Netflix’s ‘To The Bone’ Could Harm Those In Eating Disorder Recovery

Netflix recently released a trailer for To The Bone: a soon-to-be-released movie about a teenage girl with anorexia. The roughly two-minute and thirty-second trailer has prompted hours and hours of conversation on social media about the complex double bind that often results from depicting eating disorder behaviors in the media. While films like To The Bone can raise much-needed awareness about these often misunderstood illnesses, they can also potentially trigger relapse in those who are in recovery from an eating disorder and inspire those who are “on the brink” to engage in dangerous eating behaviors.

Raising Awareness or Glamorizing a Dangerous Illness?

Both the writer/director of the film, Marty Noxon and its star Lilly Collins say they have struggled with anorexia themselves and made the film with care and sensitivity. Noxon said in a statement posted on Twitter:

“Having struggled with Anorexia and Bulimia well into my 20s, I know firsthand the struggle, isolation, and shame a person feels when they are in the grips of this illness. In an effort to tell this story as responsibly as we could, we spoke with other survivors and worked with Project Heal throughout the production in the hopes of being truthful in a way that wasn’t explosive. My goal with the film was not to glamorize EDs, but to serve as a conversation starter about an issue that is too often clouded by secrecy and misconceptions,” she said. “I hope that by casting a little light into the darkness of this disease we can achieve greater understanding and guide people to help if they need it.”

However, as the National Eating Disorder Association points out in their guide to Responsible Media Coverage of Eating Disorders, the complex interplay of biological, psychological, and social forces that combine to ignite the onset of an eating disorder make depicting the stories of those who struggle with these diseases especially challenging.

Many eating disorder specialists have pointed out that the ways in which the To The Bone trailer shows detailed depictions of the lead character’s eating disorder behaviors can be triggering for those who are currently struggling or have a predisposition towards an eating disorder. They fear that the film can serve as inspiration and as a feature-length “How To” video for secretly and severely restricting food intake.

There is also some concern that the film may reinforce unfortunate stereotypes about what people who struggle with anorexia look like. The story centers around a young, white woman who looks very emaciated. While there are, of course, some people effected by eating disorders who fit that description, eating disorders can and do strike people of all genders, ages, ethnicities, and body types. Many people do not look extremely thin or ill in any way, even when they are deep in the throes of the disease. Reinforcing a false assumption about what those struggling with an eating disorder look like, makes detection of the disorder in those who don’t fit “the profile” much more difficult and puts them at greater risk of permanent physical damage and even death.

Should I Watch ‘To The Bone?

Project Heal, a not-for-profit organization that raises money and awareness for eating disorder treatment and prevention, sent an email this week in which they answered some of the Frequently Asked Questions about their involvement with the film. On the question of whether the film is potentially triggering to eating disorder sufferers, co-founder Kristina Saffran said:

“Eating disorder recovery was the most challenging journey in my life, and in the early stages, I was triggered by many things—friends from treatment, diet talk amongst peers, stepping into a gym, and seeing very underweight people. I had to understand where I was in my journey and avoid those triggers. As I progressed in recovery, I was able to be around those triggers, and now, facing them solidifies how strong I am in recovery and how I never want to go back. I hope that our community can keep this perspective in mind when carefully evaluating whether to view this film.”

If you are in recovery or are struggling with an eating disorder, it’s important that you be honest with yourself about where you are in your own recovery before you decide to sit down and watch this movie. It’s perfectly natural for you to be tempted by curiosity, especially when the film seems to be offering some validation and empathy for your previous struggles. But, if you have any doubts at all, don’t take a chance on compromising your recovery.

If you are not someone who has struggled with an eating disorder, but you intend to watch the movie in the hope that it will help you get a better understanding of what it’s like to battle one of these illnesses, take what you see on the screen with a grain of salt. And balance out what you see in the movie by reading the stories of the many different types of people who have struggled with the various types of eating disorders on the Project Heal, Eating Disorder Hope, and Remuda Ranch websites.

Ultimately, we do hope that the release of the film will lead to positive outcomes for those who struggle with eating disorders and their families by raising awareness of not only the dangers of the disease but also of the hope and healing that can be found with the right treatment program.

