All the attention goes to anorexia because it is so dramatic, but bulimia is much more common. Both can involve purging, including vomiting, laxatives and yes, exercise.
3
Watching this film was unremarkable on a number of levels, but most of all due to the centering of both anorexia nervosa and the "Type A" ED-patient - a thin, white, upper-middle class heterosexual female in her teens/early twenties. While I understand that this was based on Noxon's specific experiences, it just furthers the trope that EDs are solely the domain of young white women. Part of the reason it took me over a decade to get any sort of help was because I lived in poverty - I couldn't afford food, let alone residential treatment - but also because as a poor, brown, queer person, my peers and doctors lauded me as overcoming my racial predisposition toward obesity and diabetes, and were totally incapable of even thinking I that I too might be susceptible to an ED. When I was at a medically anorexic weight, I was constantly being complimented by coworkers, strangers, and peers on how great I looked - but it was the young, white, secretary whose similar weight sparked comments of concern and offers of care. It's so interesting how much race and class impacts medical care in this country.
20
In the midst of recovery myself, I have stayed away from watching the trailer and film. I am conflicted on the airing. I truly do feel that it is necessary for more to know the intricate horrors that these diseases spill upon individuals, families, and friends. I just hope it does not trigger or serve as "thinspiration".
I have suffered from anorexia and bulimia, co-morbid with anxiety and depression, since I was 12 years old (I will be 26 next month). I have been up and down physically and mentally throughout these years. Treatments have ranged from hospitals, drug-therapy, ECT, CBT---your whole alphabet, frankly. Some helped, some didn't. It is hard to say because the disease(s) are so multi-faceted.
I have been very fortunate to have an extremely supportive family that has helped me survive. Without them (and to be honest the financial resources they have been able to provide), I don't know where I would be. I worry constantly for those who are not so lucky.
I am on the upswing recovery-wise at the moment, but every day is a struggle. I wish the best to all others out there and am willing to chat with anyone who needs a helping hand or some encouragement. You are not alone.
I have suffered from anorexia and bulimia, co-morbid with anxiety and depression, since I was 12 years old (I will be 26 next month). I have been up and down physically and mentally throughout these years. Treatments have ranged from hospitals, drug-therapy, ECT, CBT---your whole alphabet, frankly. Some helped, some didn't. It is hard to say because the disease(s) are so multi-faceted.
I have been very fortunate to have an extremely supportive family that has helped me survive. Without them (and to be honest the financial resources they have been able to provide), I don't know where I would be. I worry constantly for those who are not so lucky.
I am on the upswing recovery-wise at the moment, but every day is a struggle. I wish the best to all others out there and am willing to chat with anyone who needs a helping hand or some encouragement. You are not alone.
5
Sending continuing healing vibes your way - my 26 year old daughter sounds exactly like you - more than 10 years into an ED, anxiety/depression - 3 in-patient, multiple outpatient and day programs and currently in a good place - please know You're not alone :)
3
"Many of those reacting to the film’s trailer worried that watching it could trigger unhealthy thoughts in viewers who may be prone to eating disorders or already struggling with them. Indeed, some experts said that people who have had eating disorders should consider the state of their health before watching the film."
Then don't watch it?
Then don't watch it?
A few points should perhaps be in discussion here.
We need to stop dividing illness into "mental" and "physical." Mental and emotional symptoms still do arise from physiological dysfunction. An over-anxious person is flooded with an overabundance of otherwise useful hormones.
If a person is so ill that they cannot recognize the effect of their behavior on those who love them best (let's ignore for the moment the effect on themselves), then perhaps they need to be inpatients.
We recognize a failure of personal responsibility when a diabetic doesn't follow medical protocols. We recognize a failure of personal responsibility when someone with diagnosed infectious disease fails to follow medical protocols.
Outside of profound psychosis or schizophrenia, a person with eating disorders recognizes what those are doing to significant others and family. The person may not know what is impelling disordered thinking, but when the entire family's existence revolves around someone who refuses to eat, that person knows they are hurting everyone. Treatment may be difficult but to evade treatment is a choice.
More and more, in this country, we refuse to attach even the smallest level of personal volition to behaviors that harm everyone.
The drug addict stealing everything in mom and dad's house for drug money is choosing to steal. That person is not delusional; is making a choice to succeed in obtaining drugs.
Choices are made, even in severe illness.
We need to stop dividing illness into "mental" and "physical." Mental and emotional symptoms still do arise from physiological dysfunction. An over-anxious person is flooded with an overabundance of otherwise useful hormones.
