Navya Kapoor
Recently, eating disorders have come into the limelight
through movies like To The Bone,
written and directed by Marti Noxon. The movie revolves around 20-year old
Ellen, who suffers from anorexia nervosa. She journeys through different
institutions, all of which fail to help her. The movie crystallizes in the
fourth—and final—institution operated by Dr. Beckham, rumored to have a “new
and different approach”. The movie presents the struggles faced by the patients
in their battle with anorexia and the accompanied social stigma and misconceptions.
In presenting the purging and
restricting categories of anorexia nervosa and bulimia nervosa, the core characteristics
of the disorders have been demonstrated well—extreme diets and starvation, distorted
perception of one’s body image, and a heightened concern with weight. Patients’
distorted perception of their body images can be seen in their attempts to lose
weight despite being underweight and extremely skinny. Ellen’s desire to reduce
her arm to the size of her thumb and index finger enclosed together stems from
her distorted perception. Patients confess their craving for foods like
chocolates, cakes, etc. indicating that they restrain consumption of
high-calorie foods not because they don't like it but to inhibit weight-gain. Further,
the comment by a patient that “I am two years of hungry” (Miller, Curtis, Lynn, & Noxon, 2017) implies that they have been starving
themselves for two years. The movie meticulously presents behavioral
manifestations of some of the symptoms such as incessant calorie counting,
purging, use of diet pills or laxatives, tasting the food only to spit it out
(to avoid calorie intake), compulsive exercising and the like.
However, the movie has a major
fallacy in the way it represents some aspects of the disorder. It fails to
translate the symptoms as part of a larger struggle, instead representing them
as a choice; anorexic and bulimic behaviors of the patients have been portrayed
to be under their control. While the will to get better and compliance to the
doctor’s recommendations positively influence the recovery process, they are
not equivalent to having complete control over one’s disorder or the resulting behavior;
the patients feel compelled to
starve, diet, purge, binge eat or engage in the like (Butcher, Mineka, &
Hooley, 2017). There are several instances of this incorrect depiction—during
family group session, Ellen’s step-sister expresses her anger at Ellen and
comments, “I just don’t get it. You know, just
eat” and the therapist does not correct her misconception. The ‘Eat up
Ellen’ cake, her mother’s remark, “I accept it now. If death is what you want”, and statements like “why
can’t you just eat?”, “okay so eat”, “can you please just try this time?” are a
few more examples of the portrayal of this misconception.
This has major consequences
since even contemporary research that confirms the biological markers of mental
disorders is not enough to dispel these misconceptions (“Eating Disorders
Program”, n.d.). Popular movies like this one reinforce the status of mental
disorders in the public imagination. This misrepresentation has serious implications
because it underpins the misconception, which leads to blaming the patient, who
is at no fault. This further worsens the patient’s suffering.
Further, there are traces of multifactorial
approach to the disorder, i.e., the diathesis-stress model. Ellen is shown to
have a family history of mental disorders: her biological mother has bipolar
disorder. Along with exhibiting Ellen’s dysfunctional interpersonal
relationships as socio-environmental stressors, the movie successfully
highlights one of the primary socio-environmental causes of eating disorders—glamorization
of ‘size zero’ and idealization of the concept of being ‘perfect’. The opening
scene shows a teenage girl with anorexia talking about the ubiquity of pictures
of “sad fat” girls in magazines or TV which are accompanied by their post-diet
skinny pictures that are exclusively loved by people. Further, emphasis is
given to reading the poem “Courage” by Anne Sexton that talks about the way people
from childhood are exposed to notions of ‘fat’ and ‘thin’. Negative and
positive connotations are respectively attached to them, and children “dr[i]nk
the acid [of being called fat] and conceal it”. Ellen’s step-mom’s remark, “not
too good, not perfect” and Ellen’s comment, “if I wanna be thin, don’t they say
that that’s better?” highlight the social appraisal of ‘thin’ as ‘perfect’. The
movie does not explicitly deal with these day-to-day social constructs;
however, it still does a good job of subtly conveying their role in negatively influencing
peoples’ notions of body image.
Some scenes in the movie not
only exhibit the physical manifestations of the disorder, but successfully
elicit their graveness. Visuals like pale complexion, sunken cheeks, exposed
ribs, bruises on the spine due to excessive crunches, and excessive body hair
also termed ‘lanugo’ (where the body grows more hair to produce warmth) leave a
lasting impression on the viewer’s mind. Megan’s miscarriage due to purging and
statements that inform that the body burns muscle and organ tissue after there
is no fat left further elicit the serious repercussions of the disorder—a fatigued
body, emaciation, medical problems like rupturing of esophagus, multi-organ
failure, infertility, and even death.
By virtue of having a large-scale
audience, the movie sets into motion a discourse around eating disorders. This
has practical implications—it creates awareness and conveys the urgent need to
change the social practices that operate as socio-environment causes. Further,
this way, parents can recognize and keep a check on their child’s symptoms, since
teenagers are the most vulnerable to developing the disorder (“Eating
Disorders”, 2018). However, this also necessitates accurate portrayal to not
only prevent further propagation of misconceptions but also to facilitate their
rectification.
References
Butcher, J. N., Mineka, S., & Hooley, J. M. (2017). Eating
Disorders and Obesity. In Abnormal psychology (pp. 299-335). Pearson Education India.
Eating Disorders Program. (n.d.). John
Hopkins Medicine: Psychiatry and Behavioral Sciences. Retrieved from https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/faq.html.
Miller, K., Curtis, B., Lynn, J. (Producers), & Noxon, M.
(Director). (2017). To The Bone [Motion
picture]. United States: Netflix.
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