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Amy Winehouse’s Struggle with Bulimia Nervosa

Saying that there is an unhealthy expectation in our culture when it comes to weight and female celebrities is an understatement. Disordered eating is so normalized in our society that few people acknowledge the gravity of the disease unless they’ve experienced it first hand.

The documentary Amy, which won the Documentary Feature Oscar Sunday night, skims the surface on the subject of disordered eating in female Hollywood and its role in the life and death of famous singer-songwriter Amy Winehouse. Unfortunately, it’s still a far cry away from bringing to light the gigantic reality of Winehouse’s probable battle with bulimia nervosa.

As well documented as Winehouse’s struggles with alcohol and drug addiction were, the possibility of her untreated eating disorder was rarely mentioned. Her thin frame and swollen face were perpetually mocked in the media, but they were always attributed to drug and alcohol addiction. But the documentary does reveal how Winehouse struggled with disordered eating habits from a young age. The singer’s mother recounts the moment a young Amy tells her about a new “diet” she’s discovered – eating and then vomiting, which allows her to eat without gaining weight. Amy’s mother says she essentially ignored the statement, attributing it to a phase that she would grow out of. Amy’s father also dismisses the mention of her eating disorder when it’s brought to his attention.

The Contributing Factors for Eating Disorders

There is not just one cause of an eating disorder. Multiple factors are involved, including genetics, metabolism, psychological issues such as trauma, personality and coping skills, and mood disorders like anxiety, PTSD, OCD and most commonly, depression. According to the National Eating Disorder Association, "substance abuse can develop before, during, or after treatment for an eating disorder," and that reliance on drugs and alcohol is "both ineffective and counterproductive in that emotions remain unaddressed, problems go unresolved, and healthy strategies to cope are not developed."

A person with bulimia nervosa can carry on bingeing and purging for a long time while otherwise maintaining a high level of functionality. The same goes for those with anorexia nervosa, binge eating disorder and purging disorder. An eating disorder can be masked in the way its sufferers are typically able to tend to the demands of relationships and daily life. This makes it easy for friends, family members and peers to overlook the disease, as the footage and interviews in Amy make clear.

The Egosyntonic Nature of Eating Disorders

One of the biggest challenges when treating a patient with an eating disorder is the fact that EDs are egosyntonic, meaning the patient views their eating disorder as being in harmony with the rest of her personality and ego, and many sufferers don’t want to get better. For many ED sufferers, their disorder is misunderstood and their treatment is incomplete; they aren’t addressing the core issues of their disorder and they don’t realize the devastating effects the eating disorder has on their body.

Eating disorders have the highest mortality rate of any mental disorder, but many people don’t know that this is the case. Those who suffer from an eating disorder may die from a medical complication like heart or organ failure, caused by the EDs toll on the body. Unfortunately, these types of medical complications are reported instead of the eating disorder that compromised the person’s health, allowing the eating disorder to remain a powerful, yet silent killer.

Remuda Ranch Can Help

At Remuda Ranch at The Meadows, we provide individualized treatment for eating disorders and co-occurring conditions affecting adolescent girls and women. We offer an acute level of care as well as inpatient and residential programming in a safe, nurturing, and non-institutional environment. Our multidisciplinary team helps patients uncover and understand the underlying cause of their eating disorder and gain the courage and skills to return home and continue on the path of recovery. Please call us at 866-332-5209 or complete the form on our website to find out if our program is right for you.

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When Your Child Needs Inpatient Eating Disorder Treatment

Making the decision to send your adolescent daughter to an inpatient treatment center for an eating disorder may be one of the scariest and most difficult things you ever do as a parent. However, given the seriousness of eating disorders — anorexia, for example, has the highest death rate of all mental illnesses — it is important that you do insist that she get the treatment she needs. As a parent, your influence is more powerful than you may think.

It is crucial that parents help young girls accept and participate in the critical care and inpatient eating disorder treatment they need. When patients are left to seek treatment on their own, they often will not follow through. They also do not see their eating behaviors as a problem, even in the face of obvious physical and emotional consequences.

Don’t Let the Disorder Make the Decisions

“You’re making a big deal out of nothing!”
“I don’t need to go away for treatment. I can get better on my own.”
“I promise I’ll eat if you don’t make me go.”