If a person is so ill that they cannot recognize the effect of their behavior on those who love them best (let's ignore for the moment the effect on themselves), then perhaps they need to be inpatients.
We recognize a failure of personal responsibility when a diabetic doesn't follow medical protocols. We recognize a failure of personal responsibility when someone with diagnosed infectious disease fails to follow medical protocols.
Outside of profound psychosis or schizophrenia, a person with eating disorders recognizes what those are doing to significant others and family. The person may not know what is impelling disordered thinking, but when the entire family's existence revolves around someone who refuses to eat, that person knows they are hurting everyone. Treatment may be difficult but to evade treatment is a choice.
More and more, in this country, we refuse to attach even the smallest level of personal volition to behaviors that harm everyone.
The drug addict stealing everything in mom and dad's house for drug money is choosing to steal. That person is not delusional; is making a choice to succeed in obtaining drugs.
Choices are made, even in severe illness.
I'm not certain of the eating disorder experience from which you speak; if you are a psychiatrist with a specialty in ED, please forgive me - but it doesn't appear that you understand the mental illness as a driver that supersedes 'personal responsibility. These kinds of comments are so terribly destructive to individuals struggling with ED, wherever they are in their struggle; from not accepting their ED to those that are 'cured' but work hard at it every day.
5
As a nutrition professional who treats eating disorders, I feel I have the authority to let you know how much your comments show a lack of understanding about the disease. Especially when you say, "but when the entire family's existence revolves around someone who refuses to eat, that person knows they are hurting everyone." What? An eating disorder robs people of their entire personality, their ability to have perspective regarding how their behavior affects others and their ability to ask for help. The person is no longer the person you know and love.
You said, "Choices are made, even in severe illness." And what if the illness itself is robbing you of the ability to make sound choices? Or choices for yourself at all?
In many cases, it is up to the family/friends at that point to help the person seek treatment. Often, parents will comment that their child is "back" when they are further along in recovery.
Not all people with eating disorders need to be inpatients either - you say that as it it's financially possible for every sufferer to do this! As if insurance companies cover it without an issue...I wish!
I could go on and on...but I will stop here for now because I have patients (outpatients) to see.
You said, "Choices are made, even in severe illness." And what if the illness itself is robbing you of the ability to make sound choices? Or choices for yourself at all?
In many cases, it is up to the family/friends at that point to help the person seek treatment. Often, parents will comment that their child is "back" when they are further along in recovery.
Not all people with eating disorders need to be inpatients either - you say that as it it's financially possible for every sufferer to do this! As if insurance companies cover it without an issue...I wish!
I could go on and on...but I will stop here for now because I have patients (outpatients) to see.
8
Some children with anorexia nervosa have PANDAS/PANS (Pediatric Autoimmune Disorder Associated with Strep or PANS-Pediatric Neuropsychiatric Disorder Syndrome.) This is an autoimmune disorder which is triggered by strep or another illness (as in PANS.) Autoimmune antibodies attack the basal ganglia and cause numerous psychiatric symptoms and physical symptoms: anxiety, OCD, school refusal, bed wetting, Tourettes Syndrome and some children stop eating and refuse to eat. This disorder can be treated with antibiotics and IVIG. Please investigate this as a possible cause if your child stops eating. Anorexia is life threatening. Some children diagnosed with anorexia have PANS/PANDAS. Children have been saved with the correct treatment for PANS/PANDAS if that is the cause of their anorexia.
4
PANDAS is not a scientifically proven condition. Many doctors do not think it is real, and think that it is a psychiatric illness. It's very irresponsible to talk about it as though it factually exists, and possibly send people on a wild goose chase, when it would be very unlikely that their child has it, and if it does in fact even exist as a real biological condition.
Back in the 1970s, before eating disorders were generally recognized as an issue, I watched one of my best friends nearly disappear from anorexia and bulimia. My impression of the trailer for this movie is that it's a glamorized, romanticized view of something this is much more ugly and painful in reality. The music sound track was enough to make my eyes roll. I won't be watching the full-length version. If the trailer annoys me, I don't hold out hope for a different outcome with the film.
There is something deeply wrong, however, with this notion of avoiding "trigger" words and media content because you're afraid facing facts might be too difficult or harmful. If someone has an eating disorder (or an addiction, or he or she was a victim of abuse or other trauma, etc.), how can avoidance of the issue be of any benefit? The point of any therapy is to first face what is true and accept it as such. At it's worst, this tip-toeing attitude around "trigger" words and subjects has stifled free speech, particularly at universities. The world is a harsh place. Hiding from difficult subjects does no one any good.
