‘To the Bone’: Why Lily Collins plays a woman with anorexia after her own eating disorder 
 
 CLOSE In a clip from the Netflix movie ‘To the Bone’ (streaming July 14), Ellen (Lily Collins) argues with Luke (Alex Sharp), a housemate also battling an eating disorder. NETFLIX 
 
 BEVERLY HILLS, Calif. — In Netflix's new anorexia movie To the Bone (streaming Friday), Lily Collins' character Ellen has a compulsive habit of measuring her tiny arm. The young woman wraps her thumb and middle finger around her barely-there bicep to check that her fingertips meet. They usually do — that's how sickly she is — and indicate how small Collins chose to get for the part. 
 
 Writer/director Marti Noxon and star Lily Collins promote their film 'To the Bone,' about a woman struggling with anorexia. (Photo: Eric Charbonneau, Invision for Netflix) 
 
 Beefing up and slimming down for roles is all part of the job of an actor. But for Collins, 28, there was an added danger: She wanted to look like someone with anorexia, years after overcoming her own disordered eating, which included consuming nearly nothing, using diet pills and throwing up. 
 
 "I personally knew that this was something I needed to do to tell this story," says Collins, who struggled with both anorexia and bulimia. "I wanted to be able to best exert my experiences on (Ellen) by going to the lengths I felt comfortable going to as an actor.” 
 
 That meant looking thin enough to worry her fans, who "lovingly, were concerned" after seeing the actress in paparazzi photos taken while she was preparing for the movie. She won't disclose how much she lost, "but I was held accountable by a nutritionist, by (our director), by my mother, by our producer," she says. 
 
 "There was never any time limit, there was never a (weight) number, (but) I didn’t want to get to the end of this experience and feel like I didn’t access what I needed to portray Ellen," says Collins, who on this day at the London West Hollywood hotel looks radiant and "strong," as the film's writer/director Marti Noxon points out. "I can honestly say I gave it everything that I could and was able to stay Lily." 
 
 Lily Collins felt that playing Ellen in 'To the Bone' was part of her "life's mission." (Photo: Netflix) 
 
 For some scenes in the film, which shows Ellen getting gradually sicker with a bruised spine (the result of obsessive crunches), sunken cheeks, furry arm hair (the body's way of keeping a too-thin body warm) and concave belly, Collins relied on special effects. "Makeup, in general, is amazing," she says, citing a baggy wardrobe, collarbone and cheekbone prosthetics and plenty of lighting and shading tricks to make her look increasingly bony. 
 
 But then there's the question: Even with the help of prosthetics, why take on a dangerous role at all? 
 
 Collins saw it as the right way to bring eating disorders into the public discourse. 
 
 It all felt serendipitous, because Noxon (who didn't know about Collins' past struggles) sent her the script just days after the actress wrote an essay about eating disorders for her memoir, Unfiltered. 
 
 Lily Collins, right, used baggy clothes, makeup and prosthetics to help her achieve the look of sickly Ellen. (Photo: Netflix) 
 
 "For me, it was a sign from the world saying, 'This is probably something that is actually bigger than you. There’s a larger thing in play here and both are going to be able to better inform one another,'” Collins says. “When you have your life’s mission and the mission of a project merge like this so beautifully, that’s like total magic." 
 
 To Noxon, whose own experience with eating disorders inspired the movie, making To the Bone "was a weird thing of touching old hurts ... to help people," she says. "(Lily and I are) both recovered and healthy and living incredible, full lives beyond our wildest dreams. We can say, 'Look, we're here.' " 
 
 Read or Share this story: https://usat.ly/2uNaiby ||||| Keanu Reeves’ phoned-in outing as a dashing doctor is one of many low points in a film whose treatment of an important topic ranges from banal to bizarre 
 
 Here is a US drama from Netflix about anorexia, notable only for its sheer extravagant awfulness. It’s a dismal TV movie of the week: trite, shallow, cautiously middlebrow and blandly complicit in the cult of female prettiness that it is supposedly criticising. 
 
