To The Bone: A psychological Movie Analysis (2024)

Marti Noxon is the author and director of the 2017 American drama film To the Bone. Lily Collins plays a young woman in the movie who is being treated for anorexia nervosa.

With anorexia, Ellen is a 20-year-old college dropout who returns to her stepmother's and father's household after battling through an in-patient treatment and failing to make any real progress, owing to her stubborn, rebellious nature. Ellen's stepmother, Susan, arranges for her to meet with a specialist, Dr. William Beckham, who recommends that Ellen enroll in his patient program because her absent father is hesitant to cope with her. Although Ellen is hesitant to do it, her younger sister convinces her otherwise.

Six patients, including Luke, a joyous ballet dancer recovering from his anorexia and a tragic knee injury, and five young women come into the house with Ellen. Luke supports the other sufferers morally and shows a particular affection for Ellen. He soon confessed his admiration for Ellen's artwork.

Ellen's father does not show up for a Beckham family therapy appointment. Ellen lived with her mother until 18 months prior, when she left to travel to Phoenix, Arizona, with a lesbian partner. It is revealed that a girl who later committed herself claimed prior artwork she had put on Tumblr as an influence. Ellen makes a commitment to try harder, but she instead keeps losing weight.

Ellen advances, renaming herself Eli and developing a close relationship with the other residents of the residence.

Later, she finds out that Megan, another lady living there, miscarried her child after starting her purging again at 12 weeks of pregnancy since she thought it was safe to do so. Eli is devastated by the incident and resolves to leave. Luke begs her to stay as she leaves, saying that he needs her and that he needs something fresh to focus on because he knows his knee condition is irreversible and he would never be able to dance properly again. Eli still departs.

Eli, who is close to death, decides to visit her mother. The following evening, her mother apologizes for not being a good enough mother, claiming that the postpartum depression she experienced after giving birth to Ellen was devastating for her, and advises that she try nursing Eli from a bottle while comforting Ellen which she learned from a wise woman in her community. Eli finds the concept weird, but she agrees to go along with it since she carves her mother’s warmth and the fear of death scares her.

Eli takes a nighttime walk after eating. She lies down on the ground and blacks out, thinking she is under a tree with Luke, who is able to convince her that she is ill. She takes the chunk of coal he offers her, which stands for her bravery. She reflects on her own body and is horrified.

Eli awakens from her dream, is glad to be alive when she had little hope for it and makes the decision to go back home. She hugs her sister and stepmother and then resumes her participation in Beckham's patient program.

The movie ends on a hopeful note where it is shown that Ellen is more hopeful about the future and determined to change for the better.

ANOREXIA NERVOSA

Anorexia nervosa is a severe and potentially fatal eating disorder that is also curable. Extreme food restriction and a strong dread of putting on weight are its defining characteristics. An eating disorder is anorexia, also referred to as anorexia nervosa. Anorexics restrict their caloric intake and the kinds of food they consume. They eventually gain weight or are unable to maintain a healthy body weight for their height, age, stature, and physical condition. They could have an obsession with exercise, purge their meals by purposeful vomiting or abusing laxatives, or all three.

Additionally, those who suffer from anorexia have a distorted perception of their bodies and a crippling fear of putting on weight.

Anorexia is a serious illness that needs to be treated. Malnutrition, threatening health dysfunction, and even death can result from anorexics' extreme weight reduction.

The movie also starts off with the main character’s parents worried that she might do some harm to herself because of her disorder and may even end up dying. She is aware of the calorie count of every single food item served to her because she dreads consuming a lot of calories and putting on weight

Causes

In the movie, a variety of reasons have been highlighted as to why the main character might have developed the eating disorder.

The therapist of the main character calls her out for carrying out this behavior of not eating to become skinny to the point where she looks scary and can scare people around her including her family members.

It can also be gathered that because of the traumatic history the main character had, she might justify her unhealthy, irrational behaviors as a punishment for herself. A fan of her artwork committed suicide and the main character was somehow mentioned in the case. The guilt might have played a causal factor.

It is also hinted in the movie that the disorder is something the main character has grown comfortable in. A cause for her not getting better is that. She has an extremely pessimistic take on the world and blames everyone but herself for her behaviors which is a faulty cognition.