There is something deeply wrong, however, with this notion of avoiding "trigger" words and media content because you're afraid facing facts might be too difficult or harmful. If someone has an eating disorder (or an addiction, or he or she was a victim of abuse or other trauma, etc.), how can avoidance of the issue be of any benefit? The point of any therapy is to first face what is true and accept it as such. At it's worst, this tip-toeing attitude around "trigger" words and subjects has stifled free speech, particularly at universities. The world is a harsh place. Hiding from difficult subjects does no one any good.
15
It was actually pretty well done and did not glamourize it at all. It was frightening to watch. It was obvious that whoever wrote it had/has and ED. It showed the effects in can have on others, but it also clearly showed some of the methods that anorexics use. For example. cutting up their food and moving food around on a plate while taking only a bite or two. I think it could be helpful for parents to see it, so they can maybe better recognize these "tricks" if their kids are using them. The movie, did not present anorexia in a glamourous light at all. It showed how it rips people apart and makes them empty inside. It showed the lack of logic involved in the victims of the disease. It showed how some of the things families actually causes more harm.
I agree with you about the triggers. Many anorexic people actively seek out "thinspiration" and go to pro-ana websites. If they seek things out, they will find it, with or without this movie. We shouldn't not talk about something, b/c it might trigger people. They can choose not to watch it. If they are looking for pro-ana stuff, they will find it and this movie is not going to push them over the edge. There are warnings at the beginning of the movie. The public should not be looking to movie makers and TV producers to a save them from every issue that might trigger them.
I agree with you about the triggers. Many anorexic people actively seek out "thinspiration" and go to pro-ana websites. If they seek things out, they will find it, with or without this movie. We shouldn't not talk about something, b/c it might trigger people. They can choose not to watch it. If they are looking for pro-ana stuff, they will find it and this movie is not going to push them over the edge. There are warnings at the beginning of the movie. The public should not be looking to movie makers and TV producers to a save them from every issue that might trigger them.
2
Eating disorders are a form of self-harm, a symptom of borderline personality disorder. My daughter was bulimic for 6 years. Not until the last year of her life was she properly diagnosed with borderline.Other signs of self-harm are cutting, drug abuse, risky behavior (sexual and otherwise).
6
Not everyone is your daughter. People have different eating disorders, and often in the absence of trauma. 65-80% of the risk of developing anorexia is genetic. Almost everyone who develops anorexia has an accompanying anxiety disorder. Bulimia is more often associated with a history of abuse. The fact is that the causes of many eating disorders - especially anorexia - are not understood, and for anorexia there are zero reliably effective treatments. NO medications are effective in treating anorexia. The efficacy of various therapy modalities (CBT, DBT) are also unsupported by research. This is part of what is so terrifying about anorexia. By all means, reach out for help, but do not expect anyone to yet have any form of "cure." Recovery is a long, hard, brave, non-linear and very uncertain battle. It is lost roughly 20% of the time. This is the most deadly neuropsychological disease, and it is routinely trivialized and ignored; research goes unfunded; treatment is often not covered by insurance. Does this disgraceful neglect have anything to do with the fact that the victims of this illness are most often young women and girls?
7
Becky, Thank you for your message. I wish you peace. Kathleen
2
I do think that the neglect does have to do with the fact that it mostly affect girls and women. When diseases frequently affect men, they are given more attention and are better addressed.
1
The one guy that gets sampled in these comments is the ONE GUY. I don't think people appreciate how incredibly pervasive eating disorders are among young men. Have you looked at the fitness industry lately? Do you know how popular sports where you have to drop weight are ie fight sports?
I don't think we should stop seeing fit people in the media, because the beauty standards for men have been roughly the same for 1000 years. But I do think that people need to pay attention to how they talk about other people's bodies - and that includes men.
I don't think we should stop seeing fit people in the media, because the beauty standards for men have been roughly the same for 1000 years. But I do think that people need to pay attention to how they talk about other people's bodies - and that includes men.
8
The thing about eating disorders that angers me the most is how much time and energy is spent daily involving the eating disorder. It impairs your ability to learn and grow. It is a thief, a beggar, and a bully of the soul. Driven by the fear of fat. It's just fat! It isn't your soul or your spirit. It is just squishy stuff on your body! I am trying so hard to live and be a whole person with the squishy stuff I've acquired since I stopped purging after 35 years, but it is taboo in our society.
