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***SPOILERS AHEAD***
To the Bone is a Netflix original movie about a young woman named Ellen who has a severe case of anorexia. After showing no signs of improvement or even the simple desire to get better, Ellen is sent home from a variety of inpatient treatment practices and programs. The only treatment option that remains is one final program that involves her living in a house with several other young adults suffering from similar eating disorders. The film showcases the symptoms of these disorders, their harmful effects, and the daily struggles these individuals go through. It powerfully depicts the healing process and tells a story of true perseverance.

Criticism

Much like Netflix original series 13 Reasons Why, To The Bone has been criticized for it’s portrayal of mental health. Topics of mental health are tricky, as they will likely receive backlash for one reason or another. This is because everyone has different experiences with mental health, different opinions related to how it should be discussed, and views on how this discussion may affect those exposed to it. The general concern is that the portrayal of anorexia, in this case, will be more harmful than helpful and/or glamorize the issue.

Interestingly enough, this discussion mirrors a plot in the film itself: It is revealed that Ellen’s art, which depicts her struggles with the eating disorder, caused one of her online fans to commit suicide. Though her drawings served as Ellen’s outlet for coping with the disorder, it became glamorized by her followers and inspired them to adapt unhealthy views and habits. The victim sends Ellen her suicide note, and the victim’s parents send Ellen explicit photographs of the suicide scene, clearly blaming her for their daughter’s death.

So the question of concern is, can sensitive topics like anorexia be discussed or portrayed without becoming glamorized or leading to further harm? While we’re still exploring the answer to this question, director of To The Bone, Marti Noxon, believes it’s important to tackle these important subjects, nonetheless. She also notes that it’s important for people to decide for themselves whether or not they are okay to digest this kind of material.

Lily Collins: Preparation for the Role

Lily Collins plays the frail, but furious Ellen in To The Bone. In order to accurately portray this character, Lily has to lose weight—a lot of weight. For Lily, this meant revisiting a troubling past, as she has a history of struggling with her own eating disorders. But she took on the task, comforted by the fact that a nutritionist would be supervising her every step of the way. Along with this transition, came unwelcomed comments—even compliments—from others. Lily recalls a moment when her mother’s friend admired her for the weight loss and even asked how to achieve the same look.

Lily assigned this reaction as one of the causes for the very existence of eating disorders. Society looks at any degree of weight loss as an achievement, leading many to have unrealistic and unhealthy ideals, concerning their bodies and their weight. This is one of many reasons director Marti and actress Lily wanted to take on this challenging film: they sought to showcase these unhealthy standards and the horribly harmful effects eating disorders can have on someone.

Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, there are a few requirements for a diagnosis of anorexia nervosa to be made. These include:

  • Purposeful, insufficient energy intake, which leads to a significantly low body weight in relation to age, sex, developmental trajectory, and physical health.
  • Intense fear of gaining weight or persistent behavior that interferes with weight gain.
  • Dislike of one’s body weight or shape, or lack of recognition of the seriousness of the low body weight.

All of these symptoms are present in Ellen, the main character of To The Bone. First, she is quite visibly underweight, due to a lack in nutrition. Though she wears baggy clothing that covers most of her body, we see her undress and reveal her unhealthily boney, fragile figure a couple different times for weigh-in. We also survey her eating habits continually throughout the show: she typically moves the food around on her plate without ever actually bringing the fork to her mouth. Second, she quite clearly fears gaining weight—she even injures her back, which becomes covered in bruises, due to her obsession and insistence on doing countless sit-ups throughout the day and night. And finally, Ellen demonstrates a strong dislike of her body weight and shape. She’s always working to lose more weight, measuring the circumference of her arm to determine progress. In addition to these symptoms, Ellen shows other cause for concern: she ignores her emotions, she becomes physically exhausted and fatigued on multiple occasions, and her actions are unpredictable.

Taylor Bennett

Taylor Bennett

Taylor Bennett is a staff writer at Thriveworks. She devotes herself to distributing important information about mental health and wellbeing, writing mental health news and self-improvement tips daily. Taylor received her bachelor’s degree in multimedia journalism, with minors in professional writing and leadership from Virginia Tech. She has published content on Thought Catalog, Odyssey, and The Traveling Parent.

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