Why “To The Bone” Gets Anorexia Wrong (And How To Change The Narrative)

As an anorexia survivor, I am befuddled and stunned by To The Bone.

Not only is it “shallow, sexist, and sick” but it is not even a good movie. An article in the Atlantic says the film, “is a mostly unremarkable film about anorexia, in that it follows the model of virtually all existing films about the subject.” It is to be noted that as I’ve written before, almost all eating disorder movies are awful, so “following the model” is not great press.

I am not even going to elaborate here on my disappointment with Project Heal, a major eating disorder advocacy organization that publicly endorsed the movie and even had a viewing party for the film. In addition to this, most treatment centers were quiet on taking a stand, and as Laura Collins Lyster-Mensh writes in a refreshing departure from generic “viewing guidelines” put out by almost every eating disorder organization, “We are all under pressure to promote the film or just talk about it, which is also good publicity.”

Project Heal co-founder Kristina Saffran suggests in a BBC interview that To The Bone is meant for the general public, in that the movie aims to open up a larger conversation. In this blog, I’m going to be talking about my concern about this portrayal of anorexia to the larger community.

To The Bone will open up a conversation, but I’m not sure if it’s the right one.

I see the movie as Marti Noxon’s story and as her message of hope. Ellen/ Eli is a brooding twenty something, full of teenage angst and emo, pro-ana Tumblr drawings. Chocolate, dances in waterfalls, and somewhat hallucinatory, dreamlike moments compel Ellen/ Eli to choose life at the end of the movie… or so we think. The movie ends with the possibility of hope and new beginnings as Ellen/ Eli re-enters treatment.

If the film is indeed a loose adaptation of director Marti Noxon’s own anorexia struggle, viewers are led to believe Ellen/ Eli does end up in recovery. Noxon and fellow film actors consulted with Project Heal in the making of the movie and have done subsequent promotional eating disorder awareness campaigns.

The movie might seem as if it has a pro-recovery message, but it doesn’t.

Despite the movie ending with Ellen/ Eli choosing hope over despair and death,  I will argue that the movie highlights hope instead of recovery. 

Hope and recovery are separate but related constructs, and it is dangerous to meld the two concepts. You can have hope without recovery and recovery without much hope. Let me explain.

When I was forced went into treatment for the second and final time, I was not at “bottom,” or so I thought in my nutrient-deprived mind. I wanted a month longer to get to however much lower I could get my weight. Did I have a reason? Did I want to die? I didn’t have a reason, and I didn’t want to die when it came down to it.

I also did not have hope.

When I entered treatment, I subconsciously knew I didn’t want to die, but I had no reason to live, either. My starved brain and starvation-based depression had me living in a cloud of darkness. When the brain is deprived of nutrients, it does not function optimally. I was not capable of hope or feeling much at all, actually.

My first morning of treatment, I was given breakfast. I looked down at the plate, having not eaten breakfast for at least a year. My immediate thought was, “I guess I’m eating breakfast now.” And I ate breakfast. It was not “orgasmic,” as To The Bone would absurdly indicate. It was just breakfast.

So I ate. I talked about my depression and hopelessness with my therapist. In full disclosure, it didn’t get any better for months. I didn’t feel happy to be alive or worthwhile as a human being. Sometimes I don’t even to this day.

The big difference between Ellen/ Eli’s hallucinatory revelation and my story is behavioral: I sat down to breakfast. I didn’t fake my way through treatment. I went through the motions. I ate snacks that challenged me.

It was not perfect, easy, or fun, but I did it with the anticipation that perhaps someday, I would feel happy. Someday, maybe, I would smile and mean it, fall in love and feel it, and find a career and enjoy it. Maybe someday. But that someday did not come into fruition for a long time.

Sometimes, eating disorder sufferers have to do the hard work of recovery without a reward.

Sometimes, we don’t have the luxury(?) of hallucinating in a desert to realize life is worth living.

Sometimes, we are plagued with ambivalence years into recovery, or worse, relapse and feel deep shame for the perception of letting others down.

Hope is a building block of recovery, but it is not the only building block. It is great when it’s there, but if it’s not, oh well. Doing the hard behavioral work is what helps people recover.

To be candid, there is nothing that is recovery-focused in To The Bone. I suppose it’s great Ellen/ Eli finds hope and returns to treatment at the end of the movie, but if this were real life, she would have to find an actual treatment center. To The Bone glamorizes a “treatment” that is a) not treatment and b) provides unnecessary, misleading, triggering details of some people’s experiences.

There is little that is pro-recovery in the entire movie. As Collins Lyster-Mesh describes perfectly:

There are no recoveries or recovered people in this movie. No one is abused, mistreated, or dies, but no one gets well or does any of the actual work of recovery from an eating disorder, unless you call having visions in the desert therapeutic. Insurance may not pay for that, but there’s no waiting list.

In eating disorder treatment and recovery, there is no lasting hope for the future without behavior change. Behavior change is not the only facet of eating disorder recovery, but it is a necessary precursor to life. Does Ellen/ Eli do the necessary work to get better, including eating more than one bite of chocolate the entire movie? We don’t know- that has been an artistic omission, and it is an omission that comes with implications.

The pro-ana commune that is passing as a treatment center in the movie is just a bunch of sick individuals talking about calories, restricting, cutting corners, and doing push ups. On a human level, it’s boring and sad, but on an advocacy level, it is terrifying and sad. Nothing about this is remotely pro-recovery. If this was a real treatment center, Keanu Reeves would have at least 10 malpractice suits on his hands for medical neglect and involuntary manslaughter (also maybe sexual assault depending on the nature of these nighttime “house calls” he does).

What scares me is not that these “unconventional methods” of essentially negligence will become in vogue (they won’t).

What scares me is what the larger public will see. What scares me is the conversation.

What conversation will come from this movie?

The movie may showcase hope, but it depicts a lot of other things as well. To The Bone is graphic, insulting, stereotypical, and crude. There are too many shots of protruding bones to count. I am concerned others will, perhaps subconsciously, file this away as a normative anorexia experience, or worse yet, see this pro ana colony as normative treatment.

