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To The Bone: 'Schools can represent a safe-haven from the film industry's seeming willingness to glamorise eating disorders'

Schools should represent a safe-haven from the sort of toxic messaging inherent in much of To The Bone's attempts to "raise awareness", writes the former government mental health champion for schools

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Schools should represent a safe-haven from the sort of toxic messaging inherent in much of To The Bone's attempts to "raise awareness", writes the former government mental health champion for schools

When you are in the grips of the worst aspects of mental illness, you want to die.

If you are a teenager experiencing mental illness, however, this does not exempt you from the standard adolescent belief that you will live forever, even if you take extreme risks with your health.

And therein lies the inherent dilemma when it comes to "awareness raising" of eating disorders, self-harm and suicidal behaviours: what an adult who is in a healthy mindset might see as prohibitive, a teenager, whose brain is naturally flooded with dopamine, sees as ‘tips’.

There are those who argue that the internet means young people are already hyperaware of the methodologies involved in self-harming and eating disordered behaviour, which gives rise to a necessity to explore them in the relatively controlled environment of school.

Others, like me, believe not only that school should represent a safe haven from this sort of toxic messaging, but that it is incumbent upon us to find more creative ways to have these necessary conversations around mental health.

It is these kinds of considerations that fuelled the furore around the Netflix movie To the Bone, which was released this weekend.

The film tells the story of Ellen, played by Lily Collins, who is 20 years old and in the throes of severe anorexia nervosa. It charts her journey towards recovery, while introducing us to Ellen’s "dysfunctional" family, the friends she makes in rehab as well as her unconventional therapist, who is played by Keanu Reeves.

Despite having been directed by Marti Noxon, who has had experience of anorexia – as has lead actor Lily Collins – the film directly contravenes media guidelines on so-called "triggering" content.

Ellen is shown partially naked at several junctures throughout. The characters mention weight, calorie intake and purging methods constantly.

Since the first swathe of magazine articles, documentaries and memories were published in the 1980s, endless research has been conducted into what is and isn’t helpful, in terms of eating disorder awareness-raising.

We know that "before and after" pictures, while designed to shock, can be used as "thinspiration" for those currently experiencing the illness.

We know that graphic detail of methodology and calorie intakes are used as yardsticks in what is a notoriously competitive disorder.

Indeed, the brilliant author Kelsey Osgood describes in her book How to Disappear Completely how, when she was institutionalised, patients with anorexia used to carry eating disorder misery memoirs around with them like Bibles, using them not as cautionary tales but as instruction manuals.

We know that eating disorders can be epidemic in their nature and that attempts to shed light upon them can do more harm than good.

All of this would be fine, if the makers of To the Bone had issued a public statement saying their film was made for entertainment purposes and that they would not recommend anyone who is either experiencing, or recovering from, an eating disorder watches it.

The problem was that, during the PR campaign in the build up to its release, Marti Noxon – as well as US-based campaign group HEAL (who consulted on the script) – claimed that the movie was an attempt to dispel the taboo around anorexia.

HEAL even claimed that anorexia was the "most stigmatised" of all mental illnesses.

Not only is this a highly subjective opinion (I don’t think any one mental illness can lay claim to being the "most" stigmatised without inadvertently causing offense to people with experience of the others), it’s also, in my opinion, plain wrong.

In many ways, I see anorexia as the most socially acceptable mental illness. That’s not to imply, of course, that it isn’t a hideous thing to endure or to demean the suffering of those who have gone through it, but anorexia is still erroneously seen by some as aspirational.

Still, we associate it with glamorous models and ethereal waifs, with willpower and restraint and saintliness – and that’s despite more than 30 years of awareness-raising.

And that’s why, when Channel 5 gave me my own private screening of To the Bone ahead of its release, I had a problem with it.

For a film that claimed to have such lofty intentions, the project does nothing to dispel the myth that anorexia is inextricably linked with glamour.

Lily Collins is razor-cheekboned, doe-eyed and expertly lit throughout. The action centres upon her struggles, with the less-aesthetically pleasing bulimics and compulsive eaters she is in treatment with demoted to her sidekicks.

She and her rehab friends are self-aware, acerbic, witty and almost Dawsons Creek-like in their behaviours and camaraderie.

As I watched, I imagined to whom I might recommend the film. Certainly not anyone who has ever been personally touched by an eating disorder. Indeed, as someone who has been in recovery from bulimia for a decade now, even I found it difficult.

Neither would I suggest a parent watch it. The narrative makes it clear that Ellen’s mother’s "scandalous" lesbian relationship and her father and stepmother’s "selfish" desire to have a life which doesn’t revolve entirely around her are to blame for her illness. This is as hurtful as it is unhelpful.

I *might* recommend a friend of someone with anorexia watch the film if they are ignorant of the fact that the condition is a mental illness and is not simply about the desire to look like a catwalk model, which, let’s be honest, in this day and age is unlikely.

I’d be hesitant, however, if the friend in question was in any way lacking in self-esteem or body confidence themselves which, again, let’s face it, most young people are.

Which brings me back to the classroom. When I first began going into schools to speak about sensitive topics like self-harm and bulimia, I was very careful not to divulge anything which might be used by my audience to perpetuate harmful behaviours.

I tried to tread a line between giving hope that it is possible to recover and impressing upon the class how not-in-any-way-aspirational an eating disorder is.

I wanted to show that mental illnesses are not something to either be ashamed of, or glamorised.

It was an exercise in experimentation at first but, having now conducted this type of education for the best part of a decade, I can say with some confidence that it is possible.

In the wake of Thirteen Reasons Why, also a Netflix production, my fear is that far from "raising awareness", film-makers want to poke the hornets’ nest of mental illness to fuel their own publicity campaigns.

And, if that is the case, to them I say this: People with mental illnesses are not pawns for your profit-making ventures and the health of one quarter of the population is too precious for this kind of risk-taking.

Natasha Devon is the former UK government mental health champion for schools and founder of the Body Gossip Education Programme and the Self-Esteem Team. She tweets as @_NatashaDevon.

For more columns by Natasha, visit her back catalogue.

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