 Lily Collins plays Ellen, a talented young artist and college dropout who has issues with body image and anorexia. She is sent to a community treatment facility under the care of the charismatic and revolutionary Dr William Beckham, played by … Keanu Reeves. But judging from his torpid line-readings, Reeves might as well be playing a non-ass-kicking version of John Wick: none of Dr Beckham’s supposed charisma is evident from this performance and there is nothing revolutionary in his clinical approach. But he is supposed to be super attractive. (When Dr Beckham arrives smartly dressed at a day out he has organised for the patients, a gay patient unironically asks if he wants to turn her straight.) 
 
 To the Bone confirms there are (almost) no good movies about anorexia Read more 
 
 Ellen’s backstory is fraught with carefully packaged emotional pain. Her mom, Judy (Lili Taylor), has gone to live with another woman, and now Ellen stays with her chivvying stepmother and her dad. Weirdly, this dad doesn’t feature in the family therapy scene and never appears in the film. Ellen’s art about herself has apparently inspired another woman with anorexia to take her own life. Collins reacts to this appalling tragedy with mild consternation, as if someone has said something lame about her on Instagram. But the movie is very squeamish about actually showing us these supposedly radical and shocking images, or telling us anything substantial about her troubled admirer. 
 
 As for the other patients, they are the usual smorgasbord of cut-out personalities, as seen in movies such as Girl, Interrupted, itself a lite version of One Flew Over the Cuckoo’s Nest. Ellen finds an emotional connection with a quirky British dancer, Luke (Alex Sharp), and encouraged by Dr Beckham (in a particularly implausible moment that pokes up from a nest of unbelievability) she experiments with changing her identity and her name, calling herself Eli. 
 
 Eventually, Eli must come to terms with her relationship with Judy, and the film features a scene in which she is redemptively fed by her with a baby’s bottle, a spectacle that does succeed in being climactically bizarre, at any rate. At the end of the film, precisely nothing useful or insightful is said about anorexia or anything else. ||||| 
 
 
 
 Anorexia is one of those subjects that seem tailor-made for a medium as darkly fascinated by bodies and self-destructive obsessions as film, and yet it always comes across as phony, simply because actors can never really look anorexic; thin and baggy-eyed is a long way from the sight of skin sucked so tightly over bones that it appears that a person’s body might crumple in on itself at any moment. That doesn’t mean that movies can’t tackle the psychology, but with only a few exceptions (e.g., the English writer-director Mike Leigh’s 1990 film Life Is Sweet, which depicts a young, working-class bulimic woman), films about eating disorders take the form of hokey, know-the-symptoms public service pamphlets aimed at teens. There’s a reason why the topic is popularly associated with cheesy TV movies. The Netflix-produced To The Bone, which was written and directed by TV veteran Marti Noxon (UnREAL, Girlfriends’ Guide To Divorce), isn’t going to change that perception. It’s snarkier and a little more self-conscious than the rest, but just as cornball. 
 
 Lily Collins stars as Ellen, a 20-year-old, internet-famous anorexic artist from a well-to-do Los Angeles family who agrees to move into a group-home-style treatment center for young people with eating disorders run by the no-bullshit Dr. Beckham (Keanu Reeves). We know Ellen has an attitude problem, because she smokes cigarettes and is introduced bailing on the latest in a string of in-patient clinics by informing her therapy group to “suck my skinny balls”; and we know she doesn’t like her prissy, Southern-accented stepmom, Susan (Carrie Preston), because she rolls her eyes when the family’s plastic-surgery-addicted maid refers to Susan as her mother. (To The Bone takes place in one of those alternate universes where no one seems to grasp the concept of step-parenthood.) With the exception of her beloved stepsister, Kelly (Liana Liberato), Ellen is surrounded by grotesques: the maid; Susan; the other patients at her last treatment facility; her unseen father; even her hippie-dippie lesbian mom (Lili Taylor), who came out when Ellen was 13. 
 
