose by giving hope a try at residential treatment.

Janine: For over twenty years, anorexia had been the albatross around my neck. I had attended a long list of hospitals and treatment programs that seemed like one failure after another. As a last chance to evade death, I exchanged the towering evergreens of the Canadian west coast for the Arizona desert. My thoughts were jumbled in a fog of starvation and self-hatred. Anorexia had promised me everything, yet it had left me barely existing.

***

It sounds like the beginning of a bad, if not odd, joke. So this Canadian and Michigander walk into a ranch in Arizona… We, the writers, Janine and Charlotte, would never have met outside the confounds of one specific time and place: residential treatment for our eating disorders in 2009-2010. While our backgrounds were very different, in nationality, interests, and phases of life, we did share the same desperation for something better than living in the torture of anorexia. So we, along with others in our program, embarked on a journey that involved nourishing ourselves spiritually, emotionally, and physically. We cried with one another but also laughed and read books for pleasure. We ate pie on Thanksgiving and talked about identity and God. It wasn’t easy, or remotely close to easy even, but we healed together. We could see the tangible changes in ourselves. We could feel that we were no longer lifeless bodies anymore. Leaving treatment, we had hope again.

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Christmas at treatment 2009

Five Years Later:

Janine and Charlotte remain best friends. In many ways, our lives are so different now, now that we are less marred by our eating disorder scars. We are no longer treatment friends: we are just friends. We enjoy having adventures together. We have gone ziplining in Whistler, British Columbia (much to Charlotte’s terror/ chagrin) and to Disneyland (twice). While 1000+ miles separate us right now, we are intentional in maintaining our relationship through the wonderful development of Skype. Our eating disorders left us hopeless and incapacitated, but slowly, sometimes at a snail-pace, we have found freedom. In our respective ways, we want to help others out of their struggles within our spheres of influence. We would never have chosen to meet how we did or have anyone suffer in the ways we have, but we would never have changed the fact that out of the living hell of an eating disorder, an amazing friendship blossomed.

janine and i recovery

Charlotte: Treatment was a beginning of a new life chapter for me; not one filled with rainbows, unicorns, popsicles, and the end of all struggling forevermore, but one filled with real emotions, thawing, pain, and joy. In treatment, I felt unconditionally accepted and loved during one of the worst points of my life. I never believed that anyone could love all of me, even the ugliest parts. The abundant love and grace I received helped me emerge out of deep shame so I could deal with the factors that had led to my eating disorder in the first place. In the last five years, I moved across the country and then back to the Midwest and somehow earned two master’s degrees in the meantime. Although I still struggle with eating disorder behaviors at times, I believe there will be a day when that won’t be the case. I am so blessed by loving friends (such as Janine!) and a therapist who deserves an honor. I couldn’t be on this journey without them. Relationships don’t inherently heal eating disorders, but support is an integral part of recovery. While I wouldn’t wish my wild, roller coaster journey onto anyone, it is my story, and I am thankful for the beautifully chaotic mess. It is my story to own and love.

Janine: I catch myself once in a while realizing how different my life is now. A moment during work when I can’t believe I’m back doing what I love. I’m able to bring energy and enthusiasm to my job working with children that I couldn’t possibly have done when my eating disorder ruled my mind. I don’t think twice about eating cupcakes with my little nieces or laughing with friends over dinner. I am no longer numb and terrified all the time. I’m able to feel the amazing and wonderful parts of life and no longer attempt to dissolve into oblivion when the guaranteed challenges arise. Recovery has not made life perfect for me, but I am able to make plans for my life that I never thought possible. Nothing about recovery has been easy but I know it has been made easier by my unexpected and unlikely friendships.

Why The Biggest Loser Sucks… But Why It’s Way Worse Than That

I watched The Biggest Loser in its infancy. I remember Jillian Michaels and Bob Harper personal training the shit out of contestants, but pre-Jillian Michaels making 500 fitness DVDs. I might also note that I watched The Biggest Loser in the worst of my eating disorder. Watching a TV show centered on weight loss seemed like a natural outflow of systematically starving myself. In recovery, I was told that it wouldn’t be a good idea to watch something like that anymore. So I stopped. In fact, I stopped engaging in any pro weight-loss media. Much to my shock, I did not miss reading about what Nicole Ritchie ate for breakfast every day. Because, all those articles are basically the same when it comes down to it anyway. Frankly, I haven’t thought much about The Biggest Loser for several years.

… until yesterday. The internet has been blowing up with controversy about the last Biggest Loser winner, Rachel Frederickson, who went too far in her quest for weight loss. Not only did she win but she became unhealthily thin. People have been freaking out left and right. OMG this person on The Biggest Loser is too thin. She might even be anorexic. Has this gone too far?

I don’t disagree. Competitive dieting can for sure lead to anorexia. I know first hand. My own attempt at dieting resulted in a life-threatening eating disorder. I think that other articles that friends have posted (e.g. this one) have expressed that well. And yes, it is a horrible show. More on that later. I am not disputing any of this.

However, my response is more of a broader commentary on our culture, more along the lines of Carrie Arnold and my friend Lauren.

Why is this the first public outcry we’ve had about this show? Oh sure, let’s starve, shame, and publicly humiliate FIFTEEN SEASONS worth of people, and then when someone is considered too thin, “Oh, maybe that was a little too much.”

Does anybody else find this insanely ironic? Shaming public weigh in’s, people working out until they vomit or pass out, and verbal abuse by the hand of personal trainers for goodness knows how many people, and someone who wins gets too thin… and now it’s too far? The whole freaking point of the show is to lose as much weight as possible. Maybe there is not something wrong with Rachel and maybe something more wrong with the show, and more importantly, our culture.

