In the landscape of mental health representation in film, few conditions have been as visually depicted yet psychologically misunderstood as eating disorders. Netflix’s 2017 film “To the Bone” attempts to bridge this gap by offering an unflinching yet compassionate look at anorexia nervosa through the eyes of a young woman’s battle for recovery. This film stands as a significant contribution to mental health awareness, challenging viewers to look beyond physical symptoms to understand the complex psychological underpinnings of eating disorders.

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Basic Film Information

Title: To the Bone
Release Date & Production Year: July 14, 2017 (premiered at Sundance Film Festival, January 2017)
Director: Marti Noxon (making her feature directorial debut, drawing from her own experiences with eating disorders)
Screenwriter: Marti Noxon
Main Cast & Characters:

• Lily Collins as Ellen/Eli, a 20-year-old artist battling anorexia nervosa
• Keanu Reeves as Dr. William Beckham, an unconventional eating disorder specialist
• Carrie Preston as Susan, Ellen’s stepmother
• Lili Taylor as Judy, Ellen’s absent mother
• Alex Sharp as Luke, a ballet dancer and fellow patient with an eating disorder
• Liana Liberato as Kelly, Ellen’s half-sister

Genre: Drama
Awards: Nominated for the Grand Jury Prize at Sundance Film Festival
Runtime & Rating: 107 minutes, TV-MA (mature themes, some language, brief sexual content)

Plot Summary

General Overview

“To the Bone” follows Ellen (who later chooses to be called Eli), a 20-year-old woman whose battle with anorexia nervosa has led her through multiple treatment programs without success. After reaching a dangerous turning point in her health, she enters an unconventional group home treatment program run by the no-nonsense Dr. Beckham. The film chronicles her journey as she confronts the roots of her disorder and struggles toward recovery.

Mental Health Themes

The film centrally explores anorexia nervosa but also touches on various forms of disordered eating, including bulimia and binge eating disorder. It examines the psychological components behind these conditions: perfectionism, control issues, family dysfunction, trauma responses, and the search for identity. The narrative also explores co-occurring mental health issues like depression, anxiety, and self-harm behaviors.

Key Turning Points

Several pivotal moments highlight the complexities of eating disorders: Ellen’s resistance to treatment protocols; her development of meaningful connections with fellow patients; a nighttime episode where she passes out from malnutrition; and a poignant scene where her mother “rebirths” her, symbolizing an emotional reset. Each turning point illustrates different aspects of the recovery process and its psychological hurdles.

Ending Analysis

The film concludes with cautious optimism rather than a definitive “cure” narrative. After a near-death experience, Ellen makes the conscious choice to pursue recovery. This ending respects the chronic nature of eating disorders while suggesting that genuine healing is possible with continued effort and support. This approach avoids the harmful trope of immediate transformation while still offering hope.

Setting & Cinematic Techniques

Filming Locations

The primary setting is a group home for eating disorder patients in Los Angeles, creating an environment that feels neither completely clinical nor completely casual. This middle ground effectively represents the liminal space between sickness and health that patients navigate. Brief scenes in Ellen’s family homes provide visual contrast, illustrating how different environments affect her relationship with food and her body.

Cinematography

Cinematographer Richard Wong employs techniques that subtly reinforce the film’s themes. The camera often frames Ellen in ways that emphasize her body’s fragility without fetishizing her thinness. Close-ups on food create moments of tension that help viewers understand the anxiety eating disorders can produce. The visual palette shifts subtly throughout the film, becoming warmer and more saturated as Ellen begins to engage more fully with life.

Sound & Music

The soundtrack features artists like Cigar, Dana Williams, and Lily Collins herself. Music serves as both diegetic coping mechanism for the characters and emotional commentary for viewers. Notably, silence is also used effectively during moments of high psychological tension, particularly during meals, mimicking the tunnel vision many individuals with eating disorders experience in food-related situations.

Acting & Character Portrayal

Lead Actor’s Performance

Lily Collins delivers a nuanced performance informed by her own history with an eating disorder. Rather than portraying anorexia through physical emaciation alone (though Collins did lose weight under medical supervision for the role), she captures the psychological complexity through subtle behaviors: the way Ellen counts calories under her breath, her ritualistic food arrangements, and the defensive humor she uses to deflect concern. Collins embodies both Ellen’s fragility and her fierce determination.

Supporting Cast

Keanu Reeves brings unexpected depth to Dr. Beckham, avoiding both the cold clinician and miracle-worker stereotypes in favor of a flawed but dedicated professional. The ensemble cast of patients offers diverse perspectives on eating disorders, challenging the stereotype that these conditions only affect young, white women. Alex Sharp’s portrayal of Luke, a male ballet dancer with anorexia, is particularly noteworthy for highlighting the often-overlooked reality of eating disorders in men.