 So perhaps Dr. Beckham, who speaks in Reeves’ usual relaxation-tape cadence, just seems like a breath of fresh air, even if moving into the group home means sharing the dinner table with a new cast of broadly defined single-issue characters: the pregnant one; the bulimic one who stashes her vomit; the English, anorexic, ballet-dancing love interest (Broadway actor Alex Sharp, making his film debut), whose adorable retro sensibilities are represented by a bedroom decorated with a picture of Frank Sinatra and a poster that just says “Jazz Festival.” Noxon is an unremarkable, at times clumsy director with no sense of staging, but she has decent taste in attractive young actors—which, however, only adds to the bogusness of the movie’s conception of illness, treatment, and family, and spoils whatever point To The Bone might have to make. It’s only in retrospect that one starts to notice how little the movie actually addresses Ellen’s condition; somewhere in trying to externalize a character’s problems through corny and ham-fisted subplots, it loses her altogether. All that’s left is a body hung in chic, loose clothes and a pretty face framed by dark caterpillar brows. ||||| 
 
 Lily Collins stars as Ellen, a young woman living with an eating disorder in "To the Bone." (Gilles Mingasson/Netflix) 
 
 “To the Bone” doesn’t come out until July 14, but a trailer for the Netflix film — about a young woman’s struggle with anorexia nervosa — has already been getting mixed reviews. 
 
 Part drama, part dark comedy, “To the Bone” stars Lily Collins as Ellen, a young woman who, after multiple stays in inpatient treatment programs, grudgingly agrees to live in a group home run by an unconventional doctor (Keanu Reeves). It premiered to generally positive reviews at this year’s Sundance Film Festival, where Netflix purchased the global rights for a reported $8 million. 
 
 Netflix posted the trailer on June 20, prompting an intense Twitter debate around whether the film glamorizes anorexia and whether it could be harmful or a trigger for those with eating disorders. The company sparked a similar conversation in April after releasing the drama series “13 Reasons Why,” which caused concern for its graphic depiction of a teenager’s suicide. 
 
 Director Marti Noxon and supporters of the film say it’s an authentic departure from the slew of made-for-TV movies and TV show subplots that have made eating disorders look like trends instead of life-threatening illnesses. But the trailer shows elements of the film — Ellen ticking off calorie counts for the items on her dinner plate, a close-up of her extremely thin frame — that highlight the challenge of portraying eating disorders on-screen in a responsible way. 
 
 Critics of the trailer have zeroed in on the film’s protagonist: a young, thin, white woman with anorexia, a prevailing narrative in pop culture despite the fact that eating disorders vary (binge-eating disorder is actually the most common eating disorder in the United States) and affect people of all backgrounds. 
 
 “It reinforces stereotypes about what an eating disorder is and looks like,” one survivor told Teen Vogue. “That imagery is everywhere, and it is actually celebrated in our culture.” 
 
 Noxon, the veteran writer-producer behind “Girlfriends’ Guide to Divorce,” “Unreal” and later episodes of “Buffy the Vampire Slayer,” based the film on her own battle with anorexia and bulimia, which began in her early teens. 
 
 She was aware of the film’s potential to be a trigger for some people and, as a result, tried to be “really conscientious in the way we approached how [Ellen] looked, how often we showed her body and in what context.” 
 
 “You want to help other people understand and have compassion for something they’ve never experienced, but you also want people who have experienced it to feel understood and seen and to give people hope,” she added. “At the same time we want it to be entertaining, so we were balancing a lot.” 
 
 
 
 Keanu Reeves stars as Dr. William Beckham in “To the Bone.” (Gilles Mingasson/Netflix) 
 
 Noxon wanted to avoid one trope in particular: “this idea that the perfectionist quality of anorexics is their most defining trait,” she said. It’s something she saw in a character with anorexia (played by “To the Bone” actress Ciara Bravo) in Fox’s short-lived dramedy “Red Band Society.” 
 
 “I appreciated their attempt to incorporate that as a real problem and a real illness,” said Noxon, who watched the series with her now 12-year-old daughter. But, she added, “it didn’t necessarily feel that the person writing it had really been through it.” 
 
 Noxon wrote “To the Bone” a few years ago, inspired by another project (an early draft for the film adaptation of “The Glass Castle”) that required her to think a lot about her childhood. 
 
