Netflix took a massive gamble back in 2017. They released a film called To the Bone, and honestly, the internet basically exploded overnight. It wasn't just a movie; it was a lightning rod for debate. People were either praising its raw honesty or accusing it of being a "how-to guide" for eating disorders. Years later, we’re still talking about it because the film touches on something incredibly uncomfortable that most Hollywood projects just glaze over with a pretty filter.
Lily Collins plays Ellen, a 20-year-old artist whose struggle with anorexia has landed her in multiple recovery programs that just didn't stick. She's cynical. She's sharp-tongued. She’s also terrifyingly thin. The film, directed by Marti Noxon, isn't just a fictional story—it’s deeply personal. Noxon herself struggled with eating disorders, as did Collins. That shared history adds a layer of "realness" that you can't really fake, but it also fueled the fire of the controversy regarding whether the film was "triggering" or "truthful."
The Thin Line Between Representation and Romanticization
Whenever a movie tackles mental illness, there’s this immediate tension. How do you show the reality of a disease like anorexia without making it look "aesthetic" or tragic in a way that appeals to the very people suffering from it? To the Bone walked right into that minefield.
Critics like those from Project HEAL and various mental health advocates pointed out that showing a body at a dangerously low weight—which Collins actually achieved under medical supervision for the role—can be a double-edged sword. For some, it’s a mirror. For others, it’s a goal. It’s a messy reality. The film doesn't shy away from the "body horror" of the condition, like the hair growth on the skin (lanugo) or the bruised spine from doing sit-ups on a hard floor.
Yet, some viewers felt the "cool, edgy" vibe of Ellen’s character made the struggle look somewhat desirable to a younger audience. This is the central conflict of the film's legacy. Is it possible to depict a self-destructive illness without inadvertently glorifying it? Noxon argued that "shame and secrecy" are what keep people sick, and by bringing the reality into the light, she hoped to start a conversation. She definitely did that.
Why Keanu Reeves' Character Was So Divisive
Enter Dr. William Beckham. Keanu Reeves plays the unconventional doctor who runs a group home called Threshold. He doesn’t use the typical clinical language. He’s blunt. He tells Ellen to "grow a pair" and stop "waiting for life to happen."
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Some fans loved this. They saw it as a refreshing break from the "coddling" often seen in medical dramas. But medical professionals? They had thoughts. Real-life treatment for Eating Disorders Not Otherwise Specified (EDNOS) or Anorexia Nervosa usually involves a massive team of dietitians, therapists, and doctors. Beckham’s "tough love" approach felt a bit like a Hollywood trope to some experts. It simplified a process that is, in reality, incredibly slow and grueling.
Honestly, the "bottle feeding" scene in the third act is probably the most polarizing moment in the entire movie. It’s weird. It’s metaphorical. It’s supposed to represent a rebirth or a return to basic nurturing, but for many viewers, it felt jarring and out of place compared to the gritty realism of the first hour. It’s one of those moments where the film leans into "art" over "medicine," and your mileage will vary depending on how much you like symbolic storytelling.
Behind the Scenes: The Risks Lily Collins Took
You can't talk about To the Bone without talking about Lily Collins' physical transformation. This wasn't just makeup and lighting. Collins, who wrote about her own history with eating disorders in her book Unfiltered: No Shame, No Regrets, Just Me, had to lose a significant amount of weight to play Ellen.
This is a huge "no-no" in many recovery circles. Usually, actors with a history of ED are advised to stay far away from roles that require calorie counting or weight loss. Collins worked with a nutritionist and was monitored throughout, but the psychological toll of "going back there" is something she’s spoken about in interviews. She felt it was necessary to tell the story, to provide a voice she didn't have when she was younger.
- The Weight Loss: It was achieved under strict medical supervision, but it sparked a debate about the ethics of the industry.