13
Many people don't realize that eating disorders can continue through and beyond middle age. As a former anorexic who still struggles with weight issues (I'm 5'7" and 100 pounds) in her middle years, believe me, I can spot them at the gym. For every hyper skinny 20-something there are at least three or four women in their 40s, 50s, and older with toothpick arms and legs, wearing their hair in severely pulled-back ponytails to mimic their youth. Many are single, divorced, or widowed; all wear black compression tights to appear even thinner. I think this phenomenon is increasing rapidly as the self-obsessed boomer generation (of which I am one) confronts aging with few or no psychological, physical, or spiritual resources. Easily broken bones are only the surface of what will become a real health epidemic among this population.
8
The first time I saw a sufferer of Anorexia was in the summer of 1966. My parent and I had been invited to tour the Islands of Greece by an American friend with his children, who invited friends of their own, and the 'Adolescent' party in this group of guests formed a number of eight.
It was not spoken of, before or after with my parent, and I gave it little thought (a rare ailment of some kind). At school in France, to my knowledge none of my classmates had this illness, we tried to keep our weight balanced, and felt quite sophisticated by the time we were seventeen with our Dior nail polish and small Shetland sweaters.
Today, we are making progress when it comes to eating disorders in America. Recently two adolescent girls, one obese, one anorexic, walking together in the City, friends looking hopeful, gave one hope for them, and for all the sufferers with their moving testimonies, speaking on behalf of others.
It brings to mind a short story 'Starving', by Elizabeth Strout in her award-winning novel of Olive Kitteridge, a teacher in Maine. Moving, and not for the faint of heart, it is now remembered as I write. We care.
Some of us are now old enough to be great grandparents, but it is you with a far stronger voice, who remind us of how difficult it can be when one is young to make the right choices. It still is, always, but you are needed to remind us of what tomorrow can bring to make this a better world.
It was not spoken of, before or after with my parent, and I gave it little thought (a rare ailment of some kind). At school in France, to my knowledge none of my classmates had this illness, we tried to keep our weight balanced, and felt quite sophisticated by the time we were seventeen with our Dior nail polish and small Shetland sweaters.
Today, we are making progress when it comes to eating disorders in America. Recently two adolescent girls, one obese, one anorexic, walking together in the City, friends looking hopeful, gave one hope for them, and for all the sufferers with their moving testimonies, speaking on behalf of others.
It brings to mind a short story 'Starving', by Elizabeth Strout in her award-winning novel of Olive Kitteridge, a teacher in Maine. Moving, and not for the faint of heart, it is now remembered as I write. We care.
Some of us are now old enough to be great grandparents, but it is you with a far stronger voice, who remind us of how difficult it can be when one is young to make the right choices. It still is, always, but you are needed to remind us of what tomorrow can bring to make this a better world.
7
I don't know what it is about Americans and food. While there are millions who are harming themselves via starvation, what about the eating disorder that impacts 2/3 of Americans? Obesity (1/3 of Americans) and overweight (another 1/3) is a way bigger problem, but we don't treat it like the disease that it is. When someone's BMI is over 25, we need to have doctors start addressing the issue as a disease. I have seen so many people's lives destroyed by obesity, it makes me sick.
6
If any of the readers have experienced anorexia nervosa and would be willing to take a survey on recovery from it for doctoral research, please follow the link below. Thank you!
https://bostoncollege.co1.qualtrics.com/jfe/form/SV_0TYOJNBB0iAQOQl
https://bostoncollege.co1.qualtrics.com/jfe/form/SV_0TYOJNBB0iAQOQl
4
when one person in the family has an eating disorder, the entire family has an eating disorder. The anorexic is the "identified patient" who is channelling the stresses of being in that family upon himself or herself. (we're all normal except for this one kid) Parents of children with eating disorders refuse to see their role in it, which is why there are now so many in-patient services, to get their children away from the toxic environment of their parents and other siblings - who are typically complicit. Medical staff have to do the difficult dance of protecting the young patient without offending the parent -who has the power to withdraw the patient from treatment if there is the least bit of suspicion that the blame for the child's sickness will fall on one of the parents or any of the other kids or grandparents or what have you.
