To the Bone’ doesn’t come out until July 14, but a trailer for the Netflix film – about a young woman’s struggle with anorexia nervosa – has already been getting mixed reviews.
Part drama, part dark comedy, ‘To the Bone’ stars Lily Collins as Ellen, a young woman who, after multiple stays in inpatient treatment programmes, grudgingly agrees to live in a group home run by an unconventional doctor (Keanu Reeves). It premiered to generally positive reviews at this year’s Sundance Film Festival, where Netflix purchased the global rights for a reported $8 million.
Netflix posted the trailer on June 20, prompting an intense Twitter debate around whether the film glamorises anorexia and whether it could be harmful or a trigger for those with eating disorders. The company sparked a similar conversation in April after releasing the drama series “13 Reasons Why,” which caused concern for its graphic depiction of a teenager’s suicide.
Director Marti Noxon and supporters of the film say it’s an authentic departure from the slew of made-for-TV movies and TV show subplots that have made eating disorders look like trends instead of life-threatening illnesses. But the trailer shows elements of the film – Ellen ticking off calorie counts for the items on her dinner plate, a close-up of her extremely thin frame – that highlight the challenge of portraying eating disorders on-screen in a responsible way.
Critics of the trailer have zeroed in on the film’s protagonist: a young, thin, white woman with anorexia, a prevailing narrative in pop culture despite the fact that eating disorders vary (binge-eating disorder is actually the most common eating disorder in the United States) and affect people of all backgrounds.
“It reinforces stereotypes about what an eating disorder is and looks like,” one survivor told Teen Vogue. “That imagery is everywhere, and it is actually celebrated in our culture.”
Noxon, the veteran writer-producer behind “Girlfriends’ Guide to Divorce,” “Unreal” and later episodes of “Buffy the Vampire Slayer,” based the film on her own battle with anorexia and bulimia, which began in her early teens.
She was aware of the film’s potential to be a trigger for some people and, as a result, tried to be “really conscientious in the way we approached how (Ellen) looked, how often we showed her body and in what context.”
“You want to help other people understand and have compassion for something they’ve never experienced, but you also want people who have experienced it to feel understood and seen and to give people hope,” she added. “At the same time we want it to be entertaining, so we were balancing a lot.”
Noxon wanted to avoid one trope in particular: “this idea that the perfectionist quality of anorexics is their most defining trait,” she said. It’s something she saw in a character with anorexia (played by “To the Bone” actress Ciara Bravo) in Fox’s short-lived dramedy “Red Band Society.”
“I appreciated their attempt to incorporate that as a real problem and a real illness,” said Noxon, who watched the series with her now 12-year-old daughter. But, she added, “it didn’t necessarily feel that the person writing it had really been through it.”
Noxon wrote ‘To the Bone’ a few years ago, inspired by another project (an early draft for the film adaptation of “The Glass Castle”) that required her to think a lot about her childhood.
“It really came back to me that I was still myself,” Noxon said. “I think if you’ve recovered from a traumatic illness, mental or otherwise, sometimes you just think of yourself as being sick. But I remembered that I still had my personality. I still had a lot of humor to me.”
That realisation gave Noxon a clear idea of how she wanted to approach the film, which she wrote in just six weeks.
“The character was going to have life to her. She wasn’t just one-dimensional,” Noxon said. “It wasn’t just about a sick person. It’s about a person struggling with her real demons.”
While “To the Bone” focuses mainly on Ellen’s recovery, it features a woman of colour battling an eating disorder and a male character with anorexia. Cynthia Bulik, founding director of the UNC Center of Excellence for Eating Disorders, has not yet seen the film, but said those inclusions are encouraging because Hollywood and news outlets often fail to show that eating disorders also affect people outside of the stereotype.
“Those people are less likely to seek treatment, they are less likely to be accurately diagnosed, because they don’t fall within the stereotypical presentation that their physician might expect,” Bulik said.
Bulik was among the collaborators on a document titled “Nine Truths About Eating Disorders,” which inspired last year’s public service announcement featuring the cast and crew of “To the Bone.”
“Eating disorders affect people of all genders, ages, races, ethnicities, body shapes, weights, sexual orientation and socioeconomic status,” Noxon says in the video.
It caught the attention of Liana Rosenman and Kristina Saffran, who met as teenagers while receiving treatment for anorexia. They co-founded Project Heal, an organisation geared toward helping eating disorder sufferers afford treatment.
Project Heal recently hosted screenings of “To the Bone” in New York and Los Angeles, but it has faced sharp criticism from members of their community on social media for supporting the film amid the trailer debate.
Rosenman and Saffran continue to stand by it.
“I thought it was very powerful,” Rosenman said. “There is a sense of humor and wittiness in it as well as just understanding what it’s like to have an eating disorder.”
Saffran doesn’t think the film glamorises eating disorders, but rather “captures how serious these illnesses are.” (Anorexia has the highest mortality rate of any mental illness, according to the National Institute of Mental Health.)
Still, the backlash to the trailer prompted Project Heal to compile a list of “Frequently Asked Questions” that recommend “carefully evaluating where you are in recovery before deciding to view this film.”
“Triggers are everywhere in eating disorder recovery,” Saffran said. “In many ways, it would have been impossible to make any sort of film that didn’t have the potential to trigger somebody who is struggling.”