 “It really came back to me that I was still myself,” Noxon said. “I think if you’ve recovered from a traumatic illness, mental or otherwise, sometimes you just think of yourself as being sick. But I remembered that I still had my personality. I still had a lot of humor to me.” 
 
 That realization gave Noxon a clear idea of how she wanted to approach the film, which she wrote in just six weeks. 
 
 “The character was going to have life to her. She wasn’t just one-dimensional,” Noxon said. “It wasn’t just about a sick person. It’s about a person struggling with her real demons.” 
 
 While “To the Bone” focuses mainly on Ellen’s recovery, it features a woman of color battling an eating disorder and a male character with anorexia. Cynthia Bulik, founding director of the UNC Center of Excellence for Eating Disorders, has not yet seen the film, but said those inclusions are encouraging because Hollywood and news outlets often fail to show that eating disorders also affect people outside of the stereotype. 
 
 “Those people are less likely to seek treatment, they are less likely to be accurately diagnosed, because they don’t fall within the stereotypical presentation that their physician might expect,” Bulik said. 
 
 Bulik was among the collaborators on a document titled “Nine Truths About Eating Disorders,” which inspired last year’s public service announcement featuring the cast and crew of “To the Bone.” 
 
 “Eating disorders affect people of all genders, ages, races, ethnicities, body shapes, weights, sexual orientation and socioeconomic status,” Noxon says in the video. 
 
 It caught the attention of Liana Rosenman and Kristina Saffran, who met as teenagers while receiving treatment for anorexia. They co-founded Project Heal, an organization geared toward helping eating disorder sufferers afford treatment. 
 
 Project Heal recently hosted screenings of “To the Bone” in New York and Los Angeles, but it has faced sharp criticism from members of their community on social media for supporting the film amid the trailer debate. 
 
 Rosenman and Saffran continue to stand by it. 
 
 “I thought it was very powerful,” Rosenman said. “There is a sense of humor and wittiness in it as well as just understanding what it’s like to have an eating disorder.” 
 
 
 
 “I was terrified that doing the movie would take me backward, but I had to remind myself that they hired me to tell a story, not to be a certain weight,” says Collins who once battled an eating disorder. “In the end, it was a gift to be able to step back into shoes I had once worn but from a more mature place.” (Netflix) 
 
 Saffran doesn’t think the film glamorizes eating disorders, but rather “captures how serious these illnesses are.” (Anorexia has the highest mortality rate of any mental illness, according to the National Institute of Mental Health.) 
 
 Still, the backlash to the trailer prompted Project Heal to compile a list of “Frequently Asked Questions” that recommend “carefully evaluating where you are in recovery before deciding to view this film.” 
 
 “Triggers are everywhere in eating disorder recovery,” Saffran said. “In many ways, it would have been impossible to make any sort of film that didn’t have the potential to trigger somebody who is struggling.” 
 
 Another concern around the film is that Collins, who has been open about her own struggle with eating disorders, lost weight for the role, which experts say can lead to relapse for those with a history of disordered eating. For her part, Collins has described the film as a cathartic experience. 
 
 “It was a new form of recovery for me,” the actress told Shape magazine. “I was terrified that doing the movie would take me backward, but I had to remind myself that they hired me to tell a story, not to be a certain weight. In the end, it was a gift to be able to step back into shoes I had once worn but from a more mature place.” 
 
 Claire Mysko, chief executive of the National Eating Disorders Association, said she is encouraged by the dialogue sparked by the trailer. 
 
 “Thirty million Americans struggle with eating disorders at some point in their lives,” Mysko said. “This is something that needs to be talked about, and we need for people to understand that this isn’t a silly fad or something that people choose.” 
 
 Mysko hasn’t yet seen “To the Bone,” but said she hopes Netflix will provide resources for viewers who may be vulnerable. NEDA has reached out to the company asking that the film link to its help line and text line. A representative for Netflix did not respond to an email inquiry about whether the film will include a link to treatment resources. 
 
 Asked if she might have benefited from seeing a film like “To the Bone” when she was struggling with her eating disorder, Noxon paused. 
 