The anorexia conversation needs to change. Anorexia films portray the same story over and over– a tragic, rich, white, straight, emaciated female with a “dysfunctional family” has anorexia.

To The Bone puts Ellen/ Eli into a tragic, starving girl Hollywood “type.” She looks waif-like and tragic as her family members fight in family therapy. She is an artist, but it appears that she is not working or going to school. She is emo, makes witty comments, and always wears dark eyeliner. She and the others in her “treatment facility” are not only able to access treatment but are able to take months off without working.

In my opinion, Ellen/ Eli is not a sympathetic character. She is two-dimensional and lacks depth. Yes, she is snarky and has enough eyeliner to star in a middle school PSA, but she has no hopes or dreams. I can relate to the narrowing of life that comes with an eating disorder, especially since she is sick the entire film. However, it doesn’t lead to interesting character growth.

Eating disorders are small and narrow diseases, and so is this movie. 

Anorexia is complex and multifaceted, and I saw none of that in To The Bone. To be frank, I didn’t feel anything at all for the characters or plot except for disgust at the triggering details that were unnecessarily included. Although I am also a white woman with privilege who struggled for years with anorexia, I do not relate whatsoever to this story.

To The Bone might be part of Marti Noxon’s story, but it is only a small part. The interesting part of Marti Noxon’s story is one that is untold by this movie- how she overcame anorexia and ended up being a successful director. That is interesting.

We don’t know where Ellen/ Eli would be in 5 years. She might open a successful indie art studio in New York City, or she might be dead. The audience does not get a window into her life or recovery. That does a disservice to survivors and the general public alike.

To The Bone does not get a pass just because it opens up a conversation.

I would be horrified if someone went up to me and said, “Do people actually get fed with bottles as part of recovery?”, or, “Do you think her mom’s postpartum depression caused her eating disorder?”, or, “Ellen got to wait until she ‘hit bottom’ so that’s what I’m going to do,” or, “Do you have ‘calorie Asperger’s’ too?” The list of misleading portrayals could go on and on and on.

We do need to have frank conversations about eating disorders.

However, To The Bone is not an adequate medium for doing so. The work should focus on awareness of the anorexia experience but also recovery and dispelling myths rather than perpetuating them. And if we’re going to make an eating disorder movie, at least can it be good??

We can do better than this. Everyone deserves better.

 

80 (Mostly Sarcastic) Thoughts I Had Watching “To The Bone”