16
Wow, I wonder if you are a parent of a child with annorexia. After 10 years of battling this nightmare with my 12 to 22 year old daughter, I never "refused" to see my role in it. The world was literally spinning, and I was wracked with guilt over working (being the breadwinner for a family of 5) and knowing we couldn't afford to go Maudsley. How can this comment possibly help any family? In all the treatment facilities the medical staff never played a game of protection; it was all brutally honest. If I felt I had the emotional capacity to save my daughter I would've. But comments like yours make parents feel even shittier than they do during this horrible darkness. Thanks for that. If it makes you feel better, our family has dissolved; I'm now divorced. I don't for a minute blame any of this on my daughters eating disorder; conversly, her courage during her final time in treatment now as an adult forced me to be completely honest with myself about my relationship and my emotions. Ms. Eldridge, blaming parents in the way you do helps no one, and not one parent I have met in my journey has not accepted a role in this. I certainly hope you are not in the theraputic field.
69
Elle, I am puzzled by your use of the word "complicit." Do you mean that parents overtly, knowingly enable and encourage the behaviors of the child with an eating disorder (in behavioral terms, by rewarding such behaviors)? Or do you mean that an unaddressed, unhealthy family dynamic is the cause of the child's disorder, so the toxic parents are complicit by their inaction? Those are two very different accusations. I wonder, too, whether you have personal experience with this, and whether you are the parent or the child in this scenario.
My own observation is that parents and siblings, in this situation, are confused, angry, hurt, desperate, frightened, and many other things. In other words, human. No family is perfect.
My own observation is that parents and siblings, in this situation, are confused, angry, hurt, desperate, frightened, and many other things. In other words, human. No family is perfect.
11
Lacking compassion, understanding and nuance, this comment is ignorant and destructive. Some families have issues that are a factor in eating disorders, many do not.
What is universally true is that when a family has a child being treated for an eating disorder, the disorder becomes the organizing principle for the family and can have profound effects on family dynamics.
What is universally true is that when a family has a child being treated for an eating disorder, the disorder becomes the organizing principle for the family and can have profound effects on family dynamics.
4
I spent years in a relationship with a man who had an eating disorder and was very open about his behaviors with me...it was so painful because I could do nothing to help, offset, heal, anything...I am a trained chef from a culinary school that specializes in food as medicine and as a healthy part of life, rather than just techniques...I was armed with all the knowledge about what would be good to eat for him, but it had nothing to do with the actual foods...and I felt utterly powerless...extreme overeating was what he dealt with and his specific behaviors surrounding eating were very ritualistic...it was amazing that he would share such painful experiences so readily, but I could not do anything but listen...and his family had a history of disordered eating as well, which I discussed at times with them...there was no help ever sought and there was a white knuckle quality to his eating as to how long he could hold on before he would binge...I am no longer with him and it was too painful to be around because there were myriad of other factors affecting his life he did not choose to address...but what I did learn is that it is not about the food or the knowledge of how to cook it or what to eat...it's about relationships to one's self and those around them...that is my 2c
38
Laura, Yours is a helpful comment. Thank you for taking the time to express it.
My mother in law has an eating disorder and is constantly telling my two beautiful daughters " you want to be skinny, don't eat that" or " tuck in your shirt you look akinnier that way". Nobody in the family has ever said anything to her until one day I did and she denied it. She is 66 years old and I have seen her weight go up and down throughout my 20 year marriage. It can happen to anyone.
24
We need to remember that people with disordered eating can affect children, and grandchildren, etc... in a destructive way. It's easy to think, "Oh, they would never harm my child." But they don't mean to. They don't see it as harm. It's a part of their lives and ingrained in them. They may even very well think that they are helping. I know someone with anorexia who would talk about how her infant was a light eater, and she thought it was cute. She was bragging about it. The child was actually becoming malnourished. Luckily, her husband recognized it, and the mother got treatment. I'm not sure what happened after that, b/c we lost touch. But her husband was thinking of leaving and taking the child with him in order to protect the baby. Going o treatment was a condition for him to even think about staying. He knew the mom had struggled with an eating disorder growing up, but thought it was "gone." I think the weight gain from pregnancy triggered her. And, since she hadn't become thin yet, it didn't occur to him that she was engaging in disordered eating. His mother actually said something about comments mom made, and how the baby didn't look terribly healthy. He added it all together and realized how serious it was. What he told me is that he didn't want the child growing up in a situation where mom was so obsessed with weight that it made the child's life miserable and endangered her.
1
While I am happy to see anorexia nervosa receiving the attention and compassion it deserves, I am saddened and angered that other forms of disordered eating do not receive the same compassion and help. Obesity in particular is an eating disorder that is met not with compassion but with scorn, ridicule, and punishment.