 “Yeah,” she said. “If I had seen where it leads, that no matter what you’re going through and however you’re externalizing your anger and your sadness, ultimately it becomes a question of ‘how do you want to live?’ The thing that my doctor did for me that so few people were doing was frame it not as a problem I had with food or my body, but a problem I had with my soul.” 
 
 To the Bone begins streaming on Netflix on July 14. ||||| "Society's to blame, the world is so unfair... I have to die," are the first words out of Ellen's mouth. She's in art therapy at an inpatient facility, tearing down another patient's struggles with magazines. She continues, "There's no point in blaming everybody. Live with it." 
 
 This is the first glimpse of Lily Collins' edgy character in Netflix's 'To The Bone', a film that, before it's even been released on the platform, has stirred up quite a bit of controversy due to its depiction of eating disorders. 
 
 The film, set to release this week on the streaming service, follows Ellen as she battles anorexia nervosa. Netflix's description calls it her "harrowing, sometimes funny journey of self-discovery". When the trailer for the film was released many were concerned with the explicit depiction of eating disorders, but Netflix stood by the project, claiming that the film had always intended to start an important conversation. 
 
 CEO of The Butterfly Foundation, Christine Morgan, spoke to HuffPost Australia about the film, and the Foundation's specific concerns around it. 
 
 "One of the aspects of an eating disorder, particularly if you have anorexia nervosa, is at a time in the illness you are looking almost 'do it better'," Morgan told HuffPost. 
 
 "There is a real vulnerability to copycat behaviour, so if you are suffering from an eating disorder and you see graphic representations of what somebody is doing or has done there is a very real risk of copycat behaviour. It's not a logical choice somebody makes, they're driven to it." 
 
 Lily Collins in Netflix's 'To The Bone'. 
 
 Another vulnerability, according to Morgan, is a genetic risk. Particularly when framed around a "life affirming illness to go through and come out the other end", individuals can be triggered into an eating disorder by graphic representations. 
 
 "We've been provided to see the film, and it's extremely graphic. Our concern is that people be alerted to the fact that there are potential trigger points and if someone feels vulnerable, they should reach out for help." 
 
 Butterfly, along with Mindframe, spoke with Netflix representatives and discussed adding trigger warnings to the film itself. 
 
 "We stressed that Australia has very robust, well-developed and evidence based guidelines around how to report on mental health issues and, in particular, around eating disorders. We told them it is unsafe if we don't put trigger warnings, and if we don't provide people with direct links to where they can get help. We haven not heard from them." 
 
 A spokesperson for Netflix said there would be no comment regarding trigger warnings for the film. 
 
 Collins has been very vocal about suffering from an eating disorder, and even wrote about it in her book 'Unfiltered'. In January she shared an Instagram image with a caption celebrating the film's premiere at Sundance. 
 
 A post shared by Lily Collins (@lilyjcollins) on Jan 21, 2017 at 3:11pm PST 
 
 "What a huge moment this is for me," the caption read. "Owning my past, being open, and having no shame or regrets about my experiences. Sharing my history with eating disorders and how personal this film has been is one of the most fulfilling experiences of my life." 
 
 It's a complex issue, with Collins speaking about how she had to lose weight to play the role, speaking about doing so in a "healthy" way. The entire narrative is weighed down in potentially triggering notions. 
 
 Similarly, the film's writer and director Marti Noxon spoke out about her own experiences with eating disorders. In a statement released by Netflix, Noxon said she had not set out to glamorise eating disorders. 
 
 "Having struggled with anorexia and bulimia well into my 20s, I know firsthand the struggle, isolation and shame a person feels when they are in the grips of this illness... My goal with the film was not to glamorize EDs, but to serve as a conversation starter about an issue that is too often clouded by secrecy and misconceptions." 
 
 Morgan said she could see where Noxon was coming from with this goal, but that it wasn't enough when it comes to potentially triggering content. 
 
 "We have an estimated 1 million Australians in 2017 with an eating disorder, but less than 25% are engaged in treatment. One of the primary reasons many are not engaged in treatment is the very high levels of stigma." 
 
