Kelsey Osgood
Jul 10, 2017 · 8 min read

The Dated Rationalizations for To The Bone

Since Netflix released the trailer for To The Bone, a film by Buffy and UnREAL alum Marti Noxon based on her bout with anorexia as a young woman, a hot debate has erupted online. Some angry viewers took to Twitter to skewer it as just another film replete with thin-spiring images of a waifish actress (in this case, Lily Collins, who wrote about her own battle with anorexia in a recently released memoir). Others claimed the heroine’s trajectory — she appears, from the trailer, to get better as the film goes on — negates the harm done by the triggering content. Supporters say that because Noxon, Collins, and consulting advocacy group Project HEAL were involved, the portrayal will undoubtedly be authentic and sensitive, and that in the grand scheme, it’s so crucial for those with mental illness to be publicly represented, that a flawed representation is better than none at all. Noxon and Collins have individually given statements on the controversy, using words like “stigma” and “taboo,” and making promises about how the film will shed light on a “misunderstood” condition.

Ten years ago, when I was still actively struggling with anorexia, I would have thought making a film about the disorder was unconscionable; even four years ago, when my book on the “virality” of the disease was published, I would have called it a dicey move. Today, I can’t muster up a lot of anger toward its existence, though I’m positive it will, as detractors claim, be a font of “anorexia porn” for those who want it to be. I also don’t particularly care that the protagonist is female, Caucasian, and visibly underweight, although no doubt many will be offended that this reinforces stereotypes about eating disorders (in fact, the movie might be in the right here: anorexia does affect men and non-Caucasians, of course, but it is still the case that a majority of sufferers are young white women from financially solvent backgrounds.) Instead, what I object to is that those involved with the film insist on justifying their project using tired bromides about anorexia, namely, that it is a taboo subject and that, by producing To the Bone, they’re shedding light on a “mysterious condition.”

To claim that anorexia is not publically discussed is nothing short of ridiculous. Not widely known — and actually, often symptomatically different than its contemporary counterpart — until the mid-twentieth century, the disease vaulted into the public consciousness after singer Karen Carpenter’s death in 1983. Back then, anorexia, then called “the slimmer’s disease”, was often discussed in ways we would now consider outmoded: sufferers were characterized as white, high-achieving teenage girls who were possessed by the desire to look like women in magazines. Articles and television specials on the illness focused on anorexic-as-sideshow aspect of the illness: the punishing exercise routines, the rigid diet plans and food behaviors, and the resulting cringe-inducing emaciation. Still, clinicians such as Hilde Bruch, who wrote the classic 1978 book The Golden Cage: The Enigma of Anorexia Nervosa, were quick to point out that anorexia was about more than just a relentless pursuit of thinness. Family pressures played a significant role, as did the “fuller freedom” women had in society, which, while exciting, was digested by some as daunting.

By the time I was in eighth grade, in 1999, the conversation about anorexia, and the illness itself, had changed. The outlying voices of the eighties who insisted anorexia was more about self-worth than fashion were by the turn of the century the dominant ones. Yes, Vogue was still thought to be corrosive to a young girl’s self esteem — it probably still is — but anorexia was no longer just about runway models and vanity. In fact, we were told that eating disorders had almost nothing to do with food and weight. In a health class unit on anorexia, we were told it was about “control.” Oprah learned from experts that it was about “personal self-destruction” rather than vanity. Steven Levenkron, author of The Best Little Girl in the World, told us it was about extreme perfectionism, while Peggy Claude-Pierre, rogue Canadian therapist, put forth the idea of eating disorder sufferer as Mother Theresa gone awry. All things considered, the prototypical anorexia sufferer, in 1999, was really quite a lovely creature: intelligent, hard working, giving, overly deferential, diligent. And she was everywhere: in memoirs, on television, on newsstands, on the lips of every teacher and parent frantic that any skipped meal meant a crisis was about to occur. You’d have had a very hard time finding one of my peers who didn’t know not only what anorexia was, but what the typical sufferer’s personality was (angelic) and what caused them such pain (that very angelic nature). It had become the sine qua non expression of angst for the late nineties young lady, the premiere choice of pathology in the “symptom pool,” a term coined by medical historian Edward Shorter referring to the historically advantageous maladaptive behaviors.[1] It was certainly not a “taboo” topic, nor was it particularly shameful to have anorexia — on the contrary, to be diagnosed with it signified all sorts of good things about your core self. This is not at all to imply that struggling with it did not cause the sufferer and his/her family enormous pain, as I know all too well that it did; rather, it is point out that to the extent that anorexia victims were “stigmatized,” it was as people who were victims of their own inherent goodness. (To contrast with, for example, substance abusers, who were then, and to some extent still are, pigeonholed as irresponsible fuck-ups.)

