Why “To The Bone” Gets Anorexia Wrong (And How To Change The Narrative)

As an anorexia survivor, I am befuddled and stunned by To The Bone.

Not only is it “shallow, sexist, and sick” but it is not even a good movie. An article in the Atlantic says the film, “is a mostly unremarkable film about anorexia, in that it follows the model of virtually all existing films about the subject.” It is to be noted that as I’ve written before, almost all eating disorder movies are awful, so “following the model” is not great press.

I am not even going to elaborate here on my disappointment with Project Heal, a major eating disorder advocacy organization that publicly endorsed the movie and even had a viewing party for the film. In addition to this, most treatment centers were quiet on taking a stand, and as Laura Collins Lyster-Mensh writes in a refreshing departure from generic “viewing guidelines” put out by almost every eating disorder organization, “We are all under pressure to promote the film or just talk about it, which is also good publicity.”

Project Heal co-founder Kristina Saffran suggests in a BBC interview that To The Bone is meant for the general public, in that the movie aims to open up a larger conversation. In this blog, I’m going to be talking about my concern about this portrayal of anorexia to the larger community.

To The Bone will open up a conversation, but I’m not sure if it’s the right one.

I see the movie as Marti Noxon’s story and as her message of hope. Ellen/ Eli is a brooding twenty something, full of teenage angst and emo, pro-ana Tumblr drawings. Chocolate, dances in waterfalls, and somewhat hallucinatory, dreamlike moments compel Ellen/ Eli to choose life at the end of the movie… or so we think. The movie ends with the possibility of hope and new beginnings as Ellen/ Eli re-enters treatment.

If the film is indeed a loose adaptation of director Marti Noxon’s own anorexia struggle, viewers are led to believe Ellen/ Eli does end up in recovery. Noxon and fellow film actors consulted with Project Heal in the making of the movie and have done subsequent promotional eating disorder awareness campaigns.

The movie might seem as if it has a pro-recovery message, but it doesn’t.

Despite the movie ending with Ellen/ Eli choosing hope over despair and death,  I will argue that the movie highlights hope instead of recovery. 

Hope and recovery are separate but related constructs, and it is dangerous to meld the two concepts. You can have hope without recovery and recovery without much hope. Let me explain.

When I was forced went into treatment for the second and final time, I was not at “bottom,” or so I thought in my nutrient-deprived mind. I wanted a month longer to get to however much lower I could get my weight. Did I have a reason? Did I want to die? I didn’t have a reason, and I didn’t want to die when it came down to it.

I also did not have hope.

When I entered treatment, I subconsciously knew I didn’t want to die, but I had no reason to live, either. My starved brain and starvation-based depression had me living in a cloud of darkness. When the brain is deprived of nutrients, it does not function optimally. I was not capable of hope or feeling much at all, actually.

My first morning of treatment, I was given breakfast. I looked down at the plate, having not eaten breakfast for at least a year. My immediate thought was, “I guess I’m eating breakfast now.” And I ate breakfast. It was not “orgasmic,” as To The Bone would absurdly indicate. It was just breakfast.

So I ate. I talked about my depression and hopelessness with my therapist. In full disclosure, it didn’t get any better for months. I didn’t feel happy to be alive or worthwhile as a human being. Sometimes I don’t even to this day.

The big difference between Ellen/ Eli’s hallucinatory revelation and my story is behavioral: I sat down to breakfast. I didn’t fake my way through treatment. I went through the motions. I ate snacks that challenged me.

It was not perfect, easy, or fun, but I did it with the anticipation that perhaps someday, I would feel happy. Someday, maybe, I would smile and mean it, fall in love and feel it, and find a career and enjoy it. Maybe someday. But that someday did not come into fruition for a long time.

Sometimes, eating disorder sufferers have to do the hard work of recovery without a reward.

Sometimes, we don’t have the luxury(?) of hallucinating in a desert to realize life is worth living.

Sometimes, we are plagued with ambivalence years into recovery, or worse, relapse and feel deep shame for the perception of letting others down.

Hope is a building block of recovery, but it is not the only building block. It is great when it’s there, but if it’s not, oh well. Doing the hard behavioral work is what helps people recover.