 "At Butterfly we support the concept of trying to raise awareness across all levels of community about the reality of this being mental illnesses. They're not properly formed, they're not lifestyle choices, and when you're in the midst of them they're an absolute hell. I accept you can't do that without portraying an eating disorder either verbally or any other way. I can understand that and indeed to an extent support films or other means of communication that raise awareness. But it's critical, it's imperative that if we're doing that, we're doing it in a way which is responsible to all of our community and in particular our young people." -Christine Morgan, CEO The Butterfly Foundation. 
 
 Noxon worked with survivors as well as consulting Project HEAL (Help to Eat, Accept and Live), the largest eating disorder nonprofit in the United States, but at this stage, Netflix has yet to comment on their plans to add helpful resources to the film. 
 
 "What trigger warnings do is putting into real time, just as you're about to watch something or have just watched it, a little alert which says 'If you find this confronting, if you find this difficult to cope with if you feel uncomfortable' or if it's a parent who's watching it who says I feel uncomfortable, then go to see an expert." 
 
 "A trigger warning to the extent of 'be careful, this could hurt you,' is like one arm of the coat hanger. It's not enough. You need to have a trigger warning and then somewhere someone can go for help." 
 
 Lily Collins has spoken out in the past about her history with eating disorders, but experts are criticising the film's graphic depictions. 
 
 Netflix's model, being instantly accessible to audiences over a variety of devices, makes things even more difficult for young, impressionable audiences. The streaming service was recently criticised with its series '13 Reasons Why', which graphically depicted sexual assault and suicide. 
 
 Netflix responded by adding extra trigger warnings to the series after mental health advocates complained against the series' strong content. 
 
 Morgan also noted that the release of 'To The Bone' aligns with school holidays. 
 
 "Those normal mechanisms we would have for alerting teachers and school communities -- we would have sent something out but obviously we're in school holidays. It's extremely disappointing to me." 
 
 "Start the conversation about eating disorders," Morgan said, "I can see merit in that. But don't do it without putting a clear direction for people who, if they feel vulnerable or uncomfortable or distressed in any way -- tell them where they can go for help." 
 
 "If you want to raise a difficult or confronting topic for discussion, then put the safeguards in place." 
 
 If you or anyone you know are overwhelmed, concerned or needing support you can contact Butterfly's National Helpline on 1800 33 4673 (8am–9pm AEST, MON – FRI) or Lifeline on 13 11 14 for 24/7 support. 
 
 Click below to subscribe to the Refresh podcast by HuffPost Australia on iTunes. 
 
 ALSO ON HUFFPOST AUSTRALIA ||||| To the Bone, starring Lily Collins, could glamourise eating disorders and should come with trigger warning, charities say 
 
 Mental health experts have said a Netflix trailer for a film about a teenage girl with anorexia could trigger psychological issues for sufferers and should come with a warning. 
 
 To the Bone, which is released next month, tells the story of 20-year-old Ellen, who struggles with anorexia and enters a group recovery home for help. But while its director says the film is intended as “a conversation starter about an issue that is too often clouded by secrecy and misconceptions”, critics say the film risks glamourising and trivialising anorexia. 
 
 Young people and mental health: 'Since diagnosis, I have taken massive strides' Read more 
 
 Netflix recently found itself at the centre of controversy over its drama 13 Reasons Why, a portrayal of a teenager’s suicide that critics said could encourage young people to kill themselves. Samaritans said the show was “extremely concerning”. 
 
 Psychiatrists have levelled similar criticisms at To the Bone. Dasha Nicholls, chair of the eating disorders faculty at the Royal College of Psychiatrists, said: “It is potentially risky to two groups of people, including those who have not yet developed an eating disorder. There is always a risk of glamourising it [anorexia] and also slightly trivialising it. 
 
 “My anxiety is that because [the movie looks like] it has a happy ending and looks like such an enriching experience that it may seem to be an appealing way to address internal conflict. I am just providing a warning about that. We have a responsibility to protect young people and people who are vulnerable.” 
 
 
 
 Nicholls said it was hard to judge the entire film on the trailer, but said: “My main message for people who will be vulnerable to this is to consume with caution.” She said a trigger warning would be a “really sensible idea”, as well as a parental advisory note. 
 
