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July 18, 2017

‘To the Bone’ on Netflix: A Therapist and Teen Review the Film

therapist review of 'To the Bone' on NetflixEven eating disorder experts have family members who struggle with eating disorders.

Today, I share my views on the film To the Bone with my teenage relative “Katie”* who is in recovery from an eating disorder - Bonnie Brennan, Licensed Professional Counselor and Certified Eating Disorders Specialist

Yes, ‘To the Bone’ is triggering 

Katie: The film To the Bone got my attention. It was unnerving to see an actress that skinny. I didn’t feel competitive, necessarily, but it was scary to see that things can get that bad. I would suggest that you consider not watching the film if you struggle with feelings like “not feeling skinny enough” or “not feeling good enough.”
 
Bonnie: I appreciate this perspective. A lot of what I have read is that people are worried that a trigger will lead to relapse, competitiveness or behaviors worsening.
 
A trigger is something that elicits emotional arousal, of any type. And, yes, this film elicits emotions. The filmmakers give a warning at the beginning of the film about this. There is no doubt that the images and depictions of behaviors are graphic and will bring up all kinds of thoughts, feelings and memories for those affected by eating disorders.
 
Learn more about managing eating disorder triggers
 
I recommend that anyone (family, friends or persons affected by eating disorders) make a mindful decision to watch this film by discussing it with a treatment team or support persons. Remember: this film will be around; there is no rush to watch if you do not feel ready.
 
If you watch the film, do so with a support person and be prepared to write down some notes about what may be triggering for you. Leave some space for discussion afterwards or take your notes to therapy with you.

‘To the Bone’ shows the diverse nature of eating disorders 

Bonnie: Eating disorders come in all shapes and sizes and affect all age groups, genders and cultures. With an estimated 30 million people affected by eating disorders, it is encouraging to see this film showcase diversity in the characters. While by no means does, the film represent all the types eating disorders encompass, we do get to see a male character and an African American character.
 
Katie: Some of the more diverse characters weren’t paid attention to enough. I would have liked to see more depth in their representations.

‘To the Bone’ highlights family involvement

Bonnie: A major strength of this film was its highlight of diverse family systems, including a lesbian couple and a stepmom who does the hard work of showing up —despite conflict and her own desperate attempts to understand and connect with her stepdaughter.
 
The film also shows themes that we commonly see at ERC: 1) parents blaming themselves and 2) family members wrestling with the very real possibility that their loved one may die.
 
Katie: I don’t think the stepmom in the film was considerate to people with eating disorders. I thought the dad should have been there more; my own father has always been there for me. I could relate to the broken family and drama that comes with divorce and remarriages.

Eating disorder treatment not typical in ‘To the Bone’

Katie: I reacted strongly to the psychiatrist who didn’t seem to care. The psychiatrist also didn’t seem to try hard enough to help the family work through it all. All psychiatrists are not like that!
 
I also had issues with how meals were represented and how the residents of the treatment center got to choose what to eat or how much to eat. This is not typical of eating disorder treatment at all, especially in a 24-hour care setting. If you have an eating disorder, you probably aren’t going to want to eat.
 
Bonnie: Here at Eating Recovery Center we take a more standard approach to meals: all food groups are represented, staff support full completion of meals and staff redirect food behaviors. Although, in the film, we do get to see some common disordered-eating behaviors that may 1) raise awareness for family members and 2) “trigger” those with eating disorders.
 
Also, most inpatient settings, especially for people with medical complications, do not look like this: a house with little supervision and frequent passes. Typically, they look more like a hospital-type environment. The house-like setting of the treatment center in the film is more characteristic of residential or transitional settings. But many people with eating disorders won’t have the resources to be able to spend six months in a residential setting like this due to barriers: access to health benefits and limitations by third party payers.
 
I did, however, like how the main character went through several episodes of care. This is important to show since eating disorders may require various “chapters” in recovery. It takes time to cultivate a healthy relationship with one’s body and food.
 
I appreciated the psychiatrist’s focus on taking residents on an outing that was about body experiencing. I liked the question asked of the main character, “how do you want to live moving forward; who do you want to be?”

Lily Collins’ decision to lose weight for 'To the Bone' was risky

Katie: Losing weight like this was a big risk; she could fall back into a dangerous pattern.
 
Bonnie: Overall, I am grateful to the artists who made this film. They were courageous to tell this extremely emotional story. The message of not letting eating disorders thrive in secrecy and isolation is brave and important.
 
I’ve treated enough people over the years to know that deciding to go public and do a film about one’s own eating disorder must have been a very difficult one to make. I am hopeful that this artist made this decision from a place of love and purpose, to raise awareness and shine a light of truth on a deadly illness.
 
To the Bone is an artistic story, through the medium of film, of one woman’s recovery. Art serves a very important purpose in our culture. It expresses issues that we are dealing with at a point in time, serves as a lens from which to look from and gives us a story to consider. As a therapist, I support artists using their voices to give us a powerful and touching story that highlights some hard truths.

Bonnie Brennan, MA, LPC, CEDS is Senior Clinical Director of Adult Services at Eating Recovery Center.

*name has been changed for privacy reasons

Eating Recovery Center on eating disorders and the film 'To the Bone'

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