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To The Bone: our talk with the experts

Posted on 15 July 2017 by Kim

SPOILER ALERT: This blog post includes some discussion about the plot of To The Bone.

One of the great things about working at the Classification Office is that we sometimes get to see material that speaks to serious social issues and problems and provide advice and support to young people and parents about what they choose to watch.

Netflix’s To The Bone has received media attention and criticism prior to its release on July 14. The film is based on the experience of the director and follows Ellen, a 20-year- old woman with anorexia, played by Lily Collins. There have been concerns about the film glamorising eating disorders and triggering body image and eating issues in vulnerable young people.

In the film, Ellen undergoes treatment at an unconventional in-patient centre run by Dr William Beckham (Keanu Reeves). Here she befriends other eating disorder (ED) patients and is forced to face her issues. Along the way she receives mixed levels of support from her family members.

What prompted a classification?

To start with, we received inquiries from a teacher and a psychologist who were concerned after seeing the film’s trailer. The trailer shows a gaunt Ellen counting calories, skipping meals, exercising excessively and fainting from starvation, all the while pretending to have her life under control. The people who approached us were worried that eating disorders could be glamorised and could potentially trigger body image and eating issues in vulnerable viewers. Advance publicity for the film has also sparked international concern and also social media controversy, with some young ED sufferers expressing that they were personally triggered by its portrayal of anorexia.

Given these concerns, the Chief Censor approached Netflix to have the film labelled clearly for New Zealand audiences.

In this case, it was clear to us – after seeing the film – we needed expert advice from those in the frontline of the struggle against ED to help us understand the impact that a film like this could have. So, we asked clinical professionals working in the field of eating disorder treatment to watch the film with us and to share their expert advice. We were really lucky, at such short notice, to be able to speak to two clinical experts who treat New Zealanders suffering from this serious mental illness.

William and Ellen from To The Bone look at each other in a hospital room

From the frontline

I was surprised and worried to hear from the experts that anorexia and other eating disorders are a growing social problem in New Zealand and have one of the highest mortality rates of any mental illness. Many sufferers struggle with the illness for years, and of those that do undergo treatment, many require several attempts before making a successful recovery.

To The Bone sheds light on anorexia (and other eating disorders), showing symptoms such as calorie-counting, excessive exercise, distorted views of body image and obsessions around food and weight. Generally this content is light-hearted, humorous even. One thing that struck us was the way the film at times paints a poignant picture of the illness, exposing the potential triggers, crippling fears of weight gain and the agonising rituals of sufferers.

The experts considered the film overall to be a reasonably well-informed and realistic portrayal of eating disorders, showing both helpful and unhelpful responses to the illness and its treatment. For example, the film helpfully shows a broad range of ED sufferers from all walks of life, and some methods of therapy depicted have real-life application. While the film stops short of showing Ellen’s full recovery, it shows that recovery is achievable with the correct support and treatment. We hope that the film will spark conversation and encourage ED sufferers and/or their loved ones to seek help.

Ellen weighs herself on a scale in To The Bone

Please be aware

The experts warned however that, depending on how the film is viewed by ED sufferers and those at risk, content may be triggering or even spark imitation. Younger viewers may also be shocked by what they see. For this reason, it is important that the film is viewed critically and if necessary with support. This is how we arrived at the RP16 classification – and the warning that the movie “shows realistic, harmful behaviour with risk of imitation”.

Viewers can be assured that the film covers more than just the lifestyles of anorexia. As well as following Ellen’s struggle and treatment, there are moments of humour and heartbreak as the film explores Ellen’s relationships with her family members and other in-patients. There is even a hint of romance.

We are aware that the online, on-demand format of Netflix allows young people to easily access the film without supervision. The RP16 classification does not prevent those under 16 from viewing the film, but clearly signals that support is required. Parents and other responsible adults (such as guardians, teachers and counsellors) can view the film with or without the young people in their care. The important thing is that the essential conversation and follow-up takes place.

While there is social benefit in young people seeing this film, it does contain some problematic content. Children and younger teenagers, especially those prone to eating disorders, need the support of a parent or other responsible adult to discuss any issues or concerns that may arise when viewing.

Kim works in the Classification and Information Units at the NZ Office of Film and Literature Classification. Her views do not represent those of the Chief Censor or of the Classification Office. Keep up with our blog posts by following us on Facebook and Twitter.

RP16 label
RP16: shows realistic, harmful behaviour with risk of imitation

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