Accuracy & Authenticity

The film benefits significantly from writer-director Marti Noxon’s personal experience with anorexia. Many moments ring true: the competitive dynamics among patients, the calculated ways Ellen circumvents treatment rules, and the complex family dynamics that often accompany eating disorders. The film also accurately portrays the medical complications of severe malnutrition, including the cardiac risks, without sensationalizing them.

Mental Health Representation: Strengths & Weaknesses

Psychological Accuracy

“To the Bone” succeeds in portraying eating disorders as complex mental illnesses rather than lifestyle choices or simple desires to be thin. It accurately shows how these disorders serve psychological functions for sufferers offering control, numbing emotional pain, or creating a sense of identity. The film also realistically portrays the ambivalence many patients feel toward recovery, an aspect often overlooked in simpler narratives.

Stigmatization vs. Awareness

The film walks a difficult line between raising awareness and potentially triggering vulnerable viewers. It includes specific behaviors that could be problematic for those actively struggling with eating disorders. However, it avoids glamorizing the illness by unflinchingly showing its devastating physical and emotional consequences. The film also challenges stigmatizing assumptions that eating disorders stem from vanity or that patients can simply “choose” to eat normally.

Impact on Public Perception

“To the Bone” helps counter several misconceptions about eating disorders. It shows that recovery isn’t linear, that these conditions affect diverse populations, and that they’re rooted in complex psychological and family dynamics rather than simple body image issues. The film also illustrates how conventional treatment approaches don’t work for everyone, highlighting the need for individualized, comprehensive care.

Critical Reception & Awards

Critics’ Reviews

The film received mixed reviews from critics, earning a 71% rating on Rotten Tomatoes. Many praised Collins’ performance and the film’s unflinching approach, while others expressed concern about potential triggers for vulnerable viewers. The Atlantic called it “a mostly sensitive, impressive debut from Marti Noxon that only occasionally veers into unnecessary territory.” Some eating disorder specialists criticized certain aspects while acknowledging the film’s overall value in raising awareness.

Audience Reactions

Reactions from viewers with lived experience of eating disorders varied widely. Many appreciated seeing their struggles represented with nuance and authenticity, while others felt the film included too many potentially triggering behaviors. The film sparked significant online discussion about responsible portrayal of mental illness in media.

Awards & Nominations

While not extensively awarded, “To the Bone” was nominated for the Grand Jury Prize at the 2017 Sundance Film Festival. Its impact was perhaps more significant in terms of cultural conversation than formal recognition.

Cultural & Social Impact

Discussions Sparked

The film generated substantial dialogue about eating disorders, particularly regarding treatment accessibility, the diversity of those affected, and the fine line between raising awareness and potential glorification. Netflix included content warnings and resources for viewers seeking help, acknowledging the sensitivity of the subject matter.

Influence on Other Films

“To the Bone” helped pave the way for more nuanced portrayals of eating disorders in film and television. Its release on Netflix also demonstrated that streaming platforms could successfully tackle difficult mental health topics, potentially encouraging similar projects.

Mental Health Advocacy

The film’s release was accompanied by resources for those struggling with eating disorders. Collins and Noxon spoke openly about their personal experiences during the promotion, helping to destigmatize these conditions and encourage those suffering to seek help.

Personal Reflection & Final Thoughts

“To the Bone” provides valuable insight into the lived experience of anorexia nervosa, particularly the internal contradictions patients face: knowing their behaviors are harmful while feeling unable to stop them. The film’s greatest strength is its ability to humanize individuals with eating disorders without minimizing the seriousness of these conditions.

I would cautiously recommend this film to those seeking to understand eating disorders better, particularly family members of affected individuals. However, I would not recommend it to someone actively struggling with an eating disorder without professional guidance, as certain scenes could be triggering despite the film’s overall positive message.

The film could have explored more deeply the societal and cultural factors that contribute to eating disorders, including diet culture and media representations of ideal bodies. Additionally, while it touches on the financial barriers to treatment, a more thorough examination of healthcare system failures would have strengthened its impact.

Conclusion

“To the Bone” represents an important step forward in mental health representation in cinema. By treating eating disorders with both honesty and compassion, it invites viewers to look beyond physical symptoms to understand the psychological complexity of these conditions. The film reminds us that recovery from mental illness isn’t a straightforward process but a winding journey requiring courage, support, and persistence.

In a culture still saturated with harmful messages about bodies and food, films like “To the Bone” play a vital role in fostering understanding and empathy. While no single portrayal can capture the full spectrum of eating disorder experiences, this film opens a necessary conversation about conditions that thrive in silence and stigma.

What are your thoughts on how “To the Bone” portrays eating disorders? Has it changed your understanding of these complex mental health conditions?