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  1. Movie starts off with Ellen writing “Suck my skinny balls” in art therapy. Love the way things are getting off to a brooding, angsty start already.
  2. Ellen and her sister are literally playing something called the “calorie game,” in which Ellen counts the calories of everything. Not sure why her sister is enabling such a weird fucked up game. Also most people with ED’s who count calories don’t play public games about it.
  3. Why is Ellen’s stepmom taking a “skinny” picture of her to attempt to show her how thin she is? When does that ever work? And what kind of weird parent takes pictures of her emaciated child to show someone probably with body dysmorphia she is too skinny?
  4. This movie is HEAVY in stereotypes here- the big clothes, the body hair (lanugo), someone asking Ellen about her emaciated self, “Do you think this is beautiful?” UGH.
  5. Dr. Beckham, Keanu Reeves, aka KR, is super hot and exchanging a weirdly flirty look with Ellen. On a human level, KR and Lily Collins are both super attractive and I get the sexual tension. In the context of this movie this is really weird and unethical, and I feel super uncomfortable.
  6. Now KR is checking out Ellen’s back bones while she’s in a hospital gown. So… he’s a psychiatrist who is doing a physical exam? What kind of doctor is this dude? I’ll tell you- it’s a doctor who doesn’t exist. No doctor does psychiatry with a little internal medicine on the side. But for now let’s go with it I guess.
  7. Why are there so many views of spines and protruding bones?? Like we get it she is skinny. Like scarily emaciated. Can we stop seeing pictures of this girl’s bones now??
  8. KR is saying some weird ass stuff: “I’m not going to treat you if you’re not interested in living.” Pretty sure doctors have ethical obligations to help people not die. Tbh sometimes people are treated for their own benefit without necessarily wanting to live. Also many people go back and forth about whether they want to get better, and they go through the motions of recovery anyway.
  9. I do appreciate the portrayal of the stepmom’s stupid comments, such as a cake in the shape of a hamburger that says, “Eat Up, Ellen.” Something similar happened to me and it was mortifying.tothebone
  10. There is so much dark brooding music in this movie. Why so much unnecessary angst? We get it. Ellen’s angsty.
  11. Now Ellen is entering treatment. I have a lot of questions about this treatment center, but I’ll start with this one- who is paying for this?? No discussion of money or insurance, which is always part of the picture unless someone is seriously loaded (ED tx is $$$$$$).
  12. Interesting how many people are seeking the “best” “unconventional” doctor and somehow have access to that level of care… No discussion of how many people DON’T have any treatment coverage whatsoever. The movie is clear: We are talking about people with serious privilege. Not just Ellen… anybody who is at this treatment center.
  13. Also this doctor is the “best” presumably because he is unconventional… where is the discourse around evidence-based treatment and actual treatment methods that WORK? Flirty, waterfall-going, existentially-empty doctors who run unsupervised programs are not generally go-to treatment options for young adults who are pretty much dying.
  14. Ellen meets a British guy named Lucas, and he is giving her a tour around the treatment center because apparently in this treatment center there is no staff (begging the question of why any normal human being or insurance company would pay for this).
  15. Note the fact that everyone is really preppy looking and white minus Lucas and one black girl. Talk about playing into the lack of diversity eating disorder stereotype….
  16. This group therapy session… just, ugh. Ellen traumatizes a poor girl by telling her how many calories are in her tube feed. There is so much wrong with this whole scene. Also in real life no one would EVER be allowed to talk about something like that in an eating disorder group therapy session. EVER. There are things called group guidelines.
  17. Did the therapist just tell a client matter-of-factly, “Now you’re thinking about how to burn it off,” in the middle of group IN FRONT OF EVERYONE?? Unspoken rule #15 for eating disorder therapists: Don’t suggest or infer the presence of ED thoughts/ behaviors in front of other people. If I learned I just gained weight at my dietitian’s office and she said, “Now you’re thinking about how to lose that weight,” I would tell her to fuck off. Then I would leave the session and never come back.
  18. No one here seems to be struggling with anything besides starving, purging, and being underweight… with the exception of the poor black girl who was probably thrown into this movie without any character context for the sake of artificially promoting diversity.
  19. At this treatment center people eat whatever they want apparently. You just need to gain weight and they don’t care how you get there?? What the actual fuck. Who cares how you get there? Everyone does!! What the hell, that’s why you’re in TREATMENT. I guess someone could binge to a normal weight (been there), but that is NOT normal.
  20. I kind of want to slap Ellen. She’s being really annoying. Not because she has an eating disorder but because her over-the-top brooding angst and smug superiority is just pissing me off.
  21. Also I’ve never seen anyone so smug and superior on day #1 of treatment. On day #1 of one of my treatment stays I was having panic attacks left and right. This is so unrealistic.
  22. For a movie that’s supposed to be about recovery and not food, there are sure a lot of food scenes in this movie….
  23. People can’t just leave the table in the middle of mealtime. Why is there no supervision for these clients??
  24. The black girl is just sitting at the table eating peanut butter. Not exactly normal eating, but she is also sitting there looking like she wants to stab everyone in the room. Same, girl, same.
  25. All they talk about is getting each other laxatives, purging, weight, and people being fat. What a waste of allocated resources. Who the fuck would pay for this IRL??
  26. KR shows up at Ellen’s bedroom at night to make a house call. What is even happening right now? What psychiatrist-turned-internist-turned makes a night house call just cuz???? My psychiatrist sees me for 15 minutes every 3 months. This is sketchy AF.
  27. This facility is everyone just feeding off of each other’s disorders. “Unconventional” is one way of putting it. Another way is super fucked up, disordered, or a facility that needs to be shut down. They are legit giving each other tips, triggering each other, and calling Emma Stone fat. How is there nobody calling them on this?
  28. KR is now a family therapist. And he’s a HORRIBLE family therapist. Like seriously awful.
  29. THERE IS SO MUCH WRONG WITH THIS FAMILY THERAPY SESSION. I literally can’t.
  30. KR lets Ellen’s family talk over each other while Ellen is sitting there looking like a romantic, tragic ghost *I take my 415th eye roll of the movie.*
  31. Kelly, the sister, is the only normal person in this entire movie besides the black girl. Actress who plays Kelly, props for showing actual emotion and having a 3D character.
  32. No one says “rexy” for anorexic. Right?? Please let’s not start saying that. I can’t take it.
  33. Ellen uses family therapy as an excuse not to eat and everyone exchanges a knowing glance. The undertone being that people with ED’s have messed up families. Playing on stereotypes again….
  34. Question: Is anyone getting medically monitored in this place? I’ve seen no blood draws, no IV’s, and these clients are acting out like crazy.
  35. Trying to scare people into eating to avoid dying is a huge part of this movie, and that just doesn’t work.
  36. The whole scene with Lucas kinda sexually trying to get Ellen to eat a chocolate bar is weirding me out. It sounds like chocolate is getting them to semi-orgasm. Has anyone who created this movie ever seen someone with an eating disorder try to eat????? It’s not like that. It may involve tears or panic attacks but certainly no orgasmic expressions of how good food tastes.
  37. Lucas is trying to force Ellen to eat, which I guess is good because no staff is ever there, and no one else seems to care she’s not eating.
  38. KR just says, “We’re never doing family therapy again. That was a shit show.” I saw that family therapy session and tbh, I think part of the shit-show nature of the family therapy has to do with the fact that KR is an AWFUL family therapist. AWFUL.
  39. KR literally just told Ellen her name seems old fashioned and that she should change it. Um WHAT??!!?? What psychiatrist/ internist/ family therapist tells a client to change her name????
  40. Ellen is Eli now. Just… whatever.
  41. Eli and Lucas pretend to have cancer and be in hospice to get free alcohol. In the meantime, Lucas tells the waitress she is chewing and spitting because of her chemo. I don’t even know what to say here… Is this supposed to be this coming of age moment that they’re out in the community and free and shit? This is a really sick way of doing that.
  42. A client mentioned her mother took her to a Holocaust museum to feel guilty about starving. That’s what you got out of seeing the Holocaust museum??
  43. KR is taking the clients to a waterfall in the dark, and they all start dancing in it. It becomes some artsy music video of dancing in a waterfall being alive. What is happening right now….
  44. Also why would a psychiatrist/ internist/ family therapist/ individual therapist would taking a bunch of teens to a waterfall in the dark alone….
  45. Is this guy still getting billed $200/ hour for dancing in a waterfall?
  46. Asking for a friend.
  47. This waterfall scene is weird as hell and I have no idea how this has to do with anything. Is the indication that waterfalls and knowing you’re alive heals eating disorders? Because that’s just not true. At all.
  48. Eli decides to eat a chocolate bar in the most eating disordered way ever by cutting it into small pieces and eating one small piece. People are giving her props though?
  49. Lucas: “Did somebody touch you as a kid or something?” That’s a great way to bring up past trauma.
  50. Lucas and Eli can’t be making out right now.
  51. Wait they’re making out right now.
  52. Are you fucking kidding me??
  53. Who falls in love in eating disorder treatment? I’m sorry, but I know a lot of people with ED’s, and that’s not really an option usually. HIGHLY unrealistic. Also Lucas is possibly in love with Eli after they’ve known each other for what, 2 days??
  54. I will say, the scene about the miscarriage is sad. Followed by the ridiculous comment by another unsupervised client, “Can you push a baby out by throwing up too hard?” Face palm.
  55. Eli keeps getting weighed in this dramatic way, and the staff is letting her see her weight. When does that ever happen in treatment? Treatment weight is almost always done facing away. I still don’t look at my weight years after my last treatment stay- it’s not something I need to know.
  56. Eli amping up her empathy about Megan’s miscarriage: “That baby was never going to make it.” Eli, stfu. For the record, at least Megan has eaten more than one bite of chocolate this entire movie.
  57. KR is now Eli’s individual therapist as well- so we have 4 disciplines going on here. Regardless of this alone being professionally irresponsible, Eli starts asking about KR’s life like all healthy therapy relationships start… and KR answers. KR says he is practically married to his work. Eli tells him, “Sounds like you’re avoiding intimacy doctor.” I just can’t right now. I think I said that earlier but I really can’t now.
  58. KR is saying some bullshit about how there is no point of life and Eli knows what to do and “stop waiting for life to be easy.” KR is the kind of therapist who gets training by watching Dr. Phil one time. He is also the kind of therapist who nobody ever sees because glib sayings and boundary-less, unethical therapy doesn’t happen in the real world.
  59. Eli runs away from treatment, ditching her friend Lucas, who says he needs her and just professed his love for her last night. To be fair, I’d run away from that treatment center too, but for different reasons.
  60. KR, being the super ethical and great doctor he is, let’s Eli run off saying, “For Eli the bottom is critical.” Tbh, for many the bottom is death. But guess he’s cool with her taking that chance?
  61. Eli ends up staying with her mom, who thinks she should feed Eli with a bottle and rock and cradle her because Eli’s mom had postpartum depression when she was born, and Eli missed out??
  62. This is hilarious, her mom is crazy.
  63. But wait, hold on, Eli wants to be fed with the bottle. The mom pulls out the baby bottle, full of rice milk.
  64. Holy shit this is happening.
  65. The camera fades out as Eli is in her mom’s arms being fed by a bottle.
  66. I feel like I’m on drugs. What is happening??
  67. Eli walks in the moonlight and starts a trippy dream sequence that I don’t understand. I guess the point of this is that Eli finally realizes she’s dying because she sees herself below the tree with all her bones sticking out. I understand this is supposed to be a formative scene in the movie, but all I can’t take it seriously. This movie is so strange. It lacks substance, depth, any semblance of professional respect, and Eli just got fed with a baby bottle. No, I’m not over that.
  68. Also the “baby feeding” thing NEVER happens. Okay, there was the Peggy Claude-Pierre book that terrified me as a freshman in college, but nobody does that anymore (I hope).
  69. What is with this movie and bones?? I know, I know you’re skinny!! I know, it’s called, “To The Bone.” I don’t know how the movie producers can realize that not everyone with anorexia has visible bones! In fact, most don’t. The constant protruding bone imagery is not only inaccurate but triggering and frustrating.
  70. Then all of a sudden Eli wakes up from the moon/ tree sequence. Eli proceeds to hug everyone in her family, and she goes back to treatment… I guess ready to get better suddenly?
  71. Wait, so last night you got fed by your mom in a baby bottle, passed out while hiking, and had a trippy dream sequence and got healed??
  72. Please don’t tell me the movie ended.
  73. The movie ended.
  74. Are you kidding me?
  75. What did I just watch for the last hour and a half?
  76. Dear God, I hope nobody thinks having an eating disorder is anything like that, or that treatment is anything like that.
  77. This movie has gotten a lot of positive press through reviews and feedback from Sundance. WHYYYYYYY??????
  78. *screams into the abyss*
  79. Breathe. It’s okay. You’re okay. People are hopefully going to realize that this is not what the normative eating disorder experience is like. Even though there are some attributes of truth, “To The Bone” has so much gross inaccuracy, as well as triggering imagery and trite, unrealistic therapeutic discourse.
  80. This is so sad. Guys, we really need to make a good movie about eating disorders. 