These are just a few of the responses you might hear when you tell your daughter she needs hospital-level care for her eating disorder. Most teens and pre-teens go to treatment in a state of denial. And, out of a sense of desperation brought on by their disorder, they may be very good at pulling the heartstrings that convince a parent to back down from sending them to treatment, or to remove them from treatment once they get there.

That’s why it is so important to stay strong when your child tries to tell you that she doesn’t haven’t a problem and can’t bear to be away. Trust your instincts. When your child begs you not to make her go, or to remove her from the care you know that she desperately needs, that’s the eating disorder talking, not her. Don’t let the eating disorder decide what’s best for your child.

If your child’s doctor, therapist, or outpatient treatment staff tell you that she needs partial hospitalization or inpatient treatment, it’s important to follow through. It means that they, as healthcare professionals, are very concerned about your child’s safety, and feel that she needs to be more closely monitored and receive a higher level of treatment to restore her weight and address any co-occurring health problems.

Sharing the Difficult News

How you approach the conversation with your child can have an important influence on her willingness to embrace her treatment plan and her perception of herself and her disorder. It’s perfectly normal for you to feel apprehensive about having the conversation. Here are just a few suggestions for helping to steer the conversation in a positive direction:

1. Be honest and hopeful.
2. Tell your child how much you love them and that this decision is being made by both parents and loved ones and is in her best interest.
3. Validate your child’s feelings but do not get into a power struggle. Example: “I know this is tough for you, but there’s no other option,” and/or “We’ll give you some time to calm down. Then, we can talk more.”
4. Express your complete confidence that she can and will get better.
5. Express your trust in her treatment and team, and your intention to stay in contact with them and support her in every way you can.

It’s also okay for you to ask for help from your treatment team in discussing the decision with your child. It is important, that you, as a parent, are the one delivering the news, but your treatment professionals can provide you with extra support and assistance.

Take Care of Yourself and Your Family Too

As you are focusing on your child’s health and well-being, don’t forget about your own. This is also a trying time for you and your family. Make sure you gather up a support network made up of friends, family, and perhaps even a therapist or other mental health professional to help you work through your personal emotional struggles.

Our Eating Disorder Program Can Help

It also might be helpful to choose a treatment facility for your child that takes a family-focused approach to treatment. At Remuda Ranch at The Meadows, families receive an extensive education on eating disorders, communication, and relationships. They also have the opportunity to do an experiential learning session with The Meadows Equine Therapy team and experience a full-day intensive “truth and love” session, where they and their loved one in recovery can share thoughts and feelings in a way they may not have been able to before.
For additional information about the treatment of eating disorders, please call to speak to an Intake Coordinator at 866-332-0836 or contact us online.

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Truth in Love: Eating Disorder Recovery for the Whole Family

By Michelle Wells, Remuda Ranch Alumna
It didn’t take long for Remuda Ranch to become my home and her residents my family, but my stay there was temporary. I knew that from the moment I arrived. Though letters from family and phone calls from home were comforting and something that I looked forward to, they were also a reminder that life beyond the ranch was going on without me.

That was good and bad, I suppose. One the one hand, it hurt. I had a husband and five kids whom I loved and missed dearly. On the other hand, it was in their voices, written notes and hand drawn pictures that I found the inspiration to live. The countdown until discharge was constant. The bridge that would get me there, Family Week, was a respite I had anticipated from the moment I arrived. After being away from home for weeks, the days leading up to Family Week were exciting and filled with anticipation. The other participants and I made welcome posters for our families. Laughing like school girls preparing for prom, we picked out our clothes, then planned and re-planned our days out.

In the quiet moments, though, I was nervous. Since our children were too young to participate, my husband and I would be a family of two. With the help of therapy and nutrition, I had changed a lot. Three concerns haunted me:
1. Not only had I gained weight, I still had a feeding tube in my nose. What would my husband think?

2. My denial had been shattered. I was really sick. I had hurt myself, but I had also hurt my family. Could my husband and our children forgive me? I had also been hurt. Could I forgive my husband?

3. As much as I wanted to go home, I knew I could not manage recovery on my own. Could our marriage become what I needed it to be? Could my husband love me the way I needed to be loved?

