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Health Team

Duke doctor: New Netflix film's portrayal of anorexia has positive, negative effects

Posted July 25

Netflix has been behind a series of controversial and original projects this year, starting earlier this year with "13 Reasons Why," which covered suicide.

Now, a new film, "To the Bone," staring Lily Collins and Keanu Reeves, tells the story of a young woman's experience with anorexia nervosa and her experiences with various treatments.

Eating disorders can begin unnoticed but develop into a life threatening problem. One expert says the new film has positive and negative effects.

In the new film, a young woman believes she is healthy, strong and in control. But she has anorexia nervosa, a problem that most people think of as an obsession with being thin.

"It's actually a severe psychiatric disorder in which the symptoms of anorexia are complex," said Dr. Nancy Zucker, director at the Duke University Center of Eating Disorders.

Zucker says the film did a good job illustrating the complexity of the disorder.

"That these individuals are lonely and suffering and really have challenges making decisions that are in their own best interest," Zuker said.

However, she's concerned about an inaccurate portrayal of treatment for anorexia nervosa.

"The young woman in this film never receives an empirically validated treatment, so the treatment that she's receiving is not evidence based," Zucker said.

Zucker says the film seems to disdain family involvement in the young woman's treatment, but she believes the film introduces important themes, which are worthy of parent-child discussions—but not without an adult watching the film with them.

"For a vulnerable child, unsupervised, it could give ideas and be unhealthy," Zucker said. "You certainly don't want to watch this movie to look for ideas about how to treat it."

Zucker also praised the film for depicting the importance of developing authentic relationships, for addressing the biological contributions of the disorder and the dangers of pregnancy for women who struggle with the problem.

Writer and director Marti Noxon struggled with anorexia and bulimia for 10 years. She tells her own story through the film.

After consulting with doctors, she decided not to mention the character Ellen's weight or goal weight, and the film only once shows the character's full body.

Numbers, she said, can stick in people's heads and become an aspiration.

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