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.

How Do I Talk to a Friend or Family Member With An Eating Disorder? (Or You Suspect They Do)

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This is 2017’s National Eating Disorders Awareness Week, and I’m excited to be writing a few posts based on requests.

My first post is how to talk to a friend or family member with an eating disorder or who might have one… from my perspective as someone in recovery. While I was struggling through the years, I heard from friends and family that they felt powerless. It was like watching a sinking ship and not knowing if they could do anything to stop its demise.

While it is impossible to cure another person, friends and family members are NOT powerless. I think about the camp counselor who talked about her own eating disorder openly without shame while I was symptomatic but not yet diagnosed; the friend who reached out to the school administration when she was concerned about me; my mom who spent countless hours trying to understand why I wouldn’t eat. I might have resented them at the time, but now I know that they planted seeds that would bear to fruition later. I didn’t enter recovery in their timing, but it did happen.

I will forever have memories of friends, family members, professors, and co-workers expressing their concern to me over the years. If you think that your words don’t make a difference or impact to someone deep within an eating disorder, you’re wrong.

I will give a cautionary note, however. For every good friend who expressed concern and gave me unconditional love during my journey, there was another who met me with insensitivity and stigma.

Talking to someone with an eating disorder can be a tricky endeavor. On the one hand, you want to express love and concern, but you don’t want to do so in a way that is off putting or hurtful.

In this blog post I will be outlining some “do’s and don’t’s” derived from years of experience of what has and hasn’t helped me.

  1. Do ask about it…

… but try not to probe or make assumptions.

Bringing up your concerns with someone you believe to be struggling can be anxiety provoking. It is a whole lot easier to pretend everything is okay. However, if you have a sinking feeling that something is wrong, and you are close enough to the person to broach the subject, by all means consider it.

Before you do so, consider these two things:

a) Don’t push it– If you bring it up and are met with defensiveness, it might not be the right time to talk. People with eating disorders can be highly secretive. In my deepest stages of denial and shame, I avoided all conversations about how I was doing. I remember how one time prior to admission to residential treatment, a teacher asked if I had an eating disorder. Taken aback, I mumbled something about having a rare digestive disorder. I wasn’t ready to admit how out of control or scared I was. Eight years later, I still remember that conversation as formative. She did not push the issue but expressed concern, and that meant a lot. Even though I wasn’t in a place to talk about it at the time, I respected her for bringing up the subject.

b) Check your assumptions– In society, we tend to associate eating disorders with “thinness” (whatever that means), but that’s just not accurate. Most people with eating disorders are not underweight. Anorexia is the most rare eating disorder, and bulimia and binge eating disorder are more common. People with eating disorders often fluctuate between periods of restriction, bingeing, and purging. I know some of my most symptomatic, out of control times were when I looked healthy. Don’t automatically assume that someone’s thinness is anorexia. It might as easily be a thyroid issue, an autoimmune disease, drug abuse, or simply body type. Similarly, don’t assume that someone doesn’t have an eating disorder because they appear to be healthy.