I am glad that the medical and psychological professions are starting to understand that gaining weight is not a choice that is under the anorexic's control when s/he is in the throes of the disease. I am waiting for the same realization to happen in the case of compulsive eating. We now know that just telling an anorexic "Oh, just eat a burger, will you, Twiggy" won't work. When will we figure out that "Oh, just put the fork down, fatso" won't either. A person whose mind is hijacked by cravings and compulsions is not necessarily capable of breaking them without intense help and support.
At their heart, eating disorders, whether eating too little, too much, or binging and purging, are driven by an intense self-loathing that drives a person to try to disappear, either by wasting away to nothingness or by hiding behind a cocoon of fat. They are two sides of the same coin, and should be treated similarly. All eating disorders are fatal; anorexia is just quicker and more obvious than diabetes and heart disease. I am happy that anorexics are no longer being blamed or shamed; I'm waiting for the same to be true for the obese.
I am glad that the medical and psychological professions are starting to understand that gaining weight is not a choice that is under the anorexic's control when s/he is in the throes of the disease. I am waiting for the same realization to happen in the case of compulsive eating. We now know that just telling an anorexic "Oh, just eat a burger, will you, Twiggy" won't work. When will we figure out that "Oh, just put the fork down, fatso" won't either. A person whose mind is hijacked by cravings and compulsions is not necessarily capable of breaking them without intense help and support.
At their heart, eating disorders, whether eating too little, too much, or binging and purging, are driven by an intense self-loathing that drives a person to try to disappear, either by wasting away to nothingness or by hiding behind a cocoon of fat. They are two sides of the same coin, and should be treated similarly. All eating disorders are fatal; anorexia is just quicker and more obvious than diabetes and heart disease. I am happy that anorexics are no longer being blamed or shamed; I'm waiting for the same to be true for the obese.
92
I don't really think that is true for the majority of overweight or obese people. The morbidly obese, yes, but for the rest of us, not so much.
1
Not unlike drug addiction, wherein the addict is similarly driven by self-destructive self-loathing.
3
Wow, Nikki, finally someone else feels the same way as I do!! I've often wondered why anorexia/bulimia gets labeled as an eating disorder, yet overeating/obesity is considered lacking will-power and being weak. I've struggled with my weight since I was 15 years old (I'm now 56) and it has been a nightmare at times. I've never been more than 40 pounds overweight, yet I find it incredibly hard to lose weight. I'm a runner now and that has helped me lose 25 pounds along with Weight Watchers, but I find myself slipping again and I would really like to get to the bottom of my issue. Why can my husband put his fork down when he's full yet I will eat a second helping? How can he simply refuse a cupcake and choose an apple when I can't? What is it about him (and others) that is wired differently from me? And why Is the girl down the street who vomits her dinner up so different from the the girl up the street who eats and eats and doesn't regurgitate her food?
9
My sister has battled anorexia twice now. When she was a teen it tore our family apart trying to deal with it. Dinner was a constant battle to get her to eat and she was in and out of treatment centers. It came back again in college and but now she has more or less been OK the last 10 years although she will never ever eat completely normally again. It has only been in the past few years she has finally sat down at the dinner table again. I think the film was OK but more superficial than I would have like to have seen. It is an incredible life or death battle in a family where any moment you are expecting a call that she has had a heart attack running on the side of the road or that her body just gave up. I think the film did not go deep enough into the horror that really is living/witnessing anorexia.
41
My friend's husband has an eating disorder. For him, it's not about weight but about not being able to eat some foods--mostly most healthy ones. His diet is very limited, almost like some autistic kids' are. It threatens his own health and makes raising healthy kids more difficult. I know it really bothers him.
12
They call it orthorexia
15
Sounds like he has Avoidant Restrictive Food Intake Disorder or ARFID. There are definitely resources to help with this. Duke University does a lot of research and treatment on ARFID.
16
I wanted to ask about my daughter - severely food allergic and every meal since she was a toddler is a battle. Now she's 17, suffers from eczema, asthma and food allergies and her diet is severely limited - organized into the columns of "can't eat" and "won't eat." It affects her social life as she doesn't want/can't eat where the kids are going. I worry for her mental and physical health. Any suggestions?
My biggest issue with this movie is that it takes an 80s story and sets it in 2017. Things that should not happen in 2017, now that we understand this is a genetic, neurobiological illness with a varied environmental component: family blaming, waiting for rock bottom, treatment that doesn't require nutritional/weight restoration and interruption of behaviors, and wacky "reparenting as an infant."
