Netflix’s ‘To the Bone’ isn’t the eating disorder film it wants to be. I would know.

ByMelissa A. Fabello

There was a moment, halfway through To the Bone, when I suddenly craved buttered popcorn.

I know, from years of counseling on mindful eating, that that’s called “habitual hunger” — desiring a food because you associate it with an activity. Usually, as I’ve taught myself, I would recognize that want, separate it from judgment and then honor it through eating. But that night, the idea of popcorn gave me pause.

See, a movie like Netflix’s upcoming release To the Bone can be dangerous for a person like me. The film follows the life (and near death) of Ellen, a 20-year-old woman with anorexia played by Lily Collins. Hopping from one inpatient treatment center to another, Ellen is defiant in her denial of the life-threatening consequences of her eating disorder, adamant she has everything under control. But when her stepmother manages to gain her admittance into a prestigious program led by Dr. Beckham, a specialist with unconventional methods and a high success rate played by Keanu Reeves, Ellen has to decide whether to really try to get better. The film is the directorial debut of Marti Noxon, known for her writing and production work on TV shows like Buffy the Vampire Slayer, Grey’s Anatomy and Unreal. As an eating disorder survivor herself, Noxon aimed to represent anorexia as authentically as possible.

I was diagnosed with an eating disorder in 2008, and although I’m mostly OK now, any seemingly trivial thing can trigger me back into restricting. And media depictions of eating disorders can be a minefield. Oftentimes, though the goal might be to normalize and destigmatize these illnesses that affect 30 million people in the U.S., films that aim to educate the public about eating disorders can be upsetting in their portrayals. When you take obsessive, compulsive behaviors, give them to a beautiful actress to interpret and then blow them up on the silver screen with gauzy lighting and artistic angles, you run the risk of glamorizing or romanticizing those very behaviors — especially in the mind of someone who’s predisposed to finding those acts enticing.

To the Bone falls into that trap a lot. It’s one of the better eating disorder movies I’ve seen, relying less on Lifetime-esque melodramatics and more on the complexity of human relationships. While much of the movie explores Ellen’s experiences with food and her body, more of it looks at how situations on the outside challenge her: her father’s absence, her stepmother’s awkward concern, her therapist’s tough love, her fellow patient’s romantic interest. They’re all caught up in an orbit around Ellen’s eating disorder, showing how painful the illness can be to everyone it touches.

But I kept a running list of potentially triggering images as I watched, and I got up to 15 before I stopped counting. Body checking, calorie counting, amenorrhea, lanugo: To the Bone shows extreme anorexia in all its horror, but also gives us the thinspiration of Lily Collins (who, by the way was required to lose weight for the role). It’s a visceral reminder of behaviors and symptoms that once felt so comforting and exhilarating conveyed through a character who embodies the “perfect” anorexic — someone who’s thinner and sicker than most people with eating disorders ever are.

Anorexia nervosa has the highest mortality rate of any mental illness at “around 10%,” former National Institute of Mental Health Director Thomas Insel wrote in 2012. But that doesn’t mean this is the only type of story that can be told about the subject. Considering the competitive “race to the bottom” mindset that many people with anorexia have, it’s a recipe for disaster to consistently portray the singular narrative of the near-death woman with anorexia. And for what?

Following the trailer’s pushback, Noxon posted on Twitter to explain that the creative team behind the film worked with Project HEAL — an organization that raises treatment money for people with eating disorders — to be “truthful in a way that wasn’t [exploitative].” She wrote that she didn’t want to glamorize eating disorders, but intended To the Bone to be “a conversation starter about an issue that is too often clouded by secrecy and misconceptions.”

Accuracy is admirable. But when we only ever show the most life-threatening examples on screen, we’re not being accurate to the reality of most eating disorders at all. This is a common mistake the genre makes: focusing on young women with anorexia who are gaunt and faint from malnutrition. Much of the drama in an eating disorder film revolves around the protagonist’s proximity to death and her loved ones’ insistence she may not survive. To the Bone is no exception. Ellen grows thinner and grayer by the minute, and every time her mother sees her, her shock grows more desperate: “You look like a ghost,” “She’s dying right in front of us,” “How is there even less of you?” This is an unfortunate reality of the illness — it’s just not the only reality. Should accuracy in portraying this specific experience of anorexia even be the primary goal in the first place? What about sensitivity? Responsibility?

The National Eating Disorders Association has a resource on their website called “Sharing Your Story Responsibly.” It’s a list of strategies the organization recommends for taking care of both yourself and your audience when discussing your experience. It makes seven suggestions, including not showing graphic images, not providing tips, not glamorizing willpower and not portraying eating disorders as hopeless, for example. It’s a reference I turn to often in my own work as a writer, activist and academic in the eating-disorder and body-acceptance fields. But of these seven recommendations made by NEDA, To the Bone breaks at least four, including some of the aforementioned along with not providing a resource list or trigger warning. That’s unacceptable, as the abundance of shock value in eating disorder media can hurt the very people you’re purporting to want to help.


In her 2013 book How to Disappear Completely, writer Kelsey Osgood names the problem with detailed depictions of eating disordered thoughts and behaviors: “Anorexia is contagious … It is a behavior that can be learned through stories.” While many works — both memoir and fiction — are meant to be cautionary, they can instead be instructive. For example, in To the Bone, a young woman with bulimia names the easiest food to purge and Ellen references a trick to tip the scale during weigh-in. What is the value in that? Who does that help? It may give the general public audience a better understanding of the inner workings of eating disorders, but is that more important than the destructive effects it can have on sufferers and survivors?

The question I’m left with is: Who is To the Bone for?

The answer is certainly not anyone who is fat, of color, disabled, trans or any other number of marginalized identities. The film features one male patient, one patient who is a queer, a plus-size black woman and lesbian parents. But these characters — though welcome and necessary in a homogenous genre that tends to focus on the plight of thin, white women — feel tokenized. Reduced to flat characters, their tropes (the man is an effeminate dancer, the implicit joke as he develops feelings for Ellen being that he might be gay; the plus-size woman struggles with binge eating, which is associated with weight gain) don’t challenge the stereotypes we hold about eating disorders so much as confirm them.

But To the Bone isn’t for sufferers and survivors who fit the thin, white, female prototype either, even when it revolves around us. There are some inside jokes that only those in the community would catch — a character who only eats peanut butter, a toast to the future with Ensure, a character with bulimia named Anna — which makes sense, given Noxon’s survivor status. But this film doesn’t feel like it’s been made with us in mind, not least of which because it tells a singular narrative that doesn’t ring true for most eating disorder experiences.

Eating disorder movies are made to titillate the general public, ostensibly to rouse them to action but really to incite pity and fear, bringing on catharsis. To the Bone is “quirky” cool with a heavy dose of sarcasm, and the portrayal of anorexia will likely feel authentic to some people’s experience. But we’re not here to be gawked at, to be inspiration porn. And while I appreciate this movie aims to wake people up to the devastating reality of the most extreme eating disorders, I’m more worried about how it could hurt those of us who live with those stories in our bodies.

Show me an eating disorder story that focuses on the trials and tribulations of recovery, rather than the despair of the illness. One that centers marginalized people who are too often ignored in these spaces. A story that shows something other than the worst-case scenario, advising how to recognize a problem in someone flying under the radar. That doesn’t run the risk of ruining me in the name of authenticity. A story like that would be revolutionary. A story like that would start a conversation I want to be a part of.

In the meantime, I have a bowl of buttered popcorn to finish.

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