TO THE BONE Review: The Perils Of Dramatising Eating Disorders

Lily Collins stars in an empathetic but underdeveloped Netflix original.

Content warning: this review (and the film under review) contains discussion of anorexia and other eating disorders.

Marti Noxon’s Netflix feature To The Bone has been cursed since its announcement. Eating disorders are uniquely difficult to depict, because even if an actor loses dangerous amounts of body weight for their role, the resultant imagery will inevitably be interpreted as glamourisation. Thus, filmmakers frequently lean into the body-horror aspects of the subject, or patronise audiences with movie-of-the-week moralising.

To The Bone doesn’t do any of those things. It endeavours to be a frank, honest look at the human beings behind eating disorders - to paint them as people, rather than as problems. And it very nearly succeeds. Nearly.

Lily Collins is clever, sassy artist Ellen, spending her early twenties bouncing between medical centres struggling with anorexia nervosa. She does situps until her spine bruises; she counts calories from memory; her body grows extra hair to keep itself warm. She’s disaffected with the world, with an addict’s razor-sharp focus only on her compulsive need to lose weight. Despite claiming that she’s “got it under control” and that she “doesn’t feel unhealthy,” there’s always further she can go - which is why she’s admitted to a treatment programme led by the controversial Dr. Beckham (Keanu Reeves), where most of the film’s action takes place.

Writer-director Noxon's screenplay bears the unmistakable touch of having been there herself (which she has). By far the film’s greatest asset, it’s full of observations not just of the experience of anorexia, but of external attitudes towards it - from the strict rulemaking of medical professionals to the well-meaning cluelessness of Ellen’s stepmother. Much like Richey Edwards’ self-deprecating lyrics on the uncompromising Manic Street Preachers album The Holy Bible, the dialogue is shot through with the gallows humour people with self-inflicted issues often exhibit. Some might take offense at that lighter touch, but far from trivialising or glamourising, Noxon’s sense of humour instead humanises her characters. These aren’t medical textbook subjects or wax-museum exhibits; they’re human beings, with lives and families and jokes and inner monologues.

To The Bone’s character-centric approach isn’t the horror movie people might expect. Rather, it’s actually life-affirming, presenting Ellen's relationships as reasons to stop wasting away. That positivity might nauseate or anger some, but it’s better than the scared-straight approach, and it wouldn’t work at all were it not for Lily Collins’ performance.

Collins’ physical transformation for the role is as alarming as you’d expect: all ribs, eye sockets, and cheekbones, swimming in oversized clothes and ever shrinking from view (even if her nutritionist-guided diet left too many telltale signs of health). As a survivor of eating disorders herself, it can’t have been easy to take on the role, but Collins approaches it with honesty and energy that frankly outshines the movie surrounding her. Her myriad micro-expressions when inspecting her weight speak volumes to the conflicting emotions conjured up by anorexia, as does her delivery of Noxon’s sardonic dialogue. By turns funny and empathetic, this would be a star-making turn for Collins were it not so stomach-turning.

For all the honesty contained within the dialogue, the film leans too heavily on it. The various therapy sessions paint a thorough picture of anorexia, but it’s all intellectual, all clinical. Noxon's direction, too, suffers from a flat, coverage-centric approach common to indie features, her camera often lacking subjectivity in a story that could really have benefited from it. Compared to the Safdie brothers’ Heaven Knows What, which similarly fictionalised writer/star Arielle Holmes’ struggles with heroin abuse, there's little sense that we're in the cauldron with these characters. It's telling that the film only truly comes alive in a hallucinatory near-death experience, rendering Ellen's surreal existence visually for one brief sequence.

Many have criticised Noxon’s decision to focus on characters over horrific imagery, claiming she has a responsibility to rub the audience's faces in her characters’ plight, lest suggestible audiences see Ellen’s skeletal state as a goal. Curiously, the film addresses this issue in its text. Ellen's backstory contains an episode wherein her Tumblr art, expressing her body issues, inspired a girl to kill herself. Reeves’ character reassures her, reminding her that “there’s plenty of other stuff out there for people to fetishise,” and he's right, but he also tells Ellen to keep her art to herself from then on. To The Bone is on Netflix. It’s an uncomfortable argument either way. But how do Noxon and other survivors create art about their experiences without depicting them? Perhaps To The Bone’s portrait of anorexia could become a useful insight for families, in the same way Depression Quest has been for depression. It's definitely a movie that demands discussion.

Moral quandaries aside, To The Bone is tragically uneven as a piece of drama. The supporting cast can’t live up to Collins' lead performance, largely due to a paucity of material. Keanu Reeves is woefully miscast as Dr Beckham, whose “unorthodox” methods are apparently limited to unconvincingly swearing at his patients. Ellen's housemates represent different colours of the eating-disorder rainbow - bulimia, compulsive eating, feeding tubes, failed pregnancy - without ever emerging as fully-formed characters. Her family, with the exception of her half-sister (a warm, genuine performance from Liana Liberato), are two-dimensional cartoons, with her father perplexingly oft-referenced but never seen. Even the great Lili Taylor, as Ellen's birth mother, gets insufficient screen time to build to the strange emotional climax in which her character is involved.

And then there's Luke, a fellow anorexia sufferer played to the hilt by Tony winner Alex Sharp (The Curious Incident of the Dog in the Night-Time). A former ballet dancer and current Raymond Chandler obsessive, Luke is an insufferable know-it-all, both in general knowledge and in his treatment, where he's further along than Ellen. Their romance - hell, even their friendship - is nearly impossible to buy, again reducing the impact of Ellen’s character arc.

But To The Bone's greatest sin is its embodiment of the very platitudes against which its protagonist spends most of the movie railing. Its message - that we have to truly want and decide to get better, and that such a decision can only come from within (even from hitting rock bottom) - speaks deep truth, but dramatically speaking, Ellen's decision isn't earned. All the elements factoring into it - her deteriorating health, her relationship with Luke, her reconnection with her birth mother - are simply not developed enough, or believably enough, to convince. So her final choice just happens, with all the weight of a Hallmark card.

Noxon and her team deserve credit for eschewing a frightening or condescending tone in favour of something more life-affirming and hopeful. But despite sharp dialogue and a strong lead performance, To The Bone is too conventional in its direction to immerse, and too distant in its stagey script and shallow supporting performances to connect with its audience. It isn’t the dangerous filth its detractors have claimed since even before its release - it’s far too empathetic for that - but it isn’t a life-changing triumph either. It’s just a bit bland, which in this case may be its worst-case scenario.

As always: if you or someone you know is in crisis, don't hesitate to ask for help. There are always people willing to lend a hand.

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