History of Eating Disorders in Film

Though the existence of eating disorders can be traced back to at least the 13th century, they have spent much of that time shrouded in secrecy and misunderstanding. Eating disorders were not widely recognized in American culture until the 1970s, and they were not given a unique entry in the DSM until the 1980s. Therefore, it was not until this time that eating disorders started appearing in film (King).

The first movie to explicitly be about a character with an eating disorder was 1981’s Lifetime movie The Best Little Girl in the World (imdb.com). The movie was about a teenage girl cheerleader and ballet dancer, Casey, suffering from anorexia and bulimia. It showed Casey receiving treatment and the impact a child with an eating disorder has on the whole family. However, it played on the stereotypes that eating disorders are diseases that only young, white females get. The movies about eating disorders that came after followed the same pattern for their protagonists (Nisar). The next movie was Kate’s Secret in 1986. It showed the story of a perfectionist mother secretly battling bulimia (imdb.com). In 1989, a movie about Karen Carpenter’s battle with anorexia, The Karen Carpenter Story, aired on CBS. It was the first nonfiction account of anorexia seen on film (Gilbert). For the Love of Nancy (1994) showed the impact of eating disorders on family members and the reality that many people are resistant to treatment (Howard). In the 1996 movie When Friendship Kills two girls realized the seriousness of their behaviors when one almost died from purging (imdb.com). Perfect Body (1997) depicted a gymnast who was scrutinized for her weight. It explored the pressures put on certain athletes and the unhealthy environments that can be created on competitive sports teams.  In the 2001 movie Dying to Dance a similar issue with females in sport was brought to light (imdb.com). Hunger Point (2003) showed how painful and consuming eating disorders are, as well as, warning signs to look for (Howard).

All of these movies attempted to show the seriousness of eating disorders, and explain them in a society where their existence was still unknown to a large percentage of people. For example,The Best Little Girl in the World showed Casey throwing up food, skipping meals, and exercising in secret. When the doctor diagnosed her with anorexia, the disease was said the be one found in adolescent girls who feel like they have no control, so they try to gain control over their bodies. The doctor also talked about the problem with unrealistic standards presented by fashion models and how anorexia can be deadly. The movie was dramatized, but in a time when eating disorders were highly elusive, it was one of the first public attempts to explain the disease (Cills). Cills says that the first movies about eating disorders were explanatory because at this time the public, as well as many professionals, were just learning that eating disorders exist. In the book The Lifetime Network: Essays on “Television for Women” in the 21st Century, Emily Newman wrote that early television movies about eating disorders were meant to educate the public on the diseases and how they are treated. These movies followed a specific formula. The protagonist would first be praised for losing a few pounds. Next, she would look for tips on how to lose more weight and fall into a cycle of harmful eating behaviors. The character would then hit rock bottom and be hospitalized or see a friend die. Newman says that these movies worked hard to show how traumatizing eating disorders are and to not glamorize or glorify them (Cills). However, through the 1990s, movies about eating disorders were limited to TV movies relegated to women’s channels. Depictions of eating disorders in more mainstream films were shown as “a fleeting, colorful character trait” (Cills). An example is the character Heather Duke in Heathers who was teased for being out of trend for having bulimia. Other examples are Daisy in Girl, Interrupted, Cher in Clueless, and Kathryn in Cruel Intentions. In 1986, the actor who played Kate in Kate’s Secret told the LA Times that she hopes people won’t think the movie is just another movie about women wanting to be skinny. They were trying to expand their audience to and bring more awareness to the seriousness of eating disorders, especially to men; however, this was difficult when all the films about about women and directed at women (Cills).

The notion that only women get eating disorders was one of the largest misconceptions facilitated by these earlier movies. It is true that eating disorder rates are higher in women, however, 25 percent of people with anorexia and 36 percent with bulimia are men (NEDA). Not one of these movies from 1981-2003 showed a male with an eating disorder. Additionally, all the women depicted in these films were young, thin, white, and financially-well-off, and the only eating disorders portrayed were anorexia and bulimia. Nisar says “for most of them, their eating disorders stemmed from an off-kilter comment about weight. Many featured traditionally feminine art forms, such as ballet. Very few diverged from this formulaic approach to the topic, limiting visibility when it came to race, gender, and the eating disorder itself.” Despite this narrow focus in terms of diversity of characters, research has shown that eating disorders affect people ages, genders, races, sizes, and socioeconomic status (NEDA). The problem with depicting only young, white, thin, wealthy females with eating disorders is that when people are presented with the same story over and over again, it gives the idea that it is the only story (King). Stereotypical depictions of people with eating disorders in film not only negatively limits perceptions of the public, but can also lead to harmful stereotypes playing a role in medical practice. A 2006 study by Gordon et. al. found that racial stereotypes play a role in the diagnosis of eating disorders. Doctors were more likely to diagnose a fictional white patients with an eating disorder than a fictional black patients presenting the same symptoms (King). Additionally, a 2012 study by Strother et. al. found that male eating disorders are under-diagnosed because assessment tools focus on female presentations of the disease. The concept that men can also be negatively impacted by societal pressures on body size and food intake, and experience feeling of worthless and loss of control is underrepresented in diagnostic criteria. Overall, there is a need for greater diversity in eating disorder films to accurately depict they wide range of people they affect and the numerous ways eating disorder and present