The Scene
Eating Disorders
7 Eating Disorder Facts for Adolescents and Young Adults
Wikipedia describes eating disorders as “mental disorders defined by abnormal eating habits that negatively affect a person’s physical or mental health.” It includes anorexia nervosa, bulimia nervosa, pica, binge eating disorder, and rumination disorder. However, it excludes obesity.
Eating disorders are linked with both genetics and situational factors. Cultural obsession with thinness as evidenced in media and advertising is thought to play a role. Ten times more females than males are affected by some type of eating disorder. In addition, these disorders often develop early in adolescence or young adults. People who have experienced sexual abuse have a higher risk of developing an eating disorder. The good news is that over 70-percent of people diagnosed with anorexia, 50-percent of those diagnosed with bulimia, and 40-percent or more of those with binge eating disorder will make a full recovery…
1. Anorexia Nervosa
People who have anorexia will deliberately restrict their food and caloric intake in order to achieve an abnormally low body weight. If left untreated, this disorder can prove fatal.
This eating disorder affects 0.4-percent of adolescents and young women. However it is estimated that more than 4-percent of all women will struggle with anorexia nervosa over the course of their lifetime.
2. Bulimia Nervosa
Bulimics tend to binge on large amounts of rich, calorie laden foods and then engage in behaviors to purge this food from their body. These behaviors can include self-induced vomiting or misuse of over the counter laxatives.
Bulimia nervosa is an eating disorder affects 1.3-percent of adolescents and young women. An additional 0.7-percent of older women will develop this disorder over the course of their life.
3. Binge Eating Disorder
This disorder is characterized by eating excessively large amounts of high calorie food in a very short period of time. The Mayo Clinic defines binge-eating disorder as “a serious eating disorder in which you frequently consume unusually large amounts of food and feel unable to stop eating.”
It is estimated that 1.6-percent of women and 0.8-percent of men worldwide are afflicted by binge eating disorder. A further 0.4-percent of women middle aged and older women will develop this disorder.
4. Cognitive Distortions Associated with Anorexia
Distorted thoughts about food, weight, and body image are central to those affected by this disorder. Patients may feel they should be perfect, which gives rise to all or nothing thinking. This in turn gives rise to obsessive perfectionism in regards to attaining the “ideal” body.
Sufferers may also reject the positive in that they see all fats and calories as negative. Anorexics also tend to unfavorably compare themselves to others, label foods as fattening, and catastrophize about weight gain. If they gain a pound, it’s the end of the world and nobody will like them.
5. Physiology and Anorexia
Food is the body’s first choice of fuel. If inadequate nutrients are eaten, then the body breaks down fat stores. Once these are depleted the body begins to break down muscle tissue. This results in the production of ketones, which enter the bloodstream and cross the blood-brain barrier.
When this happens, a person’s ability to think rationally is severely compromised. This is why patients suffering from extreme case of anorexia nervosa are hospitalized and force fed intravenously and with a gastric tube. Their lives are in danger, and psychotherapy will be ineffective until their weight is stabilized and ketones are no longer flooding the brain.
6. Pica
According to Wikipedia, pica “is characterized by an appetite for substances that are largely non-nutritive, such as paper, clay, drywall or paint.” Pica is frequently seen in developmentally challenged individuals who exhibit persistent and compulsive symptoms for more than 4 weeks.
Pica is a common disorder in children with mental disability, brain injuries, or autism. Approximately 10 to 30-percent of children between 1 and 6-years of age are affected by this disorder.
7. Rumination Disorder
This disorder is characterized by a normal intake of food followed by immediate regurgitation into the mouth and re-chewing of the food. The food is often swallowed again and occasionally spit out. Rumination disorder is most common in infants between the ages of 3 to 12 months and cognitively impaired children.
Rumination disorder may be caused by illness, abuse, stress, or as a means to gain attention. Rumination disorder can result in weight loss, dehydration, malnutrition, halitosis, tooth decay, indigestion, and chapped lips.

