After Netflix released its first trailer for To the Bone, a film about a young woman with anorexia, it didn’t take long for people to share a range of complicated feelings on the subject. Without having even seen the film, a lot of viewers were worried about the way eating disorders would be portrayed onscreen and that this piece of media could be more harmful than helpful to those in recovery.
Writer and director Marti Noxon did not anticipate that the general reaction to her film would mirror a fictional storyline in the movie. But in a classic example of life imitating art, Noxon has been forced to confront the same ideas and questions that are brought up in her own film: How do you create art about eating disorders that doesn’t glamorize it and potentially cause further harm?
“I hadn’t really thought about the film itself being a provocative piece of art, but I did think that that it would be interesting to show that it’s such a dicey thing trying to express yourself around such a hot topic,” Noxon told BuzzFeed News.
To the Bone, which debuted at the Sundance Film Festival in January and started streaming on Netflix earlier this month, tells the story of a 20-year-old college dropout named Ellen (Lily Collins) who struggles with anorexia. Ellen has been in and out of different treatment facilities and programs, and her battle with the eating disorder puts a strain on her family. She used to publish her eating disorder–related drawings online as a coping mechanism and a way of grappling with her disease. But her art garnered a significant following online, with lots of people idolizing her work and using it as thinspiration, in the process making Ellen a semifamous celebrity artist on Tumblr. One of her fans, however, kills themselves and sends Ellen the suicide note. The parents of that fan also mail Ellen explicit photographs of their daughter, blaming Ellen for the suicide.
Noxon said she didn't realize it at the time of filming or even during its original conception, but creating a movie about anorexia ended up yielding similar reactions from viewers as Ellen’s online artwork did. After she completed To the Bone, Noxon said “it was a little bit of a house of mirrors” to witness people responding similarly to how some reacted to Ellen’s controversial drawings on the internet; there was a thin line between fiction and reality.
Noxon, who herself had an eating disorder in her teens and early twenties, drew from personal experiences when creating To the Bone. She agrees the film isn’t for everyone, and that it’s important for viewers to carefully consider if they’re “ready to consume it,” a process she understands firsthand.
“When I was actively on the brink of death, [my doctor didn’t want me] around a whole bunch of other anorexics,” she said. “But he does feel, now, that the movie is really important for people in a certain process in their recovery.”
The National Association of Anorexia Nervosa and Associated Disorders reports that a minimum of 30 million people in the United States suffer from eating disorders. “The art has a right to exist,” Noxon said. "The world is full of intense things, and the worst possible conclusion, I think, would be that [the movie] shouldn’t exist.”
When Noxon, who's now 52, was dealing with these issues, the world was a different place than it is today, and the internet has changed the landscape of how we discuss eating disorders and other mental illnesses. While thinspo communities have existed prior to the internet, Tumblr, for example, which was founded in 2007, streamlined these communities and heightened their visibility to outsiders. Noxon believes it’s created a paradox for those with disorders and illnesses, in which going online can be “both really good and really bad.”
“Its proliferation of images can’t help but have some kind of subconscious effect on you,” the filmmaker said. “On the other hand, I feel like there’s a real burgeoning feminist discourse that’s happening because of the internet. Like-minded people are able to push forward a conversation that didn’t exist until women could really have a full-bodied voice that wasn’t censored by a kind of male-dominated media.”
Before making To the Bone, Noxon was already aware of anorexia communities on Tumblr because “as a recovered woman” she pays attention to what’s happening in the community. Her inspiration for the Tumblr artwork and her suicidal fan storyline, however, came from reading a graphic novel by a young woman who wrote about her experience with anorexia.
“I thought the images in it were so beautiful, but they were really painful,” she said. “I knew that it deserves to be in the world, but I also felt like I could see how someone would say it’s hurtful to make these images.”
There’s a great deal of shame surrounding eating disorders like anorexia and bulimia, and Noxon hopes To the Bone will combat that stigma. When people are “ashamed to admit it and confess that part of themselves,” she said, they sometimes resort to communicating with anonymous online communities instead of their families and other people who care about them.
“If people could talk more about it, maybe there wouldn’t be such a secret internet community of supporters around their fascination with it,” she said. “I do feel like when people take art or images or ideas and use them to harm themselves, there’s probably a bigger issue.”
Noxon emphasized that she is “so against any form of censorship,” but concedes that when dealing with such sensitive issues and depictions, “just the nature of acknowledging it could be activating for somebody.” The very existence of this film and others like it can be triggering for its intended audience.
“It’s such a strange time,” Noxon said. “On the one hand it feels like we’re living in a culture that’s so reckless and has such disregard for people’s feelings, and then on the other hand it’s like, everything needs a trigger warning.”
To the Bone has a warning of its own. Before the 107-minute movie begins, the following message appears on the screen: “The film was created by and with individuals who have struggled with eating disorders, and it includes realistic depictions that may be challenging for some viewers.”
Noxon said she agrees it’s “the most responsible thing” to do if you’re someone who creates content about eating disorders and other sensitive subject matters “because it’s prone to imitation.”
Netflix and Noxon also partnered with Project Heal, a nonprofit organization that provides funding and resources for people with eating disorders, to help viewers make sense of To the Bone. The organization released a discussion guide on its website that features sections like “Responsible Viewing," "Parental Supervision," and "Starting Conversations.” There’s also a resource guide for viewers, including information about eating-disorder recovery.
“I think that we did our very best to try to convey it in a way that was authentic and also shows that it is like a death and not fun and not glamorous,” she said. “But if simply seeing the images and seeing it represented is going to be potentially too provocative for someone, they need to check whether they’re ready to see it.”
Without ignoring the harsh realities and possible triggers To the Bone could prompt for viewers, the filmmaker wants those who watch the movie to take away a deeper understanding of what it’s like to battle anorexia. Noxon knows there’s nothing pretty about depicting eating disorders, but she wants those who suffer from them — and their loved ones too — to know there can be a light at the end of the tunnel.
“At my worst, I was trapped. I was absolutely miserable and desperate, and I thought there was no way out,” Noxon said. “The hope is that the film helps you see that you can still get a life, and find a beautiful one at that.”