All through the eighties and into the early nineties, incidents of anorexia in the United States were on the rise. Since then, they’ve been pretty much steady at around 1% of women in America. Considering how rare the illness is, then — and call me cruel, but I don’t believe in imagining that there are swaths of diagnosable people out there just in hopes of bolstering the numbers to suit my agenda — the truth is it has always gotten a disproportionate amount of airtime. Don’t believe me? Let’s break this down by numbers: according to the South Carolina Department of Mental Health, 8 million Americans suffer from an eating disorder. To contrast, 29 million Americans suffer from diabetes. Diabetes, like eating disorders, can be fatal if left untreated; diabetes, like anorexia, can be treatment resistant. Diabetes is the seventh leading cause of death amongst American citizens (anorexia does not make the top ten) and, unlike anorexia, it is unequivocally on the rise.[2] So why, then, are there no movies about diabetes? Why no endless handwringing about diabetes? The answer, or at least part of it, is this: because diabetes does not almost exclusively affect the young, and because it doesn’t have the intriguing tragic sheen of self-destruction. Thus, it is simply not romantic enough to warrant a feature-length film.

Why then, despite evidence to the contrary, the insistence that anorexia is under-recognized? I think part of what is happening here is that people mistake the things that ravage their lives for the things that ravage the world.[3] In a recent profile of Marti Noxon in New York Magazine, for example, she expresses anger at the fact that her Hollywood colleagues (mostly the men) initially dismissed the idea for To The Bone because, as she puts it, they believed it to be a “small topic.” What I suspect she means is that anorexia is not a small topic for her. The Internet is riddled with think pieces and screeds about how x condition or x problem is the scourge of society, and that the fact that most people don’t even think about these problems in their daily lives is tantamount to murder. Stillbirths. Generalized Anxiety Disorder. Endometriosis. Selfie-related deaths. Bowel cancer. All of these problems are definitely problems, but they are not, as survivors sometimes fall into believing, The Problem. And while it’s perfectly understandable to feel especially fired up about whatever you’ve personally struggled with, passion is also the enemy of unbiased scholarship and perspective. When recovered anorexics find that their particular demon has been discussed ad nauseam, they get a little frustrated, feel a little left out, and thus have to resort to repeating lines from the time-worn script in hopes that these things are still true, because if they are still true — if anorexia is indeed “overlooked” and “misunderstood” and it’s “important” to talk about (important for whom?) — it justifies their desire to “tell their stories.” This is why people still spit out the same clichés printed covers of health class pamphlets more than two decades ago. It is why people like former French model Victoire Dauxerre and, indeed, Collins herself write about anorexia in high fashion and Hollywood, respectively, and make silly pronouncements like that eating disorders in these industries are secrets they are dragging to the light, when anyone who was born prior to 1990 can surely refute that (were the confessions of Tracy Gold and Ally Sheedy and Portia de Rossi utterly pointless, then?) It is also why people make dubious — and actually borderline offensive — claims such as the one that Project HEAL made when it proclaimed anorexia “the most stigmatized, misunderstood, and under-recognized of all mental illnesses.” (The MOST stigmatized! I can think of many contenders ahead of anorexia for this depressing “honor,” most notably schizophrenia, sufferers of which are generally considered to be hopelessly insane and often dangerous.)

If Marti Noxon and Lily Collins want to tell their stories, that’s perfectly fine. The yearning to do so­ — in hopes of a catharsis, of turning your past pain into something productive — is really quite understandable, maybe even universal. Probably the movie will be satisfying for some, and triggering for others, which is the only way it ever could have worked out.[4] But don’t pretend that a biopic is an act of altruism, or that you’re showing us something we’ve never seen before. Just sack up, be honest, and say you want to talk about yourself.

[1] For more on the work of brilliant Dr. Shorter, and how it relates to anorexia, read Crazy Like Us: The Globalization of the American Psyche. Or, you know, Shorter’s work itself.

[2] Yes, suicide is a major cause of death among anorexics, but it would be an exercise in futility to try to associate, statistically, suicide in this context with anorexia. It’s just mathematically too difficult.

[3] Another reason for the defensiveness is because I think it genuinely hurts to hear that the population you were trying to help feel you have wounded them instead. While I was lucky to receive mostly positive feedback about my book, a few readers did say they were “triggered,” which obviously made me sad. The risk is double for a movie, for obvious reasons relating to the visual nature of anorexia. The truth is, of course, that you can never make your work pleasant and acceptable for everyone, unless you want to create artistic pabulum.

[4] Personally I doubt I’ll watch it, not because I’m worried about being triggered (that ship has most definitely sailed) but rather because it looks a little too Noah-Baumbach-goes-to-rehab (soundtrack by Mumford and Sons) for my taste.

Kelsey Osgood

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Author of How to Disappear Completely: On Modern Anorexia. Writes often about religion, literature, and health. kelseyosgood.com