Learning How to Live and Love

When the big day came, I hung the posters and waited out front. As my husband pulled into the parking lot and waved, the gleam in his eye made his emotions clear. Kirk was happy to see me.

 

Though Family Week would be busy and challenging, our reunion was magical. As he held me in his arms relief washed over me, a baptism, of sorts, into our new lives. My husband still loved me. He kissed me then traced my feeding tube with his finger. I pushed his hand away. My face warmed, the heat rising to my ears. Tears boiled over and trickled down my cheeks. “It’s okay,” he said. “You don’t need to hide anymore.” He held my hands in his. “Besides, it looks kind of good on you.” We laughed until we cried and then we laughed some more. We had a lot to learn. Family Week would help with that.

The first couple of mornings were filled with education. While the residents remained on campus, Kirk and the other family participants spent the mornings learning about eating disorders, communication skills, and recovery. These lessons provided a foundation for understanding and insight, necessary skills for healing beyond Remuda Ranch. Time for reflection and communicating with my primary therapist helped Kirk gain insight. He, too, played a role in my disease. Though I was the one with anorexia, we both had issues, individually and together, that needed to be addressed in order for me (and for us) to heal. In addition, Kirk found empathy and strength from talking with the other families. He was not alone.

Just like residents were assigned to family groups at Remuda Ranch, we were split up into small groups at Family Week. A few families worked together with a team of therapist throughout the week. Some of that time was spent doing activities. When words seemed exhausting, Art Therapy gave us the opportunity to feel and put expression to our experience. Years later, we still treasure a mixed media project we created together. It is a precious reminder of heartache and restoration. Zip Lining and Rock Climbing, essential elements from the challenge course, pushed us to our limits, forcing us to trust and encourage each other and the rest of our “family.” We also laughed a lot. Anorexia, the thief that keeps on taking, had stolen our joy. We were taking it back.

Truth in Love

The most difficult part of the week took place behind closed doors with our family group. At the time, we seemed like an odd match for our group. We, two younger parents with little kids, were grouped together with “older” parents of college-aged students. It is only now, writing this, that I wonder if that was by design. It must have been. Much of my own trauma had taken place during my high school and college years. I learned and healed by watching and supporting the two other families share their hurts and heal their hearts. 

 

With the guidance of two therapists, each family took turns being the focus. Kirk and I were scheduled to go last. This was beneficial for us because both of us feel more comfortable after a time of observation. We listened and heard what pain and healthy disclosure sounded like. We watched and learned how to meet sadness and sorrow with compassion. We witnessed forgiveness followed by restoration and realized we need not be afraid. Through it all, we supported the other residents and their families. By helping others we come to understand ourselves more clearly. The message to both of us was clear: eating disorders thrive in isolation; hope and healing are found in community.

When the day arrived for our “Truth in Love” exchange, I was petrified. Introverted by nature, both my husband and I struggled to communicate. Our sensitive hearts were hidden behind layers of quick wit and sarcasm. Sharing on a deep level while sitting in front of others highlighted every weakness. However, much like yanking off a Band-Aid, it was necessary for recovery.

Kirk and I sat face-to-face and knee-to-knee. With the therapists at our sides for guidance, each of us shared from notes we had prepared. We began with a message of love, the foundation to which we could always return. We proceeded with our goals, the signposts that would guide us through the morning. Those were difficult but safe exchanges, baby steps for the leaps of faith that would come later. Beautiful moments, to be sure, but our knees were knocking (literally) because we knew what was coming. We took a break to regroup.
After a quick dose of encouragement from my therapist and a few moments to breathe, Kirk and I sat down again. My reserved husband sat in front of me, looked me in the eye, and asked forgiveness. Mistake-by-mistake, offense-by-offense, he admitted his faults. His voice stammered but he had never appeared stronger. Line-by-line, I forgave him. My forgiveness was real, but I remained stoic and still, shocked that my husband had done anything that necessitated forgiveness. I, after all, was the one at Remuda Ranch.

The morning was filled with stops and starts because I was still quick to disengage and dissociate. The therapists proceeded at a slow pace, careful not to overwhelm either of us. I shared my many wrongs, some obvious and some secret, and Kirk forgave me. We chipped away at the wall that dysfunction had built between us. We were choosing to forgive and move forward. Together.

