 Credit: Netflix/Youtube Netflix’s new movie “To The Bone” opens with a warning that reads, “The film was created by and with individuals who have struggled with eating disorders, and it includes realistic depictions that may be challenging for some viewers.” While it’s partly true that some of the more realistic elements of the film could be incredibly triggering for those who are struggling with eating disorders (as well as for individuals who have the underlying genetics to develop an eating disorder), there’s also so much about this film that actually just perpetuates dangerous myths about eating disorders and recovery. The movie, which was written and directed by Marti Noxon and stars Lily Collins and Keanu Reeves, depicts a young woman’s battle with anorexia. It has been met with a lot of controversy, especially within the eating disorder recovery and treatment community. I think the creation of this film was well-intentioned. The director and lead actress both shared that they have personally struggled with eating disorders in the past and that their aim was to raise awareness and to diminish shame and secrecy. Raising awareness of eating disorders and decreasing shame and stigma surrounding seeking help is crucial. One of the positive aspects about the film is that it is opening a larger conversation about eating disorders and seeking treatment. However, as an eating disorder therapist in private practice, I have some major concerns about the way anorexia is being depicted in this movie and the impact that this can have on individuals. Concerns About The Movie As an eating disorder specialist, I know that often people with eating disorders struggle with the thought of “not being sick enough to need treatment.” This is a common eating disorder thought, and the problem with the depiction of eating disorders in this film is that it perpetuates the myth that people with anorexia always appear visibly emaciated. The film also goes out of its way to highlight Ellen’s frail appearance, with close-up shots of her spine and a scene where she takes her clothes off to reveal an emaciated frame. Therefore, I’m afraid people might view this film and think because they don’t appear “as thin” as Ellen they do not deserve to seek treatment. It also worries me that this movie is educating the general public along these same lines as well. For instance, so many people with eating disorders have experienced friends, family and treatment professionals saying incredibly damaging things such as, “You don’t look like you have anorexia.” It’s important to note that eating disorders (including anorexia) can impact people of all different shapes and sizes. You can be considered “normal weight” or “overweight” (I dislike these terms but use them to make my point) and intensely struggle with an eating disorder. You cannot tell who is struggling with an eating disorder by looking at them. Eating disorders are one of the few mental illnesses where we judge someone’s level of suffering based on their physical appearance. No matter what your body looks like, you deserve to seek treatment and support. The movie does depict a woman in a larger body; however, she of course struggles with binge eating disorder. Again, this is perpetuating the myth that you can tell what kind of eating disorder someone struggles with based on their body size, which is blatantly false. Does The Movie Glamorize Anorexia? I have a lot of compassion for the director and producer of the film, as it’s very difficult to make a movie about anorexia without glamorizing the illness. However, the issue here is that the lead character, Ellen, is super likable, glamorous, and “cool” as she is struggling with this deadly disease. Anorexia is not Lily Collins with a perfectly done smokey eye, staring sullenly out of the window, cracking funny/sarcastic one-liners, and enjoying fun escapades with friends and family. Anorexia is often feeling too depressed to want to leave your house. It’s isolating yourself from friends and family because you are afraid to be around food. It’s constant thoughts about food 24/7 and intense anxiety. For some, it’s hair falling out, low heart rate and osteopenia (however, even if you have no medical complications, you still deserve to seek treatment). It is a voice in your head that’s constantly yelling at you. It is feeling completely trapped. It’s not being able to find pleasure in things. It’s becoming a shell of your former self. While the movie attempts to show some of these complications, it’s easy to see how for those with the underlying genetics, temperamental, and psychological factors, this could easily become “aspirational.” Eating disorders are not glamorous, they are miserable and can be deadly. If you are struggling, you deserve to seek treatment and support. The Movie’s Depiction Of Treatment And Recovery I think the makers of the movie tried to highlight that anorexia is not simply about “wanting to be thin” and that it can have a devastating impact on family members, which was great. However, the movie missed the opportunity to dive deep and provide any real insight into the underlying causes of the illness (not once did they mention genetics) as well as how to effectively treat eating disorders. Further, the treatment approach shown in the movie is not at all realistic of eating disorder treatment. For instance, the woman with binge eating disorder randomly eats jars of peanut butter at every meal. Patients are allowed to choose their own food, and there appears to be little staff monitoring. Additionally, little is shown of the actual therapy component or of Ellen’s recovery journey. This aspect would actually have been helpful to highlight, as this depiction only serves to promote misconceptions about treatment and recovery. While hardly any of the actual treatment and recovery process is highlighted, specific eating disorder behaviors and “tricks” that people use in treatment are highlighted in abundance. Specific calorie counts are referenced, as are “lowest weights,” and a variety of detailed eating disorder behaviors that I will not reference here due to my desire to not unnecessary trigger anyone. We know that this kind of content can be highly triggering to people with the underlying genetics for an eating disorder and for this aspect alone, i’m highly concerned about the impact that it will have. Further, the doctor at one point advises Ellen’s family to “let her hit bottom” (terrible advice, and how are we determining “bottom” here, exactly?!) and tells Ellen that he doesn’t want to treat her if she isn’t interested in getting well. If many people with eating disorders waited until they “wanted to get better” to seek treatment, they would never seek treatment. Part of the illness is often an inability to see how “ill” that you actually are. Also, the movie doesn’t provide any resources for people who watch it and wish to seek help. It would have been easy for them to have a message at the end referencing The National Eating Disorder Association helpline; however, they chose not to do so. I was expecting to be riveted by the film, especially given that working with people with eating disorders is my passion. However, I didn’t actually even find it that interesting. It plays out a lot of tired old stereotypes about people with eating disorders, and while the main character is likable, I felt that the storyline overall fell flat. Ultimately, while I’m thankful that it’s prompted a larger discussion about eating disorders and raised awareness, I don’t think that it added anything new or helpful to the conversation. The Bottom Line If you or someone you know thinks that they might be struggling with an eating disorder, it’s so important to reach out for help from a professional. Seeking help when you are struggling is a sign of true strength, not weakness. No one should have to struggle with an eating disorder alone. With access to treatment and support, individuals with anorexia can recover and go on to lead meaningful and purpose-driven lives. Full recovery is possible! Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com
