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To The Bones- A review from a dietitian

Friday July 14th, Netflix premiered the movie To The Bone.  Prior to the premier many had opinions of the movie. Some were fearful that it would glorify an Eating Disorder, some felt the movie would put too much focus on extremely thin patients with Eating Disorders neglecting those that are within normal weight but still extremely sick, and many had a lot of opinions about the lead actress who lost a significant amount of weight for the role disclosing she is in recovery for an Eating Disorder.

My colleagues and I discussed the pretense of the movie, I communicated to families that the movie was coming out in case their daughters and sons watched the movie, and Friday I went home from work and viewed the movie.

Although Hollywood has a way of sensationalizing everything there was a lot that the movie got right.

The opening scene where Ellen counts the calories as soon as she sees the food is a good depiction of how someone with an Eating Disorder thinks. Food is not sensual it is only a number, an enemy in fact that will cause weight gain. Although this is completely irrational, it is a strong belief that is hard to break.

The scene where Ellen is working as hard as she can to do sit ups even though it is extremely hard and most likely painful shows the persistence and how far someone will go to "burn" excess calories or use exercise as a coping mechanism to distract them from an emotion they are feeling.

The consistent body checking at night with Ellen's arms as a way to measure success or failure is a constant coping mechanism many with an Eating Disorder use.

All family members are affected by a loved one who has an eating disorder. In To The Bone you see the step sister who has unconditional love which allows her to be honest in famiy therapy about how hurt she is. The father, an ostrich, I'm sure loves his daughter but buries his head in the sand with avoidance. The mother who admits she accepts Ellen's choices, although she has her own pain, creates a significant emotion from Ellen which I believe ultimately allows Ellen to decide she wants to live, and the step mother who although awkward and completely out of line with passive aggressive statements, does not give up in trying to find Ellen the help she needs.

There's a very quick scene you can absolutely miss when Ellen is with her mom's where the family labels Dr. Beckham as full of himself (not the exact words) and blames him for therapy not working. This often happens with anger displacement and we witness it in the outpatient setting. Can you imagine the stress and confusion this can cause the person in treatment?

Throughout Ellen's time in treatment there are emotional responses that immediately cause Ellen to start sit ups or run up and down stairs. This demonstrates how exercise is used as a coping mechanism and you can see that Ellen has extreme difficulty processing or dealing with emotions, especially the love story that is intertwined in this movie.

Most of all the number one thing that To the Bone got right is that reducing isolation is important and that recovery is very difficult until the person with the Eating Disorder is ready to make a change and believe in themselves and their treatment team.

I do think this movie can definitely be triggering to those who are currently suffering with an Eating Disorder but I think it is very valuable for family members to watch. We'd love to hear what you think.

In Good Health,



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