 Psychologist Dr Carolyne Keenan said: “It is very possible that some viewers may find the material distressing and triggering, and both Netflix and viewers will need to take responsibility for what they do with that. I wonder if it might be helpful to have an advisory prior to the trailer, for example, stating what viewers are about to see so that they can make an informed choice about watching.” 
 
 The movie stars Lily Collins and Keanu Reeves. While the trailer does not explain the whole plot, experts said some of the images in it could trigger emotional distress in those with anorexia. In the trailer, Collins’s character counts calories and looks extremely thin. 
 
 Leading eating disorder charity Beat recommends that the media does not report on specific low weights. In its reporting guidelines, it says: “Images, especially photographs of certain emaciated body parts are triggering.” 
 
 
 
 Nicholls said: “There is quite a lot of concern about the use of imagery, mainly from patient and carer groups. We in the medical profession are used to looking at bodies objectively ... but people can be triggered by such images.” 
 
 Despite reservations, charities and psychologists said it was important that this issue was being addressed. Keenan described it as a sensitive topic, “but one that does need to be spoken about”. 
 
 Kennan said: “Both the director and the lead actress have struggled with anorexia nervosa and created the production in collaboration with related organisations. There is evidence that they have attempted to make this a useful, informative piece in order to invite discussion.” 
 
 A spokesperson for Beat said they were waiting to see the full film before commenting further. However, they said: “We very much support the media in raising awareness of eating disorders ... Equally, we know that when eating disorders are glamourised or trivialised by the media, this can trigger negative behaviours in people who are affected by these complex mental health issues. 
 
 About 1.6 million people in the UK are affected by an eating disorder, and 11% of these people are male. Additionally, about one in 100 women aged between 15 and 30 are affected by anorexia. 
 
 
 
 The trailer has received a mixed response online. The movie’s writer and director, Marti Noxon, who based the film on her own experiences, said: “My goal with the film was not to glamorise [eating disorders] but to serve as a conversation starter about an issue that is too often clouded by secrecy and misconceptions.” 
 
 Collins, who plays the lead character in To the Bone and has experienced eating disorders herself, said: “There never was a ‘goal’ weight, but I knew that hair and makeup and wardrobe could only do so much. And that to pay tribute to the girl that I was when I was younger, and also to the character, I wanted to do it in a way that really went there – but was also healthy. But, yeah, there’s always a fine line.” 
 
 Nina Martynchyk, who experienced anorexia and is a campaigner for eating disorders awareness, said: “When someone is making a movie, they want it to be something that is enjoyable for the audience to watch and thus not too depressing. Although, making a film that is enjoyable about something as serious and devastating as anorexia consequently has a great potential to minimise the seriousness of the issue. 
 
 
 
 “I will be watching the movie – albeit with a lot of scepticism – but I wouldn’t recommend that anyone who is still struggling with an eating disorder and/or is susceptible to being triggered sees it, as I am scared it has the potential to do them harm.” 
 
 • In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. ||||| Anorexia might be among the most exasperatingly misunderstood diseases out there. Anything from its perceived irrationality to the misuse of its name as a shorthand to describe any and all thin people furthers a misconception that glamorizes a life-threatening disease and equates it to a kind of stubbornness borne of privilege. Loosely based on the director’s own past struggle with the disease, Marti Noxon’s quietly affecting and ultimately optimistic To the Bone thankfully rejects all these erroneous beliefs from the start. Instead, it soberly treats eating disorders like anorexia and bulimia as addiction-related mental and physical ailments that rob people of a normal life. 
 
 To the Bone is soundly written by Noxon herself and well-acted by a committed ensemble. Most importantly, it is refreshingly well-considered from start to finish. Not knowing in advance the film was based on the writer-director’s own experiences, I immediately felt the topic was in the hands of someone who knows precisely what she’s talking about. 
 
 Indeed, you feel Noxon’s first-hand knowledge at work in the unexpected ways she shows her empathy for lead character Ellen (Lily Collins of Okja and Rules Don’t Apply, pitch-perfect in a career-shifting performance that should significantly raise her stock.) It is the kind of empathy that both understands the inner-workings of a young person coping with struggles foreign to the majority of humankind and confronts her unreservedly when necessary. In that sense, you feel a real, unburdened sort of amity between writer Noxon and subject Ellen throughout To the Bone. Moreover, you feel a similar kinship between director Noxon and actor Collins, which makes sense once you realize Collins has also suffered from anorexia. 
 