I have a “spidey sense” in my judgments about whether someone has an eating disorder, but I can be wrong. I am also careful about bringing up the subject of a possible eating disorder. Far before I bring that topic up, I make sure to talk about my own experience, normalize the reality of eating disorders, and check the facts.

. . .

2. Do seek consultation…

… but avoid gossip.

I can’t tell you how horrible it feels to know that people have been talking about you in the whispers you slightly overhear as you pass by and in hushed conversations you know have happened. I think by all means people learn more about eating disorders if they suspect a problem in a family member or friend. Education is important. Talking to a dietitian, therapist, or an organization like the National Eating Disorders Association can be a great move. HOWEVER, when that trickles into gossip and shaming, it stops being helpful.

Sometimes a family or friend group might need to get together to discuss how best to broach the subject with a loved one, but as soon as it turns into judgment and teasing, it can become toxic.

A note about consultation: It is strangely easy to read an article from BuzzFeed or some other reputable source (joke, but in full disclosure, I love BuzzFeed) and think you’re Dr. Phil or something. “Is it about control?” I’ve had people ask me in condescending tones. As if that comment is unique and your therapist hasn’t talked about control 900 times. Eating disorders *can* have an element of control, but it is ALWAYS much more complex. Eating disorders are associated with a cluster of things that may or may not be related: psychological factors, personality types, presence of past trauma, significant stressors, biological predisposition, family history, etc. A cursory look at a non-scientific article or watching a horrible Lifetime movie about anorexia cannot make anyone an expert.

. . .

3. Do express concern about eating habits…

… but don’t do so during meal time. 

Eating with someone you’re almost sure has an eating disorder is difficult and uncomfortable.

It is SO tempting to reach across the table and critique a meal choice, or say something like, “Is that all you’re having?”, or, “Why aren’t you eating more?” In my experience, those conversations are never helpful. The person with an eating disorder, who is likely anxious from the experience eating out, is on guard and gets defensive fast.

I get it– meal time seems like the most logical time to express concern. After all, it is commonly thought that meal time is in fact the problem. When I was deep into my eating disorder, going out to eat was SO MUCH more than an hour at a restaurant. It was the fasting before and after; it was the fear of eating in front of people; it was planning a binge later in the night so I didn’t have to eat in front of people; it was looking up the menu online beforehand; it was counting calories hours before I stepped foot in the restaurant.

It is better to bring up the specific behaviors later in the day when meal time is over. Stick to the specifics about behavior and don’t make it personal. An example: “I noticed when you were at dinner tonight, you ordered a low calorie entree, and you kept putting parts of the meal in the napkin on your lap.” –> I know, easier said than done!! I’ve been the recipient of a lot of insensitive mealtime comments, but I’ve also given some insensitive mealtime comments to friends I knew were struggling. I get it: Frustration can mount in the moment at mealtime, but try to hold off until later. You’ll end up having a much better conversation.

. . .

4. Do focus on food…

… but look at the greater picture, which has a whole lot more to do than just food.

Someone I knew in graduate school said something to the extent of, “I don’t know why families don’t lock the family member with an eating disorder up and force the person to eat.”

While that is absurd, I have heard so many comments that are similarly invalidating and off base:

“Just eat.”

“It’s not that hard.”

“Don’t make this such a big deal.”

That approach doesn’t work.

Eating disorders are both about food and not about food. Of course, eating disorders are highly related to weight and food habits (that’s why they’re called eating disorders) but in some respects have little to do with food.

Restriction was my teenage coping mechanism to deal with a lot of internal chaos– undiagnosed generalized anxiety, crippling OCD, existential anxiety, depression, and feelings of hopelessness, and worthlessness.

In my years of being symptomatic, I was way more likely to talk about those things than my eating habits. I hated when people would make it seem like gaining weight or eating would solve all of my problems. My eating disorder served multiple functions in my life, and until I dealt with those, I didn’t get truly better.

On the other hand, eating disorders are necessarily about eating.

If someone is underweight or malnourished, it is impossible to look adequately at the big picture. Medical, nutritional recovery is a precursor to psychological recovery.

Sometimes in more psychoanalytic approaches to recovery, it is conceptualized that when a person deals fully with the psychological parts of the eating disorder, the symptoms will dissipate. That also doesn’t work.

If you are bringing the subject up with someone, consider the rather paradoxical statement that eating disorders are about eating, but they don’t give us the full picture of what’s going on.

. . .

5. Do take action if necessary

… but think it through first.

Eating disorders are dangerous.

Period.

It is well-known that anorexia has one of the highest mortality rates of all mental health issues, but it is definitely possible to die of bulimia or binge eating disorder too.

The first thing I tell people who haven’t gotten into treatment is: SEE A DOCTOR.

Eating disorders can be associated with some serious medical complications that can kill including (not an exhaustive list): potassium/ electrolyte imbalance, low heart rate, low blood pressure, and general heart abnormalities (that’s why people with eating disorders must have regular EKG’s).

I will reiterate here that someone of average weight, overweight, or obese can die of an eating disorder as well. All of the above medical problems can happen to a person at 70 pounds or 370 pounds.

That is why if you truly suspect a loved one or friend has an eating disorder, don’t stay silent.

In all three of my three major anorexia tail spins, the initial descent into the illness and two subsequent relapses, I needed intensive medical intervention to get back to normal. Two of those times, it was not of my own choosing. Friends, family, and even my school had to intervene on my precarious downward spirals, and thank God they did. Otherwise I might not be here right now.

With that said, if you are seriously concerned about someone who is NOT getting treatment for an eating disorder, there might be cases in which you should advocate for medical consultation or even hospitalization.

For someone with a SEVERE and UNTREATED eating disorder, it could be that lovingly suggesting a trip to the doctor or ER for a medical evaluation is what is needed in the moment. Or, perhaps looking up residential treatment options and calling the person’s insurance company for help.