The actual cause of the illness is unknown, although experts believe that inherited, environmental, biological, psychological, and other factors may be to blame.

Psychological factors- Anorexia nervosa can emerge for some people as a means of taking charge of a particular area of their lives. Since exercising control over one's eating behavior seems successful, the behavior is maintained. Common psychological factors that can facilitate the disorder are a history of depression and anxiety, improper management of stress, perfectionism, feelings of compulsion, and phobia of being fat to name a few.

Environment factors- Modern civilization places a great value on physical attractiveness, and in Western culture, a slim frame is typically regarded as more attractive. Young women are more prone than men to be affected by the condition, probably as a result of the idealizations of the female gender. An individual's health can be impacted by the pressure to adhere to an idealized body image, which also raises their chance of developing anorexia nervosa.

Genetic factors- A family history of eating disorders, depression, or substance misuse is possible, and those who are predisposed to any of these conditions are more likely to experience anorexia. This correlation can result from a genetic link that was passed down from the parents.

Biological factors- The prevalence of anorexia nervosa is highest throughout puberty, which is thought to be related to the hormonal, metabolic, and neurological changes that take place during this period. There may also be a role in the brain's aberrant biochemical makeup. The release of neurotransmitters including serotonin, norepinephrine, and dopamine, which have an impact on a person's mood and appetite, is controlled by the hypothalamic-pituitary-adrenal axis (HPA). Serotonin and norepinephrine levels are frequently lower in those with anorexia nervosa, indicating that they may have a role in the pathophysiology of the illness.

Symptoms

While watching the movie, several symptoms related to anorexia can be identified. The main character wears a lot of warm clothes, and jackets even when the weather doesn’t seem to be that cold. She compulsively does sit-ups. She has a lot of body hair called lanugo which is identified by her therapist as a defense mechanism of her body to keep herself. She seems very irritable. When asked by the doctor about her menstrual cycle, she says it was so long back that she doesn’t even remember when she last got her period.

The symptoms can be broadly divided into physical symptoms and emotional and behavioral symptoms.

Physical symptoms-Insomnia, exhaustion, excessive weight loss, thinness, discoloration, intolerance to colds, the absence of menstruation, low blood pressure, and others may be overt or hidden symptoms.

Behavioral symptoms- Under this, the anorexic person will display the following behaviors. Severely limiting one's intake of food through fasting or dieting, The consumption of laxatives, enemas, diet aids, or herbal products, as well as excessive exercise, binge eating, and self-inflicted vomiting to get rid of food, are all examples of the behaviors possibly emitted.

Emotional symptoms- Refusal to eat or inventing justifications for doing so, avoiding eating in front of others, lying about the amount of food consumed, Fear of gaining weight, which may involve routine body checks such as weighing or measuring, frequent inspection of one's reflection for perceived defects, complaining that they are overweight or that certain body portions are obese, a mood that is flat or unemotional, social isolation, mood swings come under emotional symptoms.

Treatment

In the movie, the therapies apply a number of therapeutic techniques to help the main character. Maudsley therapy, a family therapy approach highly respected for the treatment of youth, is implemented. Group therapy sessions take place along with private one on one counseling. The main character is also admitted as an in-house patient because she is categorized as being at high risk.

The general treatment methods are followed by mental health professionals in the case of anorexia nervosa.

Hospitalization- A patient may require treatment in a hospital emergency department for conditions such as cardiac rhythm abnormality, dehydration, electrolyte imbalances, or a psychiatric emergency if their life is at risk. Medical difficulties, serious behavioral issues, severe malnutrition, or a persistent unwillingness to eat may necessitate hospitalization.

Medical care- People with anorexia may first need to be fed through a tube that is inserted in their nose and goes to their stomach in severe cases (nasogastric tube).

Psychotherapy- Psychotherapies, and talk therapies have been immensely beneficial in the treatment of the anorexic person. Psychotherapy can be family-oriented or individual-based, depending on which is more benefitting to the therapeutic procedure.

Medications- Since none of the treatments for anorexia have been demonstrated to be extremely effective, none are currently licensed. Antidepressants or other psychiatric drugs can aid in treating additional mental health conditions you might have, such as depression or anxiety.

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