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 She told herself that it wouldn’t happen again. Then, after dinner she found herself reaching into the pantry for the jar of peanut butter. The TV plays in the background, as she compulsively begins to eat a package of Oreos and peanut butter straight from the jar. She feels completely out of control and powerless to stop. Thirty minutes go by, and she finds herself surrounded by empty boxes, cartons, and wrappers, from all the food that she just consumed. Her stomach aches painfully and her head is throbbing. Filled with a sense of guilt, shame, and self-loathing, she finally drifts off to sleep. It’s important to note that she is not simply “lacking willpower” or “making a choice” to eat until she feels sick. Rather, she is struggling with binge eating disorder. Binge eating disorder is the most common eating disorder in the U.S., however it is often highly misunderstood, stigmatized, and not frequently discussed. Additionally, many people who are struggling do not seek treatment due to shame, guilt, and denial of the seriousness of the illness. As an eating disorder therapist in private practice in Rockville, Maryland, I am grateful to be able to help teens and adults to recover from binge eating disorder. The following are my tips for how to cope the day after an episode of binge eating. 1. Practice self-compassion. Many of the people that I work with express feelings of shame and guilt after binge eating. It’s important to note that you are so not alone in feeling this way or in struggling with binge eating disorder. Binge eating disorder is a mental illness and you are not simply “lacking willpower” or a “undisciplined person.” No one would choose to eat until they feel physically sick. You are not choosing to struggle with an eating disorder, and you can make the choice to start working towards recovery. Also, you did the best you could with the coping skills that you had in that moment, and you can also learn from this experience. It’s so important to practice self-compassion, as well as to explore your bingeing behavior from a place of curiosity and non-judgment. “Beating yourself up” for bingeing will likely only serve to perpetuate the behavior and cause you to feel even worse. Think about how you would talk to someone that you love who was suffering from an eating disorder. It’s unlikely that you would harshly criticize and berate them. It’s crucial to practice saying kind things to yourself. You deserve to extend the same kindness to yourself that you would give to someone you love. 2. Nourish yourself, rather than restricting. The tendency or urge the day after binge eating is often to skip meals or to try to follow some kind of restrictive diet (yes, “clean eating” or cleansing falls under this category). Here’s the thing, I always encourage my clients (even if they are not physically hungry) to have a solid breakfast (plus lunch, dinner, and snacks) the day after a binge episode. It may seem paradoxical, but it’s also important they are start to honor their specific food cravings and begin to incorporate them into their regular meals. Restriction of food serves to perpetuate binge eating disorder and can be one of the triggers for bingeing (with emotional factors being another big one). If you restrict the day after a binge episode, you are actually fueling the eating disorder. I explain to clients that bingeing is often a natural and adaptive bodily response to real or perceived deprivation. Our bodies evolved to ensure our survival as a species and it makes sense that physical and/or emotional restriction can trigger subsequent binging episodes. If there were times of famine or food scarcity, we were primed to eat as much as possible when we encountered food again. Therefore, physical or emotional restriction of food can be a major trigger when it comes to binge eating. Physical restriction is the idea of depriving yourself of certain foods (i.e. not allowing myself to eat the brownie), whereas emotional restriction is eating a food while experiencing a sense of guilt or shame (i.e. I eat the brownie, but feel guilty about it). Thus, it’s important to work to challenge and eliminate any restriction, as part of your recovery from binge eating disorder. Also, it’s crucial to note that compulsive exercise or trying to “compensate” in some other way following a binge, is also only going to serve to perpetuate the binge/restrict cycle. 3. Do NOT step on the scale and instead do some self-care. If you still own a scale, I’d recommend throwing it out (although taking a hammer to it could also be therapeutic). I find that for my clients knowing their weight is unhelpful. If their weight must be monitored, then I ask that they do “blind weights” with their doctor or registered dietitian. Knowing the number that you are on the scale tells me nothing about your attractiveness, intellect, health, mental health, worthiness, or anything else of importance. When we focus on this external measure, we lose touch with our bodies and engaging in food and movement choices that actually feel pleasurable to us. Instead of stepping on a scale, I’d encourage you to practice some self-care. If you feel that your bingeing was triggered by emotional factors, I’d ask you to think about what feeling you were looking to experience (or to not feel) when you turned to food. For instance, let’s say that you were looking to feel “comfort” or “companionship.” You might then start to explore some healthier ways that you can start to get these needs met. For example, you might consider getting together with a friend or family member, playing with a pet, or drinking a cup of warm tea while cuddled up with a blanket. In therapy we also work on learning how to sit with and tolerate binge urges and uncomfortable emotions, primarily through using dialectical behavioral therapy skills. If you are not familiar with dialectical behavioral therapy (DBT) i’d highly recommend looking into this approach. The Bottom Line Living with binge eating disorder feels miserable. You are not making the choice to struggle with an eating disorder, however you can choose to reach out for help. Seeking help when you are struggling is a sign of strength, not weakness. With access to treatment and support, you can fully recover from your eating disorder, and find freedom with food, body-acceptance, and reconnect with your life values. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. She provides eating disorder recovery coaching via phone to people worldwide. Connect with Jennifer through her website: www.jenniferrollin.com |
About MeI'm an eating disorder therapist in private practice in Rockville, MD.  Archives
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