 Living with her sister Anna (Kathryn Prescott) and her overbearing but well-meaning stepmother Susan (Carrie Preston) in Los Angeles, Ellen refuses to cooperate with their efforts to get her on the right nutritional track and silently suffers in the hands of her disorder. She purges what little food she eats, does excessive sit ups and stands in the way of any real recovery. Finally agreeing to check into a home for those with eating disorders—led by Dr. William Beckham (a wise and paternal Keanu Reeves)—Ellen starts a new routine of silent disobedience. But thanks to the charming and infinitely determined ex-dancer Luke (Alex Sharp), with whom she builds a real closeness, her edges gradually start to soften. And when Ellen's biological mother (played by Lili Taylor in a brief but memorable part) comes into the picture, Noxon brings all the emotions she had thus far built carefully home. 
 
 In following Ellen’s new life, Noxon patiently sculpts the characters of her new home with small but remarkable details, enough to make them seem like real people with believable hardships as opposed to fillers intended solely to further Ellen’s story. Noxon films their collective journey with a hopeful disposition yet doesn’t disregard the fragile nature of their conditions: she doesn’t let you forget for a second how much work it is to hold onto positivity. While recent years have given us Krisha, Rachel Getting Married and Flight as stories of people battling different types of addiction, you need to look as far back as the year 2000 to land on 28 Days as a major film focusing solely on addiction and disease recovery. Given the school of thinking that approaches treating eating disorders as treating addiction, you can draw parallels between the makeshift rituals and tightknit closeness of the community portrayed in To the Bone to that of 28 Days. Still, To the Bone is nearly one-of-a-kind in the way it puts an unapologetically human, heartbreaking face on an oft-misrepresented disease. 
 
 Click here for cast and crew information.
– Director Marti Noxon has been open about her past struggles with eating disorders and says she hopes her new film starring Lily Collins as Ellen, a young woman suffering from anorexia, will "serve as a conversation starter about an issue that's too often clouded by secrecy and misconceptions," the Guardian noted in June. But ahead of To the Bone's release Friday on Netflix, plenty are discussing whether the film does more harm than good. Some reactions: Though To the Bone currently has an 81% rating from 21 critics on Rotten Tomatoes, Peter Bradshaw says it's "notable only for its sheer extravagant awfulness." Writing at the Guardian, he calls the film "trite, shallow, cautiously middlebrow, and blandly complicit in the cult of female prettiness that it is supposedly criticizing." Ignatiy Vishnevetsky at the AV Club notes "how little the movie actually addresses Ellen's condition" and leaves the impression only of "a pretty face" and "a body hung in chic, loose clothes." Christine Morgan of the Butterfly Foundation, which offers support for eating disorders, adds the film's "graphic representations" raise "a very real risk of copycat behavior," per the Huffington Post. She wants to see Netflix add a warning to the film. Kristina Saffran of Project Heal, which helps fund treatment for people suffering from eating disorders, offers a different take. "Triggers are everywhere in eating disorder recovery," she tells the Washington Post, adding "it would have been impossible to make any sort of film that didn't have the potential to trigger somebody who is struggling." Per the AP, Claire Mysko of the National Eating Disorders Association notes eating disorders are a "serious public health issue" that will affect 30 million Americans in their lifetimes, so "having eating disorders discussed on a national platform like this is really important." The film isn't just important, but also really good, adds Tomris Laffly at Film Journal International. It's "refreshingly well-considered," portrays eating disorders as "addiction-related mental and physical ailments that rob people of a normal life," and is "ultimately optimistic," she writes. But specific concerns have been made about Collins, who has admitted to struggling with eating disorders and had to lose weight for the role of Ellen, reports USA Today. Collins, however, says the weight loss was necessary "to tell this story" and done safely with oversight from a nutritionist, filmmakers, and her mother.