** Now: Before you attempt this kind of conversation with someone, heed caution! Most people who are diagnosed with an eating disorder have a treatment team or are getting support of some kind. If that is the case, step back and offer support in other ways. Suggesting hospitalization or a doctor consultation additionally has a high likelihood of pissing off the person’s eating disorder, so be prepared that you will likely be met with resistance.

There are some cases when this kind of conversation happens more organically: For example, if a friend passes out or complains of heart palpitations.

. . .

I think the reason many people don’t express concern to a friend or family member about what they’re seeing is out of fear. I get it– it’s scary. People don’t inherently know how to bring it up or what to say.

You are brave and caring to consider having a conversation that might save a life. Sometimes simple comments can go a long way, things like:

“I love you, and I’m concerned about you.”

“It seems like you’ve been struggling lately, and I want to help.”

“If you ever want to talk more about what’s  been going on for you, I’m here for you.”

For more information or to take a free screening, check out NEDA’s website.

In keeping with the National Eating Disorders Awareness Week slogan for this year, I’ll finish with this: “It’s time to talk about it.”

On Gaining Weight

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Weight gain.

Even the words can be uncomfortable.

In a society that shuns women gaining weight for almost any reason, talking about gaining weight is understandably awkward. However, for people in eating disorder recovery, weight gain (recovery reframe, courtesy of my dietitian: weight “restoration”) is often a natural, healthy part of the process… and yet, rarely do people talk about it.

So let’s talk about it. Let’s talk about weight gain restoration.

I have had to gain weight at many points in my life… the consequence of relapsing in and out of anorexia for years. The most excruciating times have been in residential treatment, when I was expected to gain 2-3 pounds per week.

In the purpose of being real, my experience of weight gain has been less than wonderful. In treatment, I spent a lot of time in oversized sweaters, laying stomach-down on couches, and trying not to gag over my thrice daily supplements. The whole process was physically uncomfortable, not to mention that psychologically, it felt like a death. I was starting to look “normal,” and I didn’t know how I felt about that.

From what I can tell, my experience of restoring weight is not unique. Someone with anorexia gaining weight is the equivalent of someone afraid of heights who has to use the Empire State building elevators every day for work, or someone with a spider phobia working in a spider-infested cubicle.

It sucks.

My main point is this: Weight gain restoration is horribly sucky but it is an absolutely crucial reality of anorexia recovery. For the rest of the post, I’m going to unpack that.

Why it is sucky:

  1. It is physically difficult for someone with anorexia to gain weight. *Disclaimer: I am not a scientist or dietitian, but I’ve seen dietitians for years, so here’s what I’ve gathered from that. If you want information from a real science writer I’ll link to Carrie Arnold’s blog here.* When someone has been engaging in eating disorder behavior, the person’s metabolism is low and body goes into “starvation mode,” as it tries to conserve nutrients and body weight.  Weight gain is difficult because the body temporarily goes into a hyper-metabolic state, meaning: It can take a LOT of calories for a person who has anorexia to gain weight for a period of time. This hypermetabolism doesn’t last forever (it goes away after 3-6 months), but while it is in effect, the weight gain process is all the more difficult.
  2. Misinformation people give that scares the shit out of you even though what they’re saying is factually unfounded. I can’t even begin to tell you how many inaccurate, triggering things I’ve heard over the years like, “Wow, I could just eat a hamburger and gain 5 pounds.” Or, “I gained a pound yesterday.” Or, “That dessert went straight to my hips.” Or worse, “I just look at a slice of cake and gain weight!” The reality is that gaining weight isn’t so straightforward. Around 3500 calories equals a pound. So unless someone is eating an additional 3500 calories per day, gaining a pound from one day is highly unlikely (and note: that’s 3500 calories on TOP of what a person normally eats). Not even to mention, bodies can fluctuate about 5 pounds per day anyway, depending on the time of the month (for women) and fluid intake. If the scale is “up,” it is much more likely the effect of water, rather than a nighttime snack of cookies.
  3. The appearance comments are awful. It is hard for people not to notice if you’ve gained a fair amount of weight. I have heard my share of annoying, triggering comments over the years. Recently, someone came up to me and said, “You’ve put meat on your bones.” Um… ok? How is a person even supposed to respond to that? “Thank you…?” “I like ice cream…?” I mean… what? Even the, “You look healthy,” comment can send me into a tizzy. It’s better not to say anything. I know if I’ve gained weight. I don’t need to hear about how you feel about it. I wish I could say I can brush off the appearance comments with ease like the feminist, anti-fat-shaming woman I am, but I can’t. They affect me. As I said earlier, gaining weight already feels like a death.

Why it is crucial:

  1. I would argue that physical recovery is the most important first step to recovery from anorexia. Without that, a) the person’s life is at stake, b) the person’s bodily organs, such as the brain, heart, and other vital organs are not getting replenished, and c) the eating disorder is still serving some purpose and therapy is ineffective. I have spent years trying to half-ass recovery, or doing pretend recovery, while I really wasn’t willing to do the work, including braving the uncomfortable feelings of weight gain. Anorexia recovery often requires weight gain. If someone is underweight and that person’s dietitian says weight gain is necessary, it’s not just something optional. For me, the real work of excavating my life didn’t even begin until I was weight restored.

I get it. For people with anorexia, gaining weight sucks. There are a million things I would rather do than gain a bunch of weight. Weight gain is sandwiched (pun partially intended) somewhere between running, which I hate, and waking up early, which I also hate.

But withholding the necessary weight for proper bodily functioning is a form of self-abuse.

Again, gaining weight in recovery from an eating disorder is not optional. It’s not fun, but it’s also not optional. Partial recovery is not real recovery.

So my recovery warriors:

You are more than a number on the scale. You are more than bodily discomfort or a slice of cake. I know that getting to your goal weight is far from easy, and neither is the road to anorexia recovery.

I am saying this as much to you as I am to myself, because I have been going through my own weight gain — dammit, I mean restoration– process, and I’m not letting myself off the hook either.

Nothing wrong with a Body by Boost!

Drops of Jupiter

It happens every year, as the seasonal sunshine wafts into my consciousness, and I remember….

Did you make it to the Milky Way to see the lights all faded, and that heaven is overrated?