It reminds me of tabloids. I see these things as I check out at the grocery store, and the stories are always the same: this person is too fat. They are overweight! Let’s have 20 unflattering pictures of them going to the grocery store. Then, actresses who might meet the criteria of anorexia have pregnancy rumors spreading because they drank some water or ate a piece of pizza. There is a very narrow window of pop culture satisfaction with a woman’s body. For the most part, all fat is a matter of repulsion to our modern media. BUT, when someone gets too thin, there is this surprising amount of mock alarm. This person is too thin, mass chaos ahhhhhh.

Our culture has a phobia of fatness. Anyone who is overweight is considered disgusting. That’s why we’ve created a reality TV show that gives them money for becoming “less lazy and more self-controlled” (note: public sentiment, not my own). When someone who is 350 pounds is publicly shamed, yelled at, and forced to vomit to get through a workout, that is acceptable to our modern American consciousness. So much so that it has been picked up for 15 seasons because of popular appeal of the show.

 And yet someone who ends up losing too much weight has gone too far, which is no longer appropriate, and the news story is so popular that is on the trending section of my Facebook page? It is such a weird double-standard. Once you get thin, you don’t deserve mockery and shaming anymore? That is too far. But if you’re “fat,” let the games begin. Vomit during your work out, if that’s what you need to do.

It is interesting how our culture legitimizes and makes value judgments about certain eating/ weight struggles. Anorexia has been in the public eye since the 1980s, but the newest eating disorder, Binge Eating Disorder (BED) is a relatively recent diagnosis (I mean it was recognized before by basically everyone in the field, but now a bunch of psychiatrists said it was legit, so now it’s officially legit). Binge Eating Disorder is thought to be the most prevalent eating disorder in the country. It affects 2.8% of people over the course of their lifetime and can often lead to obesity and other serious consequences such as death. While I haven’t watched The Biggest Loser in years, I would bet that some participants of the show have at some point struggled with this eating disorder.

As a part of eating disorder treatment, I hear over and over, Listen to your body. Love your body. Honor your body. Pretty sure that applies across the board. While I don’t specifically know best practices for treatment of BED, somehow I think that public shaming and fainting during dangerous work outs maybe are not the best strategies for treating a serious biopsychosocial disorder. People with BED can suffer with self-hatred and loathing at their propensity to eat, and behaviors can cycle. One eating disorder can be replaced with another. Are we really that surprised that someone went too far?

I am not trying to minimize the health ramifications of obesity. I understand that people can have serious health issues or prematurely die because of obesity. However, The Biggest Loser enterprise is not the right way to go about addressing this issue. Stigmatization and public shaming of people based on weight is never okay. Eating 500 calories, working out for 6 hours a day, and humiliation are never acceptable. It doesn’t matter what weight you are.

We need to take a step back and realize that the entire way that our culture views weight, eating, and exercise are deeply problematic. Can you imagine a country like France making a show like this? Neither can I. In this country, weight loss sells. Our diet industry rakes in $20 billion per year. So, the network produces season after season, and the abuse and shaming is never questioned.

 I feel badly for Rachel. I really do. I hope that she reaches a stable equilibrium. But Rachel is only one contestant– and victim– of this show. What about the other Biggest Loser contestants who “lose” the competition but develop harmful habits toward eating and exercise that might last a lifetime as a result of the show? Or they are self-conscious about their weight and feel ashamed for the duration of their lives? Yet, their unhealthy habits are discounted because they are not “thin enough” to warrant attention. No one makes stories that go viral about them.

I am concerned about Rachel, but I am also concerned about everyone else on this show, and frankly, I am concerned about the messages people get from watching it. And I am concerned that there are people whose voices are being ignored because they are not close enough to some cultural ideal. It reminds me of this Huffington Post article that was really eye opening to me. Jennifer Lawrence is applauded as a “body image hero,” and I mean, like the next person, I am enthusiastic about anyone who says, “If anybody even tries to whisper the word ‘diet,’ I’m like, ‘You can go fuck yourself.’ “

However, when I read the article, I realized that Jennifer Lawrence is a white, small Caucasian woman who meets a conventional standard for beauty, and she just happens to gloat about eating French fries. But– would a larger actress who says she likes eating be applauded as a body image hero? The author contrasts Lawrence with Melissa McCarthy, an actress with a different, bigger, body type. Melissa McCarthy is quoted saying, “I don’t know why I’m not thinner than I am.” What if Melissa McCarthy went on record saying that she loves French fries? Would there be gifs and tumblrs dedicated to her? Somehow, I don’t think so.

The author, Jenny Trout, wonders: “At what percentage of body fat does a woman earn the right to be a person?”

What is saddest to me about the whole Biggest Loser controversy is that this is what it takes for people to speak out. We should give attention and concern where attention and concern are due– this entire franchise. Rachel is not a far cry from what every other contestant has tried to do– lose as much weight as possible, and if you need to starve or almost kill yourself on the treadmill to do it, so be it.

This show is not okay, but in leaving the critique there, we are missing the public stigma and shaming associated with weight issues. We are missing the fact that millions of people are on their couches eating popcorn watching people almost kill themselves for a quarter of a million dollars. “You can never be too rich or too thin,” as the popular adage goes. The Biggest Loser attempts to handle both.

In my opinion, enough is enough. This show is a horrible outflow of our fat-phobic and paradoxical culture, and it is time that people stand up and call it out for what it is: Bullying. Shaming. Abusive. Unacceptable. It loses. And so do we.