To be candid, there is nothing that is recovery-focused in To The Bone. I suppose it’s great Ellen/ Eli finds hope and returns to treatment at the end of the movie, but if this were real life, she would have to find an actual treatment center. To The Bone glamorizes a “treatment” that is a) not treatment and b) provides unnecessary, misleading, triggering details of some people’s experiences.

There is little that is pro-recovery in the entire movie. As Collins Lyster-Mesh describes perfectly:

There are no recoveries or recovered people in this movie. No one is abused, mistreated, or dies, but no one gets well or does any of the actual work of recovery from an eating disorder, unless you call having visions in the desert therapeutic. Insurance may not pay for that, but there’s no waiting list.

In eating disorder treatment and recovery, there is no lasting hope for the future without behavior change. Behavior change is not the only facet of eating disorder recovery, but it is a necessary precursor to life. Does Ellen/ Eli do the necessary work to get better, including eating more than one bite of chocolate the entire movie? We don’t know- that has been an artistic omission, and it is an omission that comes with implications.

The pro-ana commune that is passing as a treatment center in the movie is just a bunch of sick individuals talking about calories, restricting, cutting corners, and doing push ups. On a human level, it’s boring and sad, but on an advocacy level, it is terrifying and sad. Nothing about this is remotely pro-recovery. If this was a real treatment center, Keanu Reeves would have at least 10 malpractice suits on his hands for medical neglect and involuntary manslaughter (also maybe sexual assault depending on the nature of these nighttime “house calls” he does).

What scares me is not that these “unconventional methods” of essentially negligence will become in vogue (they won’t).

What scares me is what the larger public will see. What scares me is the conversation.

What conversation will come from this movie?

The movie may showcase hope, but it depicts a lot of other things as well. To The Bone is graphic, insulting, stereotypical, and crude. There are too many shots of protruding bones to count. I am concerned others will, perhaps subconsciously, file this away as a normative anorexia experience, or worse yet, see this pro ana colony as normative treatment.

The anorexia conversation needs to change. Anorexia films portray the same story over and over– a tragic, rich, white, straight, emaciated female with a “dysfunctional family” has anorexia.

To The Bone puts Ellen/ Eli into a tragic, starving girl Hollywood “type.” She looks waif-like and tragic as her family members fight in family therapy. She is an artist, but it appears that she is not working or going to school. She is emo, makes witty comments, and always wears dark eyeliner. She and the others in her “treatment facility” are not only able to access treatment but are able to take months off without working.

In my opinion, Ellen/ Eli is not a sympathetic character. She is two-dimensional and lacks depth. Yes, she is snarky and has enough eyeliner to star in a middle school PSA, but she has no hopes or dreams. I can relate to the narrowing of life that comes with an eating disorder, especially since she is sick the entire film. However, it doesn’t lead to interesting character growth.

Eating disorders are small and narrow diseases, and so is this movie. 

Anorexia is complex and multifaceted, and I saw none of that in To The Bone. To be frank, I didn’t feel anything at all for the characters or plot except for disgust at the triggering details that were unnecessarily included. Although I am also a white woman with privilege who struggled for years with anorexia, I do not relate whatsoever to this story.

To The Bone might be part of Marti Noxon’s story, but it is only a small part. The interesting part of Marti Noxon’s story is one that is untold by this movie- how she overcame anorexia and ended up being a successful director. That is interesting.

We don’t know where Ellen/ Eli would be in 5 years. She might open a successful indie art studio in New York City, or she might be dead. The audience does not get a window into her life or recovery. That does a disservice to survivors and the general public alike.

To The Bone does not get a pass just because it opens up a conversation.

I would be horrified if someone went up to me and said, “Do people actually get fed with bottles as part of recovery?”, or, “Do you think her mom’s postpartum depression caused her eating disorder?”, or, “Ellen got to wait until she ‘hit bottom’ so that’s what I’m going to do,” or, “Do you have ‘calorie Asperger’s’ too?” The list of misleading portrayals could go on and on and on.

We do need to have frank conversations about eating disorders.

However, To The Bone is not an adequate medium for doing so. The work should focus on awareness of the anorexia experience but also recovery and dispelling myths rather than perpetuating them. And if we’re going to make an eating disorder movie, at least can it be good??

We can do better than this. Everyone deserves better.