There’s 1994’s For the Love of Nancy, which, like To the Bone, featured in the main role an actress who’d previously recovered from anorexia (Tracey Gold). There’s 1996’s When Friendship Kills, and 1997’s Perfect Body, and 2001’s Dying to Dance, and 2003’s Hunger Point. More recently, Lifetime aired Starving in Suburbia, a 2014 film that expanded the confines of the genre by including a new scare factor: pro-anorexia (colloquially known as pro-ana) websites, which supposedly lure unsuspecting teens into starving themselves by encouraging anorexics to share their own tips and tricks.
The fact that such a glut of movies exist about anorexia—compared with only a few about bulimia, and virtually none at all about binge-eating disorder, or Other Specified Feeding or Eating Disorder (OSFED), the latter of which afflicts as many as 60 percent of the patients in treatment for eating disorders—presents an uncomfortable paradox. On the one hand, Americans are surprisingly educated about anorexia. Eighty-two percent of people surveyed in 2010 described eating disorders as a serious mental and physical illness, with only 12 percent dismissing them as afflictions of vanity.
On the other, cultural portrayals of anorexia have become inextricable from the disease itself. At LitHub, JoAnna Novak has written about immersing herself in books about eating disorders as a teenager with anorexia. TV movies have bolstered the conception that such illnesses only affect young, white teenagers, but they also often provide a model for anorexics to follow. One discussion topic on the website MyProAna.com features an extremely thorough list of movies and TV shows about eating disorders; there are 11 pages of responses from users debating their various qualities: truthfulness, relatability, specific calorie and weight references. “Seen every single film and every single documentary about 20 times over,” one commenter wrote.
It might not be possible for filmmakers and documentarians to portray anorexia in a way that avoids triggering vulnerable viewers, according to Dr. Melissa Nishawala, the clinical director of the Eating Disorders Service at NYU Langone’s Child Study Center: “Because individuals struggling with anorexia nervosa often have an extreme drive to the superlative—to be the best student, to feel the most valued, and to become the thinnest—any film depicting anorexia nervosa risks igniting the quest towards starvation.” That said, Nishawala specifically advises against filmmakers including images of bony figures, focusing on numbers (calories or weights), or depicting scenes of specific eating-disordered behaviors.
When the trailer for To the Bone was released, it prompted a flood of critiques noting that the film appeared to contain many images and scenes that could be triggering to recovering anorexics. The problem, though, isn’t just with this specific film. It’s a whole genre, a culture, that has a morbid and complex fascination with emaciated female bodies. To the Bone, inspired by its director Marti Noxon’s own experiences with anorexia, is a largely sensitive and thoughtful treatment of the disorder, but it can’t dodge the fact that any truthful depiction of anorexia will, by its nature, trigger those who struggle with the disease. The question is whether the usefulness of recovery narratives is worth the damage done in feeding a cultural curiosity that’s deeply unhealthy.