The new Netflix movie is a remarkably tone-deaf and insight-free depiction of anorexia nervosa, writes Lucy Kelly.

Content warning: this article discusses anorexia and other eating disorders in detail, which may be triggering to sufferers and survivors.

It was summer in 2011 and I lay in my bed and went through my ritual of checking the bones on my body. Collarbones jutting out from my shoulders; spindly pinpoint elbows; my hip bones so sharp I didn’t need a razor blade to cut myself, I could tear my skin from the inside out with the marrow of my bones. I would tiptoe into the bathroom and take off all my clothes and step shivering onto the scales. This number would determine how my day went – how many calories I was allowed to consume, how many kilometres I would have to run, how many sit ups I would have to do, and how many words of self loathing I would spew at myself all day. My BMI was one decimal point above underweight. I told myself with confidence that I was not sick, there was nothing wrong with me. I was just doing what the voice in my head knew was best. I was going to be the best. Like the Titanic at 11:39, I was not anorexic.

When I heard that Netflix was releasing a movie about anorexia, I was prepared for the worst. I was worried that To The Bone would minimise or glamourise anorexia, but the fact that both writer-director Marti Noxon and actor Lily Collins, who stars as Ellen, had themselves experienced eating disorders gave me hope. I wanted to be pleasantly surprised.

I wasn’t. In almost every conceivable way, To The Bone ties itself up in tired old tropes about anorexia. Sure, it’s better to talk about the illness than pretend it doesn’t exist, but this movie does about as much for the anorexia conversation as this article about a girl who cured her own eating disorder by getting fit instead. To The Bone is one more depiction of anorexia that only succeeds in trivialising the illness, encouraging the wholly incorrect view that a bit of positive thinking and self examination is all you need to get back on track.

Eating disorders are widely romanticised, this we know. Of all the mental illnesses, anorexia is perhaps the most glamourised and least understood. With a 20% mortality rate, anorexia is the most lethal mental illness; anorexics are more likely to commit suicide than depression and bipolar sufferers combined. You’re more likely to die as an anorexic than you are as a smoker. If you do live, there’s a 20% chance that you will never fully recover; the long term effects of anorexia will go on to cause you considerable ill health for the rest of your life. When you become unwell with anorexia at its most brutal and intense, your chances of a complete recovery are around 50/50 – in medicine those are terrible odds. So why do we continue to hear people say so offhandedly “I wish I could just be anorexic,” as if it is a lifestyle choice? Why do so many people refer to it as a diet that went too far, or call runway models anorexic as a descriptor for their body type? Why is it not accepted as a universal truth that anorexia is a serious condition and it can kill you?

For me, one of the most disturbing parts of To The Bone was the way it depicts Ellen’s parents. They’re detached and unsupportive, and the film suggests that they are in some way to blame for their daughter’s illness. That too is a stereotype of anorexia – no other mental illness lays the blame so strongly on the victim’s mother. But don’t say my parents should have done more to address my own eating disorder. My parents were in over their heads, with every available service denying them adequate help and their own daughter a monster stuck inside a skeletal little girl’s body. Anorexia doesn’t care how loving or careful your parents are, nor how useless and removed they are, nor how controlling and overbearing they are. Anorexia will destroy your whole family with no apologies. My mother continued to love me while I told her I hated her. She was there at every doctor’s visit, every hospital trip, every therapy session. She watched her child balance on the edge of life and death and beg to die, and she went on believing I would be someday okay, and kept fighting to make that a reality. And she got tired, and she felt helpless.

Surely both Collins and Noxon know that those who love you unconditionally before you got sick and during your ugliest moments are those that deserve accolades, not the boy who fell in love with you while you were in hospital. Which by the way, is perhaps the most ridiculous part of To The Bone. Ellen’s anorexia is a backdrop from which to hang another pathetic love story, as if love is always the ultimate goal in a woman’s life – not surviving, not growing, not healing, not claiming back the life your eating disorder stole from you.

Here’s a list of things I was concerned about once I started to recover:

• School
• My weight
• All my tattered and destroyed relationships with my friends and family.
• My weight
• My heart functioning physically
• My weight
• My reproductive organs
• My weight
• Being in pain. All the time.
• My weight.
• My future

Here’s a list of things I was not concerned about:

• Finding love
• Boys
• Girls
• Sex
• Romance
• Dating

But that’s not the only stereotype To The Bone embraces: there’s the token black girl who SURPRISE is also the token binge eater; the token boy, a ballet dancer; the one younger girl; the one who’s older. And of course all of them are white and middle class (don’t tell me I don’t know they’re middle class: they’re in a private treatment centre in a country without public healthcare – trust me, they have money). This denies the reality that eating disorders do not discriminate. Yes, anorexia is a socially communicable disease that largely impacts Western countries where media influence is high, and yes, it largely impacts girls and is less likely to affect those living in poverty (but there’s not a huge difference in anorexia rates in working, middle, and upper classes). But it’s also a fact that men get eating disorders, not just quirky ballet dancers but bodybuilders, and plumbers, and academics. People of colour also get eating disorders, and not only binge eating. And one other thing: anorexia is not the only eating disorder worth paying attention to. Sure it looks the prettiest – there’s a blatant ugliness to binge eating and purging that you can’t gloss over in film – but other eating disorders are just as common as anorexia, if not more so.

