Marti Noxon's Film To The Bone

Director Marti Noxon’s 2017 film To the Bone follows the story of 20-year-old Ellen’s (nickname Eli) struggle with anorexia nervosa. The movie opens with Eli being expelled from a mental hospital after being disrespectful to another patient. Her stepmother, clearly concerned, sends her to Dr. Beckham, an unconventional doctor specializing in eating disorders. Eli is sent to a recovery home, where she meets six other patients, the most notable of which is Luke, who also has anorexia but has made significant strides towards recovery. At first, Eli is pessimistic, cold, and unreceptive to efforts to help her. However, through her emotional connection with Luke and growing friendship with the other recovery home residents, she becomes more open

Most strikingly, she is very skinny, and her mother comments that she looks “like a ghost”. Her spine and ribs are visible through her skin, clearly showing she has a lower-than-normal body weight. She also exhibits other physical symptoms—when asked by Dr. Beckham about when she last got her period, she is unable to remember, which aligns with the loss of a menstrual cycle common to the disorder. In the same scene, Dr. Beckham comments on Eli’s lanugo. Eli is also seen throughout the film covering herself with long-sleeved clothing or thick blankets, aligning with anorexia sufferers’ tendency to get cold easily. Another physical mark on Eli’s body are the bruises along her spine due to obsessively doing sit-ups. Eli is depicted wincing and yelping in pain as she continues to exercise, which matches obsessive exercise behaviors associated with the restricting subtype of anorexia nervosa. In several scenes, Eli is seen wrapping her thumb and index finger around her upper arm. This is consistent with the symptom of body checking—Eli is using the circumference of her arm as a measure of how skinny she is. In another scene, Eli tells her sister “I’ve got it under control. Nothing bad is going to happen”. Later, she says to Dr Beckham, “I don’t feel that unhealthy”. This aligns with patients’ refusal to acknowledge the

Once again aligning with the restricting subtype, Eli is seen playing with any food served to her instead of eating it, cutting it into small pieces. However, in another scene, Eli makes a deal with another recovery home resident, Anna, to acquire laxatives. This aligns with the binge-eating/purging subtype of the disorder, and contradicts a previous statement made by Eli regarding how purging is “not her thing”. This inconsistency can be attributed within the narrative to Eli’s desperation to maintain a lower weight in this new environment, or outside the narrative to a desire of the filmmakers to show a wider variety of symptoms of anorexia nervosa. It can also be due to these subtypes existing on a continuum and Eli not fitting neatly into one of them (which is described as “not uncommon” by the DSM-5) (American Psychological Association, 2013). In a later scene, Eli confesses to Luke that when she cannot fall asleep, she draws food. On one hand, this aligns with sleep disturbances that can be observed in anorexia nervosa. On the other hand, thinking about food in this positive way (drawing it to relax or fall asleep) is not a symptom noted in research. This could be explained by Eli’s trajectory towards recovery at this point in the film’s narrative, or as emphasis that anorexia is not just about food, but restrictive behaviors. Narratively, it strengthens the emotional connection between the lead and a possible romantic