Stories
To The Bone: As someone who suffered from anorexia, here’s my take on the Netflix film
I was apprehensive about watching To The Bone.
The trailer didn’t give much away, and I didn’t know what impact it could have on me as someone who had suffered from anorexia in the past.
Is Netflix film To The Bone helpful or triggering for people with anorexia?
But since I felt I was in a stable place, I was eager to see the full film. And I’m very glad I did.
I think it is brilliantly executed as it follows the turmoil of living with anorexia nervosa and powerfully shows that no eating disorder is a ‘lifestyle choice’ or about vanity.
The central character, Ellen, continually tries to reassure everyone that she has it ‘under control’.
It’s a classic quote capturing the crux of living with an eating disorder – that we con ourselves into thinking we’re OK but in reality, the eating disorder is in control.
And the film doesn’t give straight forward answers to the ‘why can’t they just eat?’ question because there aren’t any, and it’s honest about this.
Although I’ve seen many people for anorexia treatment, even I was struck by the scene a short way into the film showing Ellen, played by Lily Collins, smoking.
It depicts the stark reality of what eating disorders do to the body – Collins is in fact 28, playing a 20-year-old who looks about 12.
I was more than a little disturbed by the scene where Ellen was being fed like a baby, though – her line, ‘will you feed me please’, was chilling.
Eating disorders are often about a desire for a child’s body, or at least to be child like, and everything about recovery is about becoming an adult, taking responsibility etc.
And they are about so much more than eating food – they’re about needing nourishment of every kind.
There are parts of the film that didn’t quite feel authentic.
For example, Ellen’s sit-ups and body checking was a little simplistic, but I can understand the need to simplify the symptoms for the sake of keeping the film an average length.
I was also a little disappointed by the romantic element as I can’t see this featuring in 99% eating disorder journeys, but I understand it was a film primarily for entertainment purposes so I can forgive them for this.
I can also accept that this could represent the fact that most people do make close friends struggling with similar issues; it’s only natural.
Another thing I was struck by was how ‘the problem’ was being spoken about so openly with all family members (apart from the dad, who was painfully missing throughout).
It didn’t depict (probably because there wouldn’t be time) the agonising secrets eating disorder sufferers usually carry with them for long periods of time.
This is an example of how drastically different everyone’s story is.
That said, it did demonstrate how someone with no understanding of anorexia can naively collude with the disorder very well – in one scene, Ellen’s sister gets it triumphantly wrong when she congratulates her for having ‘calorie Asperger’s’.
Perhaps Ellen’s family are shown in a bit of a negative light though, and this may be difficult for friends and family members who watch the film.
I started weeping at the end of the family therapy scene as the camera closed in on Ellen’s face, the empathy I felt was astounding as the conversation was going on around her but her head was in turmoil, and she was unable to join in.
I desperately wanted Ellen to scream and cry, but she couldn’t. That was the point – even if she’d wanted to she just couldn’t, and Collins captured this perfectly.

A few things that might resonate with viewers
I think the story will resonate with a lot of people, either on the journey or having recovered as it covers some basic truths openly and honestly, for example:
- Feeling like a problem
- Body checking
- A tired, worn out, grey body with bruises and lanugo
- Denial and ambivalence
- People trying to help and getting it so wrong
- Peers at different stages of recovery is helpful but can have a negative impact too
- Blaming the therapy when it doesn’t work
- ‘Cheating’ in therapy
At a crucial point in the film, Ellen becomes Eli and this resonated with me too.
I had to get to a point in my journey where I had to choose recovery, I had to want to be someone new. I didn’t need to change my name but I had to stop the silence and choose to be someone who talked honestly and openly, and now no-one can stop me.
I have to admit, the film’s therapist reminded me of mine, although mine didn’t make me swear in the street.

The trailer and description pre-release described him as ‘alternative’, but it was the straight talking that did it for me – and I think that’s usually what sufferers needs.
We don’t need wrapping in cotton wool, nor do we need ‘the hard line’ – we just need some honesty.
My therapist never told me how to get better; we all have the answers within us, we just have to discover the road and walk it for ourselves.
I’m sure there are many people who will slate the film for showing an ‘alternative’ recovery house where people are ‘allowed to eat what they like, or not’.

Reach out to anyone you feel comfortable with about your mental health issues; it’s never wrong or appeared/viewed as bad to talk openly to anyone who you feel comfortable with.
For all those who have been contributing to breaking/ending the stigma around mental illness (not just celebs but us normal/infamous/popular people); I’m proud of you and keep going! You’re doing more than enough on your end; keep being selfish and taking care of your mental health and wellbeing! Your mental health is just as important as your physical health, make both your high priorities!

Eating Disorders
When someone has an eating disorder, their weight is the prime focus of their life. Their all-consuming preoccupation with calories, grams of fat, exercise and weight allows them to displace the painful emotions or situations that are at the heart of the problem and gives them a false sense of being in control. Read more about the details and types of Eating Disorders below.
Eating Disorders
Every day, we are surrounded by different messages from different sources that impact the way we feel about the way we look. For some, poor body image is a sign of a serious problem: an eating disorder. Eating disorders are not just about food. They are often a way to cope with difficult problems or regain a sense of control. They are complicated illnesses that affect a person’s sense of identity, worth, and self-esteem.
