Eating Disorders in the Media – To the Bone (2017)

Published on: August 21, 2022

‍

Eating disorders representations in the media have sparked conversations regarding the accuracy of their demonstration in films and television series. When we think about “eating disorders in the media”, most of them include mainly young, Caucasian, women struggling with the disorder. They also focus on the commonly known eating disorders such as anorexia nervosa and bulimia, although the spectrum includes other overlooked disorders such as binge eating.

A common downfall of eating disorders representation in the media is solely due to the limited screen time it takes to efficiently capture the true nature of eating disorders. Movies tend to display a quick onset of the disorder (and often, it is related to a traumatic event) and they also don’t have the time to show the complications of the treatment process. The treatment process for an eating disorder is one of the most complex processes as it should take a multiple disciplinary approach which involves therapists, psychiatrists, and nutritionists. However, the media tends to reduce this complexity to a simple revelation that leads the characters to finally “heal” from their disorder.

Movie brief

The movie “To the Bone” revolves around Ellen’s journey with anorexia nervosa. Ellen is a 20-year-old anorexia nervosa patient who is seen in the movie to be significantly underweight and is struggling to remain in treatment for a consistent amount of time. Both her divorced biological parents have abandoned her and have become no longer present in her life. The only people who were seen supporting her were her stepmother and sister who pushed Ellen to attend a treatment centre run by a doctor with unusual treatment methods. There Ellen meets a group of patients also diagnosed with eating disorders including anorexia nervosa and bulimia nervosa. The movie takes us through Ellen’s time in the treatment centre and her interactions with other patients.

Eating disorders in the movie

While the movie showcased a variety of eating disorders, we will be focusing on the disorder displayed by the main character (Ellen), which is anorexia nervosa. In the movie, Ellen displayed the main symptoms of anorexia nervosa, as well as other physical signs of the disorder, including:

Dry skin, especially her lips
Fine hairs appearing on her body to keep her warm
Menstrual cycle disturbances
Light-headedness and fainting due to malnutrition
Excessive exercise causing yellow patches on her back from the pressure on her back

An illustration of Ellen’s extreme fear of gaining weight, which is one of the symptoms of anorexia nervosa

Among the symptoms of anorexia nervosa displayed by Ellen in the movie are her obsessions regarding her calorie intake and her ability to tell how many calories are present in everything she eats, including calories in the IV fluids she takes, as we see her trying to check the IV packages of another patient for the calorie intake information. We also see Ellen take apart her food into small pieces and avoid eating any carbs. She would restrict herself to eating small amounts of protein. Sometimes, she is also shown to chew and spit out the food she takes when going out with one of the other patients in the treatment center. She would measure her weight loss progress using her fingers on her arm.

When Ellen experiences any stress or anxiety, whether it is related to her weight gain fears or not, she resorts to exercising in order to burn off calories. Excessive exercise causes yellow patches on her back from the pressure she puts on it.

An explanation of other factors that contribute to Ellen’s eating disorder

Although the movie did not delve deeper into the factors that influenced the onset of the disorder, there are a few circumstances that may have led to its development.

Among these circumstances are her relationship with her parents and the stress caused by their divorce and abandonment. During this time, there were few events that weren’t in her control, which could mean that she engaged in her eating disorder behaviors as a way to regain some control over her life. It’s not uncommon for people struggling with eating disorders to want to feel a sense of autonomy amidst the uncertainties in their lives.

Another stressor for Ellen had to do with her parents not being entirely involved with her treatment process and her stepmother’s lack of understanding and awareness regarding her disorder, despite their best intentions to help her out. Ellen’s support system was more focused on finding someone to blame for her situation instead of focusing their attention on supporting her journey to recovery, which added to her stress and contributed to her deteriorating mental health.

Eating Disorders Explained

Anorexia Nervosa

Anorexia nervosa entails an intense fear and preoccupation with the control of one’s calorie intake and their weight gain. Someone suffering from AN may lean towards exercising excessively and following an incredible strict diet in order to have some control over their body weight. A person with AN may view their body through an inaccurate lens and may truly believe that they are overweight, when in fact they are more likely to be underweight.

The symptoms of anorexia nervosa include:

A restriction in food and/or calorie intake, leading to significantly low body weight in the context of age, sex, developmental stage, and physical health.
An intense fear of gaining weight or becoming fat or persistent behaviour that leads to weight loss, even though the person is at a significantly low weight.
The experience of an inaccurate perception of one’s body image, or a lack of awareness regarding the severity of the current low body weight.

There are two types:

Restricting type: This involves restricting food intact through dieting, fasting, and/or excessive exercise, without binge eating or purging.

