Complicit in the culture of 'thinspo'

Madeleine Pownall watches 'To the bone'.

A film about anorexia was always going to divide opinions. Many have praised the Netflix drama for opening up dialogue surrounding eating disorders and for showing an honest portrayal of suffering with anorexia. Others, however, have condemned the film for glamourising mental health disorders. Psychologists be warned: this film is largely as irresponsible and psychologically messy as it sounds.

The story revolves around Ellen (Lily Collins), a moody 20-year-old art school drop-out. She sulks around the inpatient eating disorder unit in layers of baggy clothes and heavy eye-liner – the archetypal ‘cool inpatient girl’ (using the same cookie-cutter casting formula as Girl, Interrupted, a strikingly similar but much less squeamish film). Ellen is painfully thin, and during her weigh-ins the camera takes much delight in showcasing her skeletal frame. It is supposed to be shocking. It is supposed to make the viewer recoil in horror and feel a pang of sympathy and admittedly, it works. 'Do you think you look beautiful?' Ellen’s Stepmother (Carrie Preston) asks, watching her step on the scales in her underwear. However, the overriding problem with this film is that Ellen really is beautiful. Teen Vogue recently featured Lily Collins, the actress who portrays Ellen, in a beauty editorial, cooing over how she is 'impossibly gorgeous'. She fits perfectly into the caricature of white, Western, slim beauty that her eating disorder is supposedly a product of. This makes the whole thing quite tricky. Even with her skeletal frame, fuzzy skin and bruised bones, she looks pretty. Therefore, it is not surprising that anorexic community (‘pro-ana’) sites have latched onto images of Collins in the film. It also means that the film has the potential to be triggering for audiences who have suffered or are suffering with an eating disorder.

A fellow inpatient Luke (Alex Sharp) tells Ellen she is 'dazzling' on more than one occasion, and an awkward romance begins to grow. This also proves problematic. The film attempts in many places to have the charming ‘I-love-you-despite-your-illness’ motif of other similarly marketed films like The Fault in Our Stars. However, all too often it forgets that Ellen’s illness is psychological. It clumsily attempts to incorporate a sense of beauty and romance into a clinical emotional setting.

The main problem with To The Bone is that it is too closely entwined with the culture it is supposedly criticising. We learn that the anorexia themed drawings Ellen posts on Tumblr led to another young sufferer’s suicide. This all seems horribly ironic, given that camera stills from To The Bone have already ended up on so-called ‘thinspiration’ social media sites. According to Lewis and Arbuthnott (2012) pro-eating disorder search terms are searched on the internet more than 13 million times annually, and I fear that this film will only add to those figures. The story is entirely complicit in the culture of ‘thinspo’ that it attempts to condemn. So much so, that it goes as far as to sensationalise anorexia. Ellen’s personality and warmth could have been a welcome rebuttal against this potentially traumatic theme. However, her spiky and sarcastic sense of humour feels too forced and unnatural to have any real impact. It also leads to, in places, rather offensive and poorly considered dialogue (on arrival at the inpatient house she claims that she is 'not on-trend enough' to self-harm).

In one particularly uncomfortable scene, Ellen goes out to dinner with Luke. She refuses to eat, and instead chews and spits out every mouthful of her meal into a paper napkin. She is gawked at by the waitress, and the pair find the whole thing quite hilarious. The other inpatients teach her about laxatives, calorie counting, and pathetically attempt to enforce rules around meal times (most of which are largely ignored). However, there is so much missing from the plot. This is not simply eating disorder awareness. This is a step-by-step guide on how to be a successful anorexic.

For psychologists, the real issue lies with the portrayal of 'radical' Dr William Beckham (Keanu Reeves), who runs the inpatient unit. Throughout the film, I eagerly awaited the ‘revolutionary’ method or approach of the great psychiatrist. I continue to wait. Bizarrely, it seems that Dr Beckham runs the inpatient unit just as any trained psychologist or psychiatrist would: psychotherapy sessions, no doors, ban on exercise (although Ellen continues to do sit-ups through the night) and group therapy sessions. There is one scene where he takes the inpatients to a water art installation (to teach them the beauty of life), but that is just about the only off-the-cuff method he employs. There is nothing about Dr Beckham’s work that deviates from standard practice (or at least, nothing that I can identify as different from the months I worked at an eating disorder inpatient ward in Leeds). Although giving credit where it’s due, the film does not venture into ‘miracle recovery’ territory. It does however suggest that the revolutionary work of Dr Beckham was pivotal in Ellen’s ability to battle her anorexia.

Since the release of both To The Bone and similar Netflix drama 13 Reasons Why, it is now clear how difficult, or perhaps impossible, it is to discuss mental health illness without sensationalising the disorders. Indeed, I am left feeling slightly unsure about why films like this were ever deemed a good idea in the first place. You don’t need to be a qualified psychologist to recognise that an hour and 20 minute depiction of anorexia is going to be triggering for many viewers. Unfortunately, the producers of To The Bone seem to have ignored this reality. Potential relapse is deemed as collateral damage; 'raising awareness' is the key motivator. Also, despite discussing a lot of valid and important issues, the film doesn’t actually say anything particularly helpful about eating disorders. It certainly doesn’t say anything useful about strategies for recovery. The film ends with Ellen walking out into the desert, presumably to end her life. She hallucinates and finds herself sat on the branch of a tree looking down at her naked lifeless skeletal body on the ground. 'Is that me?' she gasps. Following that, she (literally) marches back to the inpatient house to properly start recovery. And then presumably everyone lives happily ever after.

Eating disorders are a community, and I fear that this film only serves to further ignite the fire of thinspiration. All in all it may be insightful, but it certainly is not helpful.

- Reviewed by Madeleine Pownall, an undergraduate at the University of Lincoln. She blogs at


Lewis, S.P. & Arbuthnott, A.E. (2012). Searching for thinspiration: the nature of internet searches for pro-eating disorder websites. Cyberpsychology, Behavior, and Social Networking, 15(4), 200-204.

BPS Members can discuss this article

Already a member? Or Create an account

Not a member? Find out about becoming a member or subscriber