Possibly the largest problem is the mistaken idea there is always some "underlying cause" for an eating disorder. In a genetically vulnerable person (which can often be identified by innate temperament), a negative energy balance (often unintentional) will alter brain wiring so that eating activates the anxiety center of the brain rather than the pleasure center. Nutritional restoration and a high enough weight can switch this down or off so that a person can then develop an understanding of their wiring and develop the skills to ensure they don't enter this negative energy balance state.
Of course, there are people with other issues and toxic family dynamics who experience this and that seems to make a "sexier" movie - and it is only one story and not the most common one.
For anyone interested in learning what we know in 2017, a 20 minute TED Talk by Dr. Laura Hill called "Eating Disorders from the Inside Out" is an amazing primer.
Possibly the largest problem is the mistaken idea there is always some "underlying cause" for an eating disorder. In a genetically vulnerable person (which can often be identified by innate temperament), a negative energy balance (often unintentional) will alter brain wiring so that eating activates the anxiety center of the brain rather than the pleasure center. Nutritional restoration and a high enough weight can switch this down or off so that a person can then develop an understanding of their wiring and develop the skills to ensure they don't enter this negative energy balance state.
Of course, there are people with other issues and toxic family dynamics who experience this and that seems to make a "sexier" movie - and it is only one story and not the most common one.
For anyone interested in learning what we know in 2017, a 20 minute TED Talk by Dr. Laura Hill called "Eating Disorders from the Inside Out" is an amazing primer.
46
I just watched the movie and I think some of your assumptions are off base. In the movie, patients do get weighed. Moreover, there is one scene where the therapist clearly says "There is not one underlying cause." Just my 2c.
1
You criticize the movie for attributing it to some underlying cause just before you describe what you believe is an underlying cause.
4
I've both watched the move and have current lived experience with this. That line was the best one in the movie-and yet he didn't discuss the multiple influences (genetics is 50-70%). I did think the relationship with the sister was strong and genuine.
There is zero percent chance a residential treatment center would allow patients to choose their own food or whether or not to eat. That was upsetting. As was the idea it was a matter of simply "choosing" to get well.
There is zero percent chance a residential treatment center would allow patients to choose their own food or whether or not to eat. That was upsetting. As was the idea it was a matter of simply "choosing" to get well.
25
I have specialized in the treatment of eating disorders for nearly 2 decades. For the most part, eating disorder professionals were not permitted access to the film prior to the premier. Members of the media are routinely provided advance screenings of films in order to review films for publication. Especially when a film is on a topic of such gravity and with significant potential life changing impact on its—often young—viewers, I believe this refusal to allow clinicians and other professionals to get a head start on it so they could meaningfully contribute to the conversation around the film, beyond what lay people in the media can provide, was unwise and bordering on irresponsible.
I have a lot of thoughts about this film, it's benefits and risk. For more of my thoughts on this, please go to: https://www.psychologytoday.com/blog/one-more-bite/201707/chilledto-the-...
I have a lot of thoughts about this film, it's benefits and risk. For more of my thoughts on this, please go to: https://www.psychologytoday.com/blog/one-more-bite/201707/chilledto-the-...
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Having a bit of advance notice would also help doctors anticipate some of the reactions to the film they might see in patients.
22
You must have gotten wind about the film, especially with its sensational premiere at Sundance. Did you bother to request an advance copy?
6
Thank-you for providing a reality check for those who haven't experienced eating disorders first-hand. For those who have - we unfortunately understand these realties. I imagine providing the whole ugly truth on eating disorders would not make for an entertaining 'view'. I was particularly bothered with how Eli's 'choice' to recover happens in an instant - certainly life events can help a patient move towards recovery - but the instantaneous nature of her 'finally' willing to get better perpetuates the thought that eating disorders are more of a choice.
I know women in their 60's and 70's with eating disorders. They are everywhere. They have a skewed perception of themselves and manage to live on a few hundred calories per day. I would be interested in the medical evaluation of what happens to one's body, etc. during this turmoil.
19
They have osteoporosis, for starters.
4
I agree, I think this is common and unrecognized. I hear so many women say things like "At my age I don't need to eat much," and clearly there is pride in refusing food and eating as little as possible. Digestive issues, frequent infections with slow recovery, chronic pain, poor sleep, cold intolerance and low energy can all be related to malnutrition, although many people do not make the connection.