Binge-eating/purging type: This includes recurrent episodes of binge-eating and/or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

While the signs of anorexia nervosa may be subtle at the beginning, they are likely to develop gradually. If you think that you or someone you know may be struggling with anorexia nervosa for a consistent and prolonged manner, these are some signs to look out for:

Drastic weight loss
Wearing loose clothes to hide their body
A severe preoccupation with a strict diet, food, and body weight
Frequent conversations surrounding weight loss
Avoiding certain food groups
Inconsistent menstruation

Bulimia Nervosa

Someone suffering from bulimia nervosa will experience frequent episodes of binging significantly large portions of food and then proceeding to purge what they had consumed. Bulimia nervosa also leads to an intense preoccupation with food as well as an inaccurate picture of their body image.

The symptoms of bulimia nervosa include:

Frequent episodes of binge eating, which are characterized by:

Eating significantly large amounts of food in a short period of time
Experiencing a sense of loss of control during the episode

Engaging in inappropriate weight loss behavior in order to compensate for binge-eating behavior(s), such as
Self-induced vomiting
Misuse of laxatives, diuretics, or other medications
Fasting
Excessive exercise

Self-evaluation is unnecessarily based on body shape and weight.

If you think that you or someone you know may be struggling with bulimia nervosa for a consistent and prolonged manner, these are some signs to look out for

Binge eating evidence e.g., large amounts of food disappearing in a short amount of time
Purging evidence e.g., packages of laxatives
Exercising excessively
A preoccupation with food, body weight

Binge Eating Disorder

A person who is struggling with a binge eating disorder will experience episodes of bingeing a large portion of food in a short period of time, however, he or she will not purge afterwards. With time, this may cause them to become overweight with time.

The symptoms of binge eating disorder include:

Frequent episodes of binge eating, which are characterized by:
Eating significantly large amounts of food in a short period of time
Experiencing a sense of loss of control during the episode

Binge eating episodes are linked to three or more of the following:
Eating more rapidly than usual
Eating until uncomfortably full
Eating large amounts of food despite not being physically hungry
Eating alone due to the embarrassment of eating large amounts of food
Feelings of disgust with oneself, depression, or guilt.

Binge eating is accompanied by feelings of distress

If you suspect someone you know is suffering from binge eating disorder, there are some warning signs to look for:

Binge eating evidence, e.g., large amounts of food disappearing in a short amount of time
Hoarding food
Skipping meals
Avoiding eating in front of others
Dieting but without losing weight

Avoidant/restrictive food intake disorder

Avoidant/restrictive food intake disorder causes one to avoid certain foods because of their texture, smell, taste, or color. A fear of weight gain is not a risk, but avoiding certain foods may cause failure to meet the minimum daily nutritional requirements.

The symptoms of avoidant/restrictive food intake disorder include:

An eating or feeding disturbance associated with one or more of the following:
Marked weight loss
Nutritional deficiency
Relying on enteral feeding or oral nutritional supplements
A disturbance in psychosocial functioning

The symptoms are not associated with any other physical or psychological disorder

Rumination disorder

Rumination disorder is characterized by the backward flow of recently consumed food from the individual’s stomach to their mouth. After that, the food is re-chewed, re-swallowed or spat out. Rumination involves an unintentional stomach muscular contraction and it may be initiated by a viral infection, stress, or a medical condition or injury. The symptoms are not related to another eating disorder or mental health condition.

Pica

Pica involves the constant eating of non-nutritive non-foods such as paper, paint, soap, chalk, or clay. Individuals are generally less likely to avoid foods, but are at risk for intestinal blockage or toxic effects from ingested items. These behaviors do not occur as a part of a cultural or social practice and do not occur in the context of another mental disorder.

Disordered Eating

Disordered eating is not considered a disorder or diagnosis, however, it’s important to distinguish it from eating disorders as it’s easy to confuse them. Disordered eating contains behaviors that are common with behaviors displayed in eating disorders; however, they come in a less frequent and less intense manner. A person showing patterns of disordered eating does not necessarily mean they will develop an eating disorder; however, an unhealthy eating pattern, if it becomes too severe, may contribute to the development of an eating disorder.

Some of the features of disordered eating include:

Calorie restriction, binging, or purging on a limited basis
Avoiding certain food groups
Emotional eating, which is using food to cope with stress, boredom, or difficult emotions
Skipping meals
Excessively working out

Disclaimer

While both eating disorders and disordered eating can be distinguished, they are connected in some way. A person struggling with an eating disorder will likely display disordered eating behaviors, but not everyone displaying disordered eating will be diagnosed with an eating disorder.

If you have any reason to believe that you or someone you know is struggling with any of the eating disorders mentioned above, it’s critical to seek professional help as soon as possible to ease the symptoms, catch it early on, and work on its further development.

‍

Eating Disorders in the Media - To the Bone (2017)

Explore

Resources

More