What Parents Can Learn About Their Own Kids From Netflix's “To the Bone”

Amy Hendel | Jul 31st 2017 Sep 13th 2017

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Could my child have anorexia

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The movie begins with a warning to viewers. A girl blames the constant food ads and visuals that show “girls are happier when they lose weight” for instigating or encouraging anorexia and disordered eating. “It’s like the world is trying to make us crazy,” she says. She may be right. For vulnerable children and teens, these may indeed nudge behaviors. At the core of anorexia is body distortion — you see fat despite being dangerously thin. The distortion persists even as health deteriorates.

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Signs of anorexia

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The desire for thinness may be due to psychological factors and environmental cues. The individuals may be losing weight regularly and past the point of “healthy.” They diet though they’re bone thin. They eat in isolation and “play” with their food. They go to the bathroom after meals (to purge). They look at full-body mirrors incessantly. They refrain from events that involve food. They obsessively exercise. Menstruation stops. Furlike hair (lanugo) can appear. They’re often cold and may have depression.

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More signs and risk factors for anorexia

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Someone with anorexia may refuse to discuss weight and be inflexible. They often wear layers to hide weight loss. They live by rigid schedules. They cook for others and engage with food rituals. It’s more than just a diet gone awry. Causes may include a genetic predisposition, environmental factors, and psychological issues. A child or teen encouraged to lose weight can develop anorexia. Anxiety disorder may precede anorexia.

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Boys are not excluded

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Girls with ADHD may be prone to eating disorders. Though anorexia is more commonly found in females, boys and young men are also at risk, especially if they have body dysmorphia. In the movie, actor Alex Sharp plays a young male dancer who struggles with his weight, though he embraces therapy and “normal eating,” during recovery from a knee injury. Compulsive exercise with a focus on body parts is often present. In the U.S., about 20 million women and 10 million men have eating disorders.

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The patient isn’t the only one affected by this disease

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Family members are challenged by this disease. “A Mega-Gulp of diet soda is not breakfast,” says stepmom to Ellen in the film. The movie shares realistic interactions between Ellen and her parents (she has two sets). Her sister, who is incredibly loving, empathic, and forgiving, finally tells her, “I don’t have a sister.” Teens do sit-ups at every opportunity, use hidden barf bags, and show true panic at meals.  The therapist at their facility makes it clear that he will only treat if the patient is interested.

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Facebook, Instagram, Snapchat, and never-ending selfies

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Teens get constant reminders that physically, they don’t measure up to the beauty standard. Social media takes it to a 24/7 obsession for some. To an anorexic, the dining room table is a torture chamber. Starving gives them the euphoria that they crave. There is also a whole community online sharing tips for extreme weight loss, such as the easiest foods to purge, as mentioned in the movie. There’s a “calorie Asperger’s” is a joke that’s shared in the movie, but it’s also painfully true.

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What parents can do

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You cannot scare a person with anorexia straight. You should seek help quickly and intervene before the disease entrenches for the best chance of a sustained recovery. The family needs to learn to give unconditional love and support. It may take time and trying different approaches to find effective therapy. Long term, in-patient treatment away from the family with a team of experts is often necessary. The family may need to change behaviors as well. Willingness from the patient to heal is crucial.

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The person ultimately chooses to heal and to live

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The movie shows a very poignant scene with Ellen’s biological mom rocking and feeding her with a bottle. In a sense, Ellen’s mom is trying to grasp at mistakes she may have made, and her attempts to right those possible wrongs will likely strike a chord with all moms. This disease ultimately requires the person with anorexia to “be willing to feel and to want to be alive.” The patient may need to hit rock bottom. The recovery rate is 40 to 50 percent for three-plus years of abstinence from behaviors.

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There is always hope

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In one of the last scenes, Ellen is semiconscious, outside in the heat, and she has an out-of-body experience, seeing her emaciated body as she floats above. She wakes up, taking her pulse to see if she’s still alive. We’ve wondered throughout the movie, will she make it? Thanks to an unconventional therapist played by Keanu Reeves, she does. Despite no guarantees, she appears to be on the road to recovery, supported by her family. Despite the difficult storyline, the movie’s message is one of hope.