- The Family Dynamics: The movie shines when it shows how an eating disorder isn't just an individual's problem—it’s a family's "elephant in the room." The scene with the stepmother (Carrie Preston) and the biological mother (Lili Taylor) captures that chaotic, desperate energy of people who want to help but have no idea how.
- The Support Group: The secondary characters in the house—like Luke, the male dancer dealing with a hip injury—remind us that anorexia isn't just a "white teenage girl" disease.
What the Movie Gets Right (and What it Misses)
Let's be real: no single movie can encapsulate the entire experience of an eating disorder. To the Bone focuses heavily on the restrictive side of the spectrum. While it briefly mentions other forms of disordered eating, it mostly stays in the lane of the "starving artist" trope.
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What it gets right is the internal monologue. The "calorie counting" scene where Ellen identifies the exact caloric content of a plate of food just by looking at it? That is hauntingly accurate for many survivors. It captures the obsession. It captures the way the brain becomes a calculator, stripping the joy out of everything.
What it misses, according to some experts at the National Eating Disorders Association (NEDA), is the diversity of the struggle. Eating disorders affect people of all sizes, races, and socioeconomic backgrounds. By casting a lead who fits the "waif-like" stereotype, the film stays within a very specific, traditional Hollywood box. It doesn't really explore the "atypical anorexia" where someone might be at a "normal" weight but still be physically starving themselves to death.
The Ending: Hope or Hype?
The end of the film is notoriously ambiguous. Ellen has a hallucinatory experience in the desert—a "rock bottom" moment—and decides she wants to live. We don't see her get "cured." We don't see her eat a burger and live happily ever after.
This was a deliberate choice. Recovery isn't a destination; it's a process. By ending on a note of intent rather than completion, the movie stays true to the reality that the road back is long. But for some, this felt unsatisfying. They wanted more resolution. They wanted to know she made it.
Navigating the Triggers: A Guide for Viewers
If you’re planning to watch To the Bone for the first time, you need to be honest with yourself about where you are mentally. This isn't a "light" Netflix watch for a Friday night.
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- Check your headspace: If you are currently struggling or in early recovery, this movie can be a massive trigger. The visual imagery is intense.
- Watch with a friend: Don't process this alone. There’s a lot to unpack regarding the family trauma and the medical ethics presented.
- Remember it's one perspective: This is Marti Noxon’s story. It is not the definitive experience for everyone.
- Know the resources: If the film hits too close to home, reach out to professional organizations.
Actionable Steps for Those Seeking Help or Understanding
Watching a film like this often brings up buried feelings or questions about how to support a loved one. Instead of just letting the credits roll and moving on, here is how to actually use the film as a tool for better understanding.
Educate yourself on the "Ed" voice. In the film, Ellen often talks to herself or thinks in a way that sounds like a separate entity. Understanding that an eating disorder often functions like an intrusive, externalized voice can help family members realize that the "defiance" they see isn't the person—it's the illness.
Avoid comments on physical appearance. One of the biggest takeaways from the discourse surrounding the film is how damaging "compliments" can be. In the movie, Ellen receives various comments on her body that she interprets through the lens of her illness. If you know someone struggling, focus on their feelings and their presence, not their size.
Focus on "The Why," not "The What." Ellen’s art is her outlet. The movie suggests that the disorder is often a coping mechanism for deeper trauma or a lack of control. If you’re trying to help someone, stop focusing on the food (the "what") and start looking at the emotional triggers (the "why").
Consult professional guidelines. If you are a content creator or educator, look at the Mindset or NEDA guidelines for reporting on and depicting eating disorders. They provide clear frameworks on how to avoid the "how-to" trap that To the Bone was often accused of falling into.
The movie isn't perfect. It’s flawed, it’s provocative, and at times, it’s deeply painful. But it forced a global conversation about a topic that usually stays hidden in bathroom stalls and oversized sweaters. Whether you find it helpful or harmful, its impact on the cultural conversation surrounding mental health is undeniable.