While inpatient facilities like the home depicted in the film do exist for private insurance holders in the US, there’s no such thing in New Zealand, bar a couple of hugely expensive private facilities. In fact in all New Zealand there are only around 10 inpatient beds allocated to adolescents with eating disorders, and these are all located within big public hospitals, and most often in general medicine wards. As soon as you’re well enough that you’re not actively ripping your feeding tube out, and your heart stops shrinking inside your aching chest, they either send you home or to the psychiatric unit. Which also has few available beds, and is also part of a bigger hospital. The psychiatric ward in Starship Hospital is on the ground floor, tucked in a dark little corner next to a looming brick wall. None of the windows open and there’s no outdoor area – not exactly To The Bone‘s picture of healing and self development.

The truth is that there needs to be a change in anorexia services in New Zealand; what we have now is just not good enough. I was waitlisted for treatment because I wasn’t actively suicidal (I lied about this), even though my BMI was alarmingly low and I was so medically unstable that my family had a hospital bag permanently packed and a pre written letter from my GP to show the doctors on admission. But I wasn’t sick enough for help in the eyes of the only eating disorder service in Auckland. That’s not the world of eating disorders as depicted in To The Bone, which suggests that all you need is a bunch of money, a man to love, a cool art exhibition and an inspiring poem to set an unwell person on the right track.

I related to fleeting moments in the movie. When the group therapy coordinator spoke of eating disorders as an addiction she was absolutely right. True starvation is a high like no other – it’s the best kind of drug and I never wanted to come down. I’d feel the cells in my body light up like fairy lights on a Christmas tree; my heart would race, my vision would blur, endorphins would fire. The way the characters in To The Bone spoke of the unbearable fear around consuming calories was equally relatable. When I was at my sickest my unhinged paranoia toward calories was like Donald Trump’s attitude to minority groups. But the rest of the film was so far from my lived reality that it was almost laughable – and therefore thankfully not at all triggering. The male doctor going into the girls’ bedrooms at night with them alone to talk? Telling her to change her name because he doesn’t like it? Referring to self harmers as “over achievers” when in fact the majority of eating disordered patients will have co-morbidities such as anxiety, depression, self harm, or suicidal ideation? Ludicrous.

I kept a diary of poetry from the day I first started restricting my calories until the day I was admitted to hospital. My angsty 16 year old diary does a better job of telling an authentic and engaging story than this film does.

Anorexia is not these gaunt girls looking like Kate Moss with dark eyeliner and baggy clothes; anorexia is not beautiful. It is not a phase, it’s not a diet gone too far, it’s not a choice, and you will not look like some frail little pixie with boys saying they’re in love with you and handsome doctors trying to unlock the door to your soul while gentle music plays.

You will be a monster. You will have a scratched raw voice from purging. You will cry while you run for miles on blistered broken feet. You will pass out when you stand, you will begin wetting the bed again, you will lie awake at night doing sit ups til your spine is bruised and bleeding. You will live a hollowed existence. You will hate yourself so much you want to die. You will lose all your friends. You will spiral into a place of insanity. where you can see the fat growing in front of your eyes, where the calories whisper sweet nothings into your ears, where nobody and no food can be trusted. The doctor will tell you that you are dying, that your organs are failing in your little glass body, and your heart is winding down like a clock coming to a halt and you will look them in the eye and say “I’d rather die than gain weight.” You will scream and beg your mother Let me die let me die let me die while she tries to get you to eat, you will decide that this death is too slow, too painful, too agonising. And you will clean out your closet, write your goodbyes and plan to take matters into your own hands.

And you will live. You will continue to scream and fight and tell them all that you don’t want to recover. And one day you will swallow your food without being coerced. One day you will finish a meal. One day you will look in the mirror and not burst into tears. You will stand complicit on the scales and try not to roll your eyes through group therapy, and try to be honest with your therapist. You will learn to nurture your body. You will find within you a will to live. You will feel fresh air on your face and wonder if maybe you have a future. One day, two years later, you will be walking down a street in Wellington and you’ll say “I’m hungry,” and your mother will swallow tears because it is the first time you’ve spoken those words since you were 14. You will recover. It will be so hard, so painful, so endless and exhausting, it might take five years. But you will survive. You will live a whole and meaningful life. And you will be okay.

Where to get help

• Need to talk? Free call or text 1737 any time for support from a trained counsellor
• Healthline: 0800 611 116. (Available 24 hours, 7 days a week and free to callers throughout New Zealand, including from a mobile phone)
• Families Empowered & Supporting Treatment of Eating Disorders (F.E.A.S.T) 24 hour online forum

The NZ Mental Health Foundation has more information and advice on the causes, symptoms and treatment of eating disorders.

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