I am almost 13 years old, and my after school regimen is set in stone. I walk home every day from my nearby middle school, make myself Easy Mac, and watch TRL (Total Request Live) on MTV with Carson Daly. I get my cheese fix, eyes glued to the music videos blasting on the screen. I remember my favorite song from that time period being “Drops of Jupiter” by Train. I listen to it over and over, and tears would roll down my face.

I do not understand why I cry, or why the emptiness inside throbs around my heart strings. My days are slow and boring, and my weekends are lonely. While other students plan end-of-school pool parties and spring sleepovers, I think about why some things are so beautiful and why others are so sad, and why there is a void in my soul, and I cry.

Tell me, did you fall for a shooting star–
One without a permanent scar?

My liposuction-obsessed nutrition teacher has a new assignment for our 7th grade class: record your food intake for a full day, and we will receive print out how our eating matches with how we should be eating. I am terrified for this day, just as I was terrified for a public weighing in gym class just a year earlier.

This is my chance, I tell myself. I want to show that I don’t have to eat Easy Mac every day, that I can forgo all snacks for sucking hard candy. Just for this day. I still remember that day, and the discipline it took to do what would later become second-nature: restriction.

The print out of my nutritional intake comes back, and it is affirmed that I had not eaten enough for the day. My reaction to this finding: relief. A deep sigh of relief that for one day I could control my pre-puberty hunger pangs. I am proud of myself, and I feel productive, much more productive than I have felt getting A’s in school. For the first time, maybe ever, I feel worthy.

The restriction doesn’t stick, because my body is growing rapidly, and I let myself honor my healthy appetite, but I will always remember this day.

And tell me, did Venus blow your mind?
Was it everything you wanted to find? 

I decide in the spring to go on a “diet.” Or more practically, I want to eat less at parties. I start trying to manipulate my food intake, and it blows up in my face. I restrict only to consume large amounts of sweets at parties anyway because I am so hungry from restricting. I grow increasingly frustrated at myself. I don’t want to be that person who gorges herself at get-togethers with friends. I start using the word fat in my deprecating self-talk. I want to be in control. I don’t want to get “fat” and get made fun of for my weight like other girls in my grade. I devote all my time and energy into making my “diet” work. I become obsessed with controlling my food intake. It doesn’t happen right away, but I am meandering, puttering around a black hole, and eventually, I fall into it.

The diet doesn’t stick.

Anorexia does.

And did you miss me while you were looking for yourself out there?

I fall hard and fast. Within only a month, a clusterfuck of genes and environment have culminated in the worst way– my genetic predisposition, personality characteristics, life stressors, and environmental/ social/ spiritual issues brew the perfect storm for anorexia’s sneaky suction cup into my life.

I know nothing about anorexia, but I am addicted to whatever it is that is happening to me. My life feels more manageable and safe. My inner loneliness is traded for obsessing about cookbooks and trying to force other people to eat. Emotional pain is replaced with constant fatigue, to the point that I wonder if I have contracted mono.

I no longer worry about parties or friends or being a failure. I am too tired, so I don’t give a shit about anything. All that matters is the scale, my weight, and my food intake.

I no longer cry. I no longer feel.

I like it.

It will change my life. It will ruin my life. It will almost kill me. But right now, in my 13-year-old starvation “high,” I like this.


Can you imagine no love, pride, deep-fried chicken?
Your best friend always sticking up for you even when I know you’re wrong
Can you imagine no first dance, freeze dried romance, five-hour phone conversation?
The best soy latte that you ever had and me

Fourteen years have passed since that season of my life, but those years have been filled with suffering and scars to show for the wear and tear. My body is weaker and has accumulated some permanent damage.

The worst thing I hear people say to me is that they wish they had my “self-control” in regards to eating. They have no idea what they are saying. Yes, my eating disorder resulted in weight loss. But at the expense of what?

I didn’t have late nights spent with friends in high school. The day of my high school graduation ceremony, in fact, I was too hazy to remember anything except for my internal debate about eating a snack. The month before I graduated from college, I was medically withdrawn and sent to treatment. Hours and hours and days and days and years and over a decade were lost of my life.

I didn’t have meaningful teenage memories. No 5 hour phone conversations with crushes. No staying out late. No eating out. Nothing fun was able to penetrate my stone wall of isolation and anorexia. For that I mourn.

And now you’re lonely looking for yourself out there.

Even now, chills run up and down my spine hearing the song “Drops of Jupiter.” I am haunted by the memory of a 13-year-old girl, barely a teenager, whose aching, throbbing soul wanted purpose and meaning and also macaroni and cheese. I am haunted about why what started as a cursory diet became a self-sustaining monster.

Looking back, I see the warning signs of anorexia in neon colors. It feels as though I am near train tracks, watching a train approaching as fast as lightning. I shout out to my sad 13-year-old-self standing in the tracks, “Get out, you have to dodge this train, whatever you do, move off those tracks.”

My aching, throbbing soul longs for answers and meaning for the long, lonely journey that has robbed me of vitality and life in the last 14 years. And yet, such answers elude me, so I must find meaning in the questions. As a perfectionist and control freak, this is unacceptable. I hate the questions, and yet I must live in them.

I can’t remember what it is like to eat without thinking about what I am eating. It is hard not to mentally tally calories when I spent over a decade memorizing the calories of every single food product ever invented.

I hope that someday my default response to stress will be to pull out a good book or do some deep breathing rather than the instantaneous craving to starve. I hope that someday I can eat a cookie without my mind analyzing the fact that I’ve eaten a cookie.

I want to know who I am. I want to get to know the existentially empty, angsty, anxious, insecure 13-year-old that is inside of me.

I don’t want to be a lonely wanderer.

Despite all the wounds and scars from a journey I never wanted to have, I can’t change what has been. Anorexia has been my past, and its after effects still impact me today. And yet, out of the tattered ruins of brokenness, I have to believe that out of ashes something beautiful will arise.

The 44-Pound Woman Story

FYI I will NOT be posting any thinspo images in this article, this is Rachael in a healthier place (my assumption)

It’s all over the media. It is trending on Facebook, Twitter, Instagram, and Go Fund Me: Rachael Farrokh, only 37 years old, made a social media plea to help her get treatment for anorexia, and her video went viral.

