Netflix took a massive gamble back in 2017. When they dropped the To the Bone movie, nobody expected it to still be a lightning rod for controversy almost a decade later. It's a raw, uncomfortable, and deeply personal look at anorexia nervosa that basically divided the internet into two camps: those who felt seen and those who felt triggered.
Honestly, it’s a tough watch.
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The story follows Ellen, a 20-year-old artist played by Lily Collins, who has bounced in and out of recovery programs like a pinball. She’s cynical. She’s skeletal. She’s "winning" at her disorder until she lands in a non-traditional group home run by a doctor who uses some pretty unorthodox methods. Keanu Reeves plays the doctor, by the way, and he brings this weirdly grounding energy to a movie that otherwise feels like it’s constantly on the verge of a panic attack.
The Real Controversy Behind the Casting
You can't talk about this film without talking about Lily Collins.
The irony here is thick. Collins has been very open in her memoir, Unfiltered: No Shame, No Regrets, Just Me, about her own real-life struggles with eating disorders as a teenager. For the To the Bone movie, she had to lose a significant amount of weight under medical supervision. This sent the mental health community into a tailspin.
Is it ethical?
Many experts, including those from organizations like the National Eating Disorders Association (NEDA), voiced concerns that seeing a real person—especially one with a history of ED—starve themselves for a role is inherently dangerous. It’s not just "method acting" at that point. It’s playing with fire.
The filmmakers, including director Marti Noxon, argued that the authenticity was the point. Noxon herself is a survivor of anorexia. She wanted the film to look real because, in her view, glossing over the physical devastation of the disease is a form of lying. But critics countered that the visual of a "beautifully thin" actress actually serves as "thinspo" (thin inspiration) for people currently struggling with restrictive eating.
It’s a catch-22. You want to show the truth, but the truth itself can be a weapon.
Dr. Beckham and the "Tough Love" Model
Keanu Reeves’ character, Dr. William Beckham, represents a specific type of treatment philosophy. He’s the guy who tells you to "grow a pair" and stop being a victim. In the world of clinical psychology, this is... polarizing.
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Most modern residential treatment centers focus heavily on Dialectical Behavior Therapy (DBT) and specialized nutritional support. Beckham’s approach in the To the Bone movie is much more philosophical. He wants Ellen to choose life because she actually wants to live it, not because she’s being forced to eat by a tube.
- He ignores the "rules."
- He uses profanity.
- He pushes patients into the "real world" before they might be ready.
While this makes for great cinema, real-life recovery rarely looks this cinematic. Most people in Ellen’s position would be in a high-intensity medical wing, not a quirky house in Los Angeles with a view. There’s a scene where the group goes to an art installment that mimics rain, and it’s meant to be this soul-awakening moment. In reality? Most patients at that weight are struggling with bradycardia (low heart rate) and can barely stand for ten minutes, let alone contemplate the "majesty of existence" in a rainy art gallery.
What the Movie Gets Right About the "Pro-Ana" Subculture
One of the most chilling aspects of the film is Ellen’s "fame." She’s an artist, and her drawings were posted on Tumblr, where they became a focal point for the pro-anorexia community. The movie mentions a girl who followed Ellen’s art and ended up taking her own life.
This is where the To the Bone movie actually hits a home run in terms of accuracy.
The internet is a dark place for ED sufferers. The film captures that specific guilt—the realization that your own "private" struggle can accidentally encourage someone else to starve themselves. It tackles the idea that anorexia isn't just about wanting to be thin; it’s often about a distorted sense of control or an obsession with an "aesthetic" that eventually consumes the person behind it.
Breaking the "Perfect Victim" Trope
Usually, in movies about eating disorders, the lead is a fragile, soft-spoken girl.
Ellen is a jerk.
She’s prickly, mean, and dismissive of her family’s pain.
This is actually a very honest portrayal. Chronic starvation changes your brain chemistry. It makes you irritable. It makes you hyper-focused on yourself because your brain is literally in survival mode. By making Ellen "unlikable" at times, Noxon avoids the trap of romanticizing the illness.
The Families Left in the Wake
Let’s talk about the stepmom, Wendy. Carrie Preston plays her with this frantic, desperate energy that anyone who has dealt with a sick family member will recognize instantly.
The scene where the family sits in a "therapy circle" is brutal. It’s messy. You have the biological mom who has her own issues, the "cool" stepmom who is trying too hard, and the sister who is just plain angry. The sister’s perspective is often overlooked in these stories. She basically tells Ellen, "You’re sucking all the air out of the room."
It sounds harsh, but it’s a reality. Eating disorders are often called "family diseases" because they hold everyone hostage. The To the Bone movie doesn't give the family a clean "Hollywood" resolution, which is probably the most realistic thing about it.
The Limits of the Narrative
We have to acknowledge that the film is very white and very middle-class.
Anorexia doesn't discriminate.
Men have it. People of color have it. People in larger bodies have it (atypical anorexia).
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While the film includes a male character, Luke (played by Alex Sharp), it largely stays within the stereotypical demographic of the "waif-like white girl." This has been a major point of criticism from experts who argue that we need more stories about the diversity of eating disorders. If the only image we see of an ED is a thin white woman, then people who don't fit that mold won't seek help because they don't think they’re "sick enough."
Navigating the Visuals: A Warning
If you’re planning on watching or re-watching, you need to be aware of the "body checking" scenes. There are moments where characters measure their arm circumference with their fingers. This is a classic ED behavior. For a casual viewer, it’s just a sad detail. For someone in the throes of an illness, it’s a "how-to" guide.
The To the Bone movie uses these visuals to establish the severity of Ellen’s condition, but they are undeniably graphic. The makeup team did an incredible job of making the actors look genuinely ill—gray skin, dark circles, lanugo (fine hair grown by the body to stay warm). It’s effective, but it’s also a lot.
Actionable Takeaways for Viewers
If you or someone you know is struggling, watching this movie shouldn't be your first step. It’s an exploration, not a manual for recovery.
- Check your headspace. If you’re feeling vulnerable about your body image, skip this one. Seriously. It’s not going anywhere; you can watch it when you’re in a stronger place.
- Separate the "Keanu Effect" from reality. Dr. Beckham is a character. In the real world, recovery involves a team: a dietitian, a therapist, and a medical doctor. Don't look for a "maverick" to save you; look for a clinical team.
- Talk about the sister. If you watch this with family, focus on the younger sister’s monologue. It’s a great starting point for discussing how the illness affects everyone in the house, not just the person who isn't eating.
- Use the resources. If the film brings up feelings you can’t shake, reach out to the National Eating Disorders Association (NEDA) or the equivalent in your country. They have helplines and chat options that are way more helpful than a Netflix movie.
The To the Bone movie isn't perfect. It’s a flawed, deeply personal, and sometimes dangerous piece of art. But it started a conversation that we’re still having today, and in the world of mental health advocacy, sometimes being loud and controversial is better than being ignored. It forces us to look at the bones—the structural failures of our treatment systems and the fragile, resilient people trying to survive them.
If you find yourself obsessing over the calorie counts mentioned in the film or the specific weights of the actors, that is a red flag. The goal of the film was to show the "bottom" so that people would want to climb back up. Make sure you're focusing on the climb, not the floor.