Weighty con­cerns about a film

‘To the Bone’ di­rec­tor says care was taken not to glam­or­ize anorexia

The Washington Post Sunday - - ARTS & STYLE - BY BETHONIE BUT­LER

“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 pro­grams, 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 glam­or­izes 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 (bingeeat­ing 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 re­al­iza­tion 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 color 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 or­ga­ni­za­tion 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 glam­or­izes 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.”

An­other con­cern around the film is that Collins, who has been open about her own strug­gle with eat­ing dis­or­ders, lost weight for the role, which ex­perts say can lead to re­lapse for those with a his­tory of dis­or­dered eat­ing. For her part, Collins has de­scribed the film as a cathar­tic ex­pe­ri­ence.

“It was a new form of re­cov­ery for me,” the ac­tress told Shape mag­a­zine. “I was ter­ri­fied that do­ing the movie would take me back­ward, but I had to re­mind my­self that they hired me to tell a story, not to be a cer­tain weight. In the end, it was a gift to be able to step back into shoes I had once worn but from a more ma­ture place.”

Claire Mysko, chief ex­ec­u­tive of the Na­tional Eat­ing Dis­or­ders As­so­ci­a­tion, said she is en­cour­aged by the di­a­logue sparked by the trailer.

“Thirty mil­lion Amer­i­cans strug­gle with eat­ing dis­or­ders at some point in their lives,” Mysko said. “This is some­thing that needs to be talked about, and we need for peo­ple to un­der­stand that this isn’t a silly fad or some­thing that peo­ple choose.”

Mysko hasn’t yet seen “To the Bone,” but said she hopes Net­flix will pro­vide re­sources for view­ers who may be vul­ner­a­ble. NEDA has reached out to the com­pany ask­ing that the film link to its help line and text line. A rep­re­sen­ta­tive for Net­flix did not re­spond to an email in­quiry about whether the film will in­clude a link to treat­ment re­sources.

Asked if she might have ben­e­fited from see­ing a film like “To the Bone” when she was strug­gling with her eat­ing dis­or­der, Noxon paused.

“Yeah,” she said. “If I had seen where it leads, that no mat­ter what you’re go­ing through and how­ever you’re ex­ter­nal­iz­ing your anger and your sad­ness, ul­ti­mately it be­comes a ques­tion of ‘how do you want to live?’ The thing that my doc­tor did for me that so few peo­ple were do­ing was frame it not as a prob­lem I had with food or my body, but a prob­lem I had with my soul.” To the Bone be­gins stream­ing on Net­flix on July 14.


ABOVE: Liana Lib­er­ato, left, and Lily Collins star in “To the Bone,” a Net­flix film that looks at anorexia.

BE­LOW: Collins, whose char­ac­ter is be­ing treated for anorexia, has had per­sonal strug­gles with eat­ing dis­or­ders. She says the film “was a new form of re­cov­ery for me.”

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