Since a traumatic exchange was pivotal in the development of my eating disorder, our therapists had decided that a role play was important to my recovery. With the therapists’ guiding us, we reenacted the event. This time Kirk responded differently and acted as my protector. Although the scene did not play out as smoothly or dramatically as they had likely hoped, I learned and healed a lot. I understood that my husband was willing to risk everything to save me. I knew I was no longer alone. I realized that my family of origin no longer wielded power over me. I could create a future that looked different from my past.

After the intensive family work, our family group talked as a whole about our exchange. It was a valuable time filled with insight and support, a chance to look inside at ourselves and our relationship and an opportunity to learn from our experiences. By discussing what they had witnessed, the other families helped me see things about my behavior that I had missed. The others couples provided insight about our relationship.

Some shared how they had struggled with similar issues. They praised our strengths and challenged us in areas where we needed to grow. The other patients encouraged me. They had witnessed the progress I had made during my stay at Remuda. When we returned to campus, my Family Week group encouraged one another and held each other accountable. Giving and receiving support within the context of healthy relationships, I learned, brings lasting transformation.

The Long View

Though we had both grown a lot during Family Week, there was much work to be done, so before Kirk returned home we met with my primary therapist. This gave us an opportunity to discuss my needs, the importance of aftercare, and our plan for future treatment. An IOP would be necessary as I stepped back into the real world. We would need to continue working individually and as a couple, if I wanted to stay on the road to recovery. Our time with my therapist helped us get a realistic view of the long-term recovery process. I had been sick for a very long time; it would be a long time before I was well. With a concrete plan of action returning home no longer felt so scary. Kirk and I both had hope for our future.

 

Family Week was an important part of our healing. My husband understood much more about eating disorders, relationships, and recovery. He better understood the severity of my illness, but he also felt more equipped to build a future. Family Week helped us remember what it felt like to love and laugh again, but it also gave us the desire to talk about the hard things.

Family Week gave us a sense of community and family. We no longer felt like “freaks” battling an unknown foe. Family Week remains in our hearts as a time of healing and promise, a retreat to the desert where we caught our breath, gathered our tools, practiced our skills, and built our army. I now see it as a sort of boot camp. The lessons we learned during Family Week continue to teach us and shape our relationship.

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Few Facts About Teen Anorexia and Adult Anorexia

Eating is part of our daily activities. We cannot live without food for more than 11 days. However, there are girls of age 8-35 who under the peer pressure, become victim of Anorexia Nervosa. Anorexia in teens is very common these days due to pressure of maintaining good body. The victim fails to differentiate between good body and healthy body. She often avoids food or purges it out after eating. 

Below mentioned are some facts about teen anorexia and adult anorexia…

1. It is a type of mental illness. A person with eating disorder is categorized as mental patient struggling with making peace with the body. They often feel unusual eating habits damages their body.
2. Out of 10 anorexic patients, 9 are women and 1 is male. Women are conscious about their body thus, they practice purging of food.
3. Anorexia Nervosa could become a reason of death. Person obsessing with thin body often fall into the trap of anorexia nervosa. If it isn’t stopped on time, it could be life-taking experience. Many times girls do not share this with their parents and they become physically and mentally weaker day by day.
4. 30 million people are victims of one or the other eating disorder. As the girls grow older, their fear of becoming fat is overtaking their life. The 40% of girls in 3^rd grade are victims of anorexia.
5. Anorexia could be genetic. Thus, if a girl is anorexic or has been anorexic, there are chances that her daughter could suffer the same. Thus, one should keep eye on their children if they themselves have remained victim of anorexia.
6. Anorexia could also lead to depression and other disorders. Amongst all, very few get the treatment of Anorexia. Only 10% of people with eating disorders receive treatment. Only 35% seek treatment from a facility that specializes in eating disorders.
7. The most important fact about anorexia nervosa is that it can be healed with Remuda Ranch. Remuda Ranch heals every kind of disorder including anorexia nervosa. At Remuda Ranch we guide women and girls through recovery by examining the root causes of their disorders. For more than 25 years Remuda Ranch at The Meadows has been helping people recover from eating disorders. Our experienced staff is here to help you.

Because there is hope, there is help.

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