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The new eating disorders movie “To The Bone”

On Friday July 14th Netflix released a documentary about eating disorders and anorexia called “To The Bone”. The movie stars Lily Colins as Ellen who has been though treatment for anorexia many times and her family decides to try an “unconventional” approach with Dr. William Beckham, played by Keanu Reeves. The movie features characters from Ellen’s treatment center struggling with various eating disorders, as well as a focus on Ellen’s family life. The trailer for the film was already controversial and many eating disorders experts had commented that the movie could be triggering for many to watch. I have loved reading everyone’s thoughts on the film over the past month but wanted to wait until I saw the documentary before officially commenting.

I respect the fact that you cannot easily make a movie about a controversial topic and that many are going to disagree with details and have strong opinions about the outcome. However I really do appreciate that the project was made in the first place and know that it was made with the best intentions. Both the movie’s director, Marti Noxon, and star, Lily Colins, admit they have struggled with disordered eating and wanted to bring awareness to the public about this topic. This specific documentary has raised so much awareness about anorexia and eating disorders in a way that no “safe” educational documentary would have done. I believe the movie showed the pain and obsession that people go through when it comes to struggling with disordered eating. It presented a picture of anguish around food and showed all characters struggling with anxiety and depression, which is very true of clients with eating disorders.

With appreciation for the creation of the movie, I do have many concerns as others have expressed. My main concern is not really about triggering details, but rather about the overall concept that the movie showed “eating disorder treatment”. This “unconventional treatment” was NOT eating disorder treatment. In the movie this character was actually told “she needs to hit rock bottom before getting better”. Umm WHAT? Would you ever tell someone “Well you need to get to stage 4 cancer before getting chemotherapy?” The movie didn’t show the realistic amount of food someone actually needs in a day of ED recovery. The movie didn’t show therapy needed to process thoughts, feelings, and emotions of recovering from an eating disorder. And unfortunately it didn’t mention all the negative side effects of anorexia, including that anorexia has the highest mortality rate of any mental illness.  Some clients in the movie were given a TON of freedom, allowing for the “dramatic effect” to play out. Clients were allowed to skip meals if they choose to do so, and one client was allowed to eat peanut butter as a meal, not realistic in eating disorder treatment. As a side note, of course that “peanut butter client” had to be overweight and struggle with binge eating disorder, presenting a dangerous stereotype.

It’s a passion on mine to educate others about weight inclusive wellness but also weight-inclusive struggles. I liked the fact that the movie did not give specific weight numbers when characters stepped on the scale or talked about their body image (although the movie did reference calorie amounts), but I feel they could have done a better job at educating others that people in all different body shapes and sizes can struggle with disordered eating. There was a lot of controversy surrounding the main lead Lily Colins having to “lose weight in a healthy way” to play the role of Ellen. I understand that she worked with a nutritionist and had a lot of medical supervision, and was fine throughout the process. However, my jaw still dropped when I heard that considering she admitted she struggled with disordered eating. Trying to lose weight or “diet” when you’ve come from disordered eating is a recipe for disaster and can be a major trigger for stepping back into disordered eating.

Recovery is possible and unfortunately this movie missed the opportunity to educate others about that. I truly wish they showed what the other side of ED recovery is like instead of ending at unknown points with so many of the clients that were struggling. Even just a brief 10 minute closing about recovery would have made such a difference in this movie because it would have shown that life is worth living. I also would have loved to see resources about getting help, but there was no mention of valuable resources like NEDA (https://www.nationaleatingdisorders.org/) or ED referral (www.edreferral.com) to reach out to get help. But yet, to all the people involved with “To the Bone”, THANK YOU for getting people talking. If this movie was “safe”, it wouldn’t be receiving the attention it is. My husband sat with me as I watched the movie and actually had thoughtful questions about eating disorders and mental illness. I talk about this topic all the time but it took this movie for him to think about it in a different way. Remember if you are struggling, reach out for help because recovery is worth it.

Break Up With the Scale

As a dietitian that believes in the Health at Every Size principles, I choose to practice something I like to call weight inclusive wellness. I respect size diversity and believe that people of various weights can have healthy behaviors and habits, and also have a positive relationship with food.

I had a really great conversation with a client last week about why I hate the scale. I cannot take credit for the following analogy but I love it! Dieting for weight loss is like playing the slot machines at Atlantic City. You see everyone around you winning (ding ding ding!!) and go into gambling thinking that YOU will hit the jackpot. But remember, we all know casinos get your money and statistics show we will not win. This is why weighing yourself does more harm than good: We all think we’re going to see a number we like (aka hitting the jackpot) but statistics show we will not win. The scale will probably creep back up over time and lead to negative feelings about food and body image. The good news is that there is a solution in weight inclusive wellness. You can be happy and healthy without focusing on the scale.

why scales harm

5 Ways to Measure “Success” Without Using the Scale:

Instead of focusing on the scale to measure progress, try to ask yourself these insightful questions:

1. How are you feeling about overall body image?

2. Are you responding to different emotions in a way that works for you?

3. What can you do to increase your self-care?

4. Can you try to eat when you’re hungry and stop when you’re full and mentally satisfied?

5. Can you move your body in a respectful, joyful way?

These questions can help guide you to a plan of action to feel happy and healthy about food and body image.

Resources For Eating Disorders And Intuitive Eating

I find myself suggesting resources all the time to clients and healthcare professionals to help everyone learn more about eating disorders, intuitive eating, and health at every size. I figured it’s time to share these valuable books/podcasts/e-courses with all of you.  It doesn’t matter if you are a client, family member, or healthcare professional- we ALL have a lot to learn.

Top Resources for Eating Disorders

International Federation of Eating Disorder Dietitians www.eddietitians.com/

International Association of Eating Disorder Professionals www.iaedp.com/

National Eating Disorder Association www.nationaleatingdisorders.org/

BOOKS

Life Without Ed, by Jenni Schaefer

8 Keys to Recover from an Eating Disorder, by Carolyn Costin

Overcoming Binge Eating, by Christopher Fairburn

Almost Anorexic, by Jennifer Thomas

PODCASTS
(Find these in your podcast app or itunes!)

The Recovery Warrior Show

The Eating Disorder Recovery Podcast

Resources for Health at Every Size and Intuitive Eating

Registered Dietitians for Body Confidence www.rd4bc.com

The Health at Every Size Community www.haescommunity.org/

The Association for Size Diversity and Health www.sizediversityandhealth.org/

Intuitive Eating Community http://www.intuitiveeating.org/

BOOKS

Intuitive Eating by Evelyn Tribole and Elyse Resch

Intuitive Eating Workbook

Health at Every Size by Linda Bacon

Body Respect by Linda BaconBody Kindness by Rebecca Scritchfield

Savvy Girl, A Guide to Eating by Sumner Brooks and Brittany Deal

PODCASTS
(Find these in your podcasts app or itunes!)

Love, Food

Body Kindness

Food Psych

Dietitians Unplugged

Life, Unrestricted

The Body Love Project

E-COURSES

EDRDPro Symposium:15 experts (myself included!!) presenting on eating disorders, HAES, and intuitive eating! The symposium begins April 28th.

Kylie Mitchell’s IMMAEATTHAT “How to Eat” Course 

Christy Harrison’s Intuitive Eating Fundamentals Course

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