6
try the internet
Eating disorders are so very misunderstood, even by those affected by them; including family, friends, etc. It seems no 2 are alike. After 3 inpatient stays over 9 years, my now 26 daughter found the words that made it clear'er' to me because as we all know - there is no rational understanding of this illness. She said she wanted to "disappear" and was able to relate why. Finally, I had a starting point, a basis of understanding how she feels, instead of just "control" - the word that is so often thrown around as a cause for eating disorders.
21
I hate the "C" word! Control is a symptom rather than a cause. So frustrating to her it said so knowingly by anyone whose seen a Lifetime TV movie on anorexia. I hope your daughter is doing well today. Mine is at 22 because 5 years ago we got the most up-to-date treatment in the world at UC San Diego - geographically lucky made all the difference for us.
19
My daughter was at Monte Nido (the original) in Monte Nido, CA most recently - and is doing well (fingers crossed) but she's been out only since late May, following a 3 month stay (ouch). Glad your daughter is also well and I appreciate the info on San Diego - though I hope to never need it :)
If the trailer accurately reflects the movie, To the Bone may do more harm than good. Girls will look at beautiful, waif-like Lilly Collins and want to look just like her. The fact that she is slowly dying of a terrible disease won't register as much as the fact that a handsome doctor is devoting himself to her treatment and a sweetly adorkable guy her own age is hanging around giving her pep talks.
In the 1980's there was a program in which recovering bulimics were sent to schools to tell young girls just how hideous eating disorders were. Researchers found that when the speakers were slender and attractive the audience ignored what they had to say and were more likely to develop eating disorders than a control group. The takeaway was something along the lines of, "I'll just get a little bulimic for a little while until I'm thin, and then I'll quit."
This film would be more responsible if it starred a less attractive heroine and a middle-aged female doctor. Of course, such a film would never get made because Hollywood sells exactly the kind of unhealthy attitudes toward the female body that have made eating disorders so pervasive.
In the 1980's there was a program in which recovering bulimics were sent to schools to tell young girls just how hideous eating disorders were. Researchers found that when the speakers were slender and attractive the audience ignored what they had to say and were more likely to develop eating disorders than a control group. The takeaway was something along the lines of, "I'll just get a little bulimic for a little while until I'm thin, and then I'll quit."
This film would be more responsible if it starred a less attractive heroine and a middle-aged female doctor. Of course, such a film would never get made because Hollywood sells exactly the kind of unhealthy attitudes toward the female body that have made eating disorders so pervasive.
104
I understand and agree with your comment. But the movie only can be effective if people see it. I can understand how the thin is sexy opinion can drive the desire to lose too much weight but if people spent any amount of time with someone deep in the throes of this terrible disease they would not find it sexy at all. Watching someone you love turn "inside out" is torture. My daughter lived through that stage despite weight so low that not a single one of her doctors thought she would. She is at a healthy weight for several years now but the "recovery" period really never ends. The struggle just continues. The process at it's worst is simply horrifying and in some ways beyond description.
At the lowest, nearly fatal level she said to me" dad, I never meant it to go this far". Thanks to some talented people and her inner strength she survived a brutal but necessary rehab and continues the fight every day.
There is nothing sexy about people with a disease that causes them to starve themselves to death. The true visual, the rehab experience, the patients going about their days with feeding tubes, the people in wheelchairs too weak to walk, the 24 hour supervision even at the most personal of times might have a profound effect on someone who wants to help. But I don't think it alone would have helped my daughter. After all, she never meant it to go this far.
I have to believe that any exposure for this disease is good .
At the lowest, nearly fatal level she said to me" dad, I never meant it to go this far". Thanks to some talented people and her inner strength she survived a brutal but necessary rehab and continues the fight every day.
There is nothing sexy about people with a disease that causes them to starve themselves to death. The true visual, the rehab experience, the patients going about their days with feeding tubes, the people in wheelchairs too weak to walk, the 24 hour supervision even at the most personal of times might have a profound effect on someone who wants to help. But I don't think it alone would have helped my daughter. After all, she never meant it to go this far.
I have to believe that any exposure for this disease is good .
23
So many AMENS to this comment. Why, dear god, why, must we perpetuate this horror. The still used in this article says it all. I just hope my semi-recovered eating disordered daughter doesn't see this.
3
These people's voices and stories are extremely important. I see you - you matter - and I do not want you to disappear. Thank you for having the courage to share.
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Thank you so much, Sara.
7