The media followed soon after, printing article after article with names like, 44 Pound Woman Dying of Anorexia Seeks Desperate Help. The world responded to this viral video and the subsequent news coverage, and Rachael’s Go Fund Me page raised over $120,000.

I am glad that  as a result of this, she is going to get help at Denver ACUTE, an eating disorder treatment center in Denver that helps with medical stabilization. I believe that Rachael Farrokh deserves and does desperately need treatment.

As an honest caveat to what will follow, I do not know extensive details on this story, so I cannot say I know much about this woman’s case. I have not watched her Youtube video plea, nor will I. I will not look at the ultra-thin pictures that pop up on my Facebook.

However, I will say this: the media coverage on this story has highly disturbed me.

In my opinion, the media coverage of Rachael Farrokh’s struggle for treatment does a disservice to all of us in:

1. Inaccurately portraying the reality of most eating disorders

2. Perpetuating the glamorization of anorexia and the exploitation of extremely sick individuals

3. Failing to address the systemic issues at play

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1. I want to take a step back.

Around 20 million women and 10 million men will struggle with an eating disorder in their lives. Currently, there are four major types of eating disorders (per the DSM-V): anorexia, bulimia, binge eating disorder, and otherwise specified feeding or eating disorder (OSFED).

One of the changes to anorexia in the new DSM is the removal of the criteria that people with the disorder must be 15% under their ideal body weight, because that is sometimes not the case. In fact, people with restrictive eating patterns or anorexia can appear of “normal” weights to others. 

Further, the most common eating disorder is NOT anorexia, it is binge eating disorder. Around 1-5% of people have this disorder, and it is associated with recurrent episodes of binge eating. Most people with this disorder, as well as bulimia, are of normal weight.

The point I’m making is this: people with life-threatening, treatment-meriting eating disorders do NOT necessarily have to be underweight to warrant immediate treatment.

You do not have to be 44 pounds to have an eating disorder… or 54, or 104, or 154, or 204.

Eating disorders are life-threatening and should be treated seriously at their earliest signs and symptoms. Purging can be life-threatening at ANY weight. Binge eating disorder and restrictive eating can be life threatening-too. People with eating disorders are usually required to get medical supervision because electrolyte levels, potassium, hormones, etc. must be monitored, thus reaffirming the point that regardless of the diagnosis eating disorders are serious.

This woman is not the norm of people with an eating disorder. Some or most of the time, eating disorders are not visible to the outside eye. At my “sickest” (binging, overexercising, restricting, whatever) people have been completely unable to tell that I was close to breaking down.

I worry about this media coverage. I know the way my brain used to think. I wanted to lose x pounds or get to x weight to feel like I was “worthy” of treatment. For people with eating disorders, this viral story can be triggering and harmful.

2. In a Communication class, I learned this point: “The media is the message.” I want to look at the message that comes through the articles.

In the news articles I saw, I viewed many pictures of Rachael looking severely emaciated and vulnerable, and media articles used words like “desperate” and “shockingly thin.” I’m glad that donations poured in, but why did this story become so popular in the first place?

The media has a strange, glamor-tinted fascination with anorexia. The more severe the story, the more people are interested. In a country full of “obesity epidemic” lingo and sayings like, “You can never be too rich or too thin,” culture is fascinated with people who maybe “went too far” by developing severe anorexia. They receive our sympathy points, and we read the articles. Oh yes, we read those articles about Rachael Farrokh. We saw the pictures, the many pictures.

The pictures that accompanied many of these articles (and the Youtube clip) are nothing short of what Kelsey Osgood coined, eating disorder porn. These images aren’t healthy to anyone. They are triggering to ED sufferers, exploitative of a woman who is clearly dying or is at extreme medical risk, and they falsely portrays what an eating disorder is like in most cases.

Rachael Farrokh is sick. Her body and mind are deprived of nourishment they need to survive. And in the midst of that the media is fascinated with how she looks, and these constant pictures seem exploitative, as if she is being show off in some theater of the grotesque and public pity.

Anorexia and other eating disorders are not sexy or glamorous, as media messages might indicate.

They are severe psychosocial disorders, and those suffering from them need treatment, rather than being exploited by their pictures being blown up on the internet.

3. Even as I write this, I think that deep down, this whole story is a farce to the real story. The real story is this: Stories like this should not be happening in the first place.

Why can’t all people with eating disorders receive affordable eating disorder treatment?

Why does there need to be a Go Fund Me page not only for Rachael but for anyone with an eating disorder?

Well, that’s an easy answer: because the American health care system is not conducive to helping people get eating disorder treatment. 

ED sufferers have a high mortality and relapse rate, and insurance companies (in my experience historically) do not like to cover full, comprehensive treatment for treating the disorder.

A few years ago, I was at a point in my life in which I was looking at doing IOP (intensive outpatient) treatment. My insurance company denied my claim for services, even though I was out of control and in desperate need for help. I flat-out asked this question: “If I weighed 5 pounds less, would you authorize me to go to treatment?” Whoever I was talking to at the ever wonderful Blue Cross didn’t directly answer that question but did say this, “You might have a better case.”

You might have a better case.

As if I have to plead the right to receive eating disorder services, that my insurance company is all but telling me: Lose 5 pounds and you can get the help that you need.

How fucked up is that.

As I’ve said in this blog post several times, eating disorders are severe, and weight is often not a good indicator of how much someone needs or “deserves” treatment.

Everyone deserves treatment. NO ONE deserves to go through the living hell of an eating disorder. While we heard about Rachael’s extreme story in the news, there are countless people who are unable to afford treatment and are dying as a result.

The American health care system needs to understand ALL eating disorders for what they are and be able to offer treatment for those who need it.

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In sum, the media has done a disservice to others with eating disorders. The articles full of glamour-tinted images of someone dying of anorexia do not accurately describe the experience of most people with eating disorders. In addition, no articles I’ve read mention the systemic injustices having to do with lack of insurance coverage for eating disorder treatment.

I have nothing against Rachael Farrokh. I hope she recovers fully and goes on to live a full, meaningful life. But the media, society, and we as individuals need to think critically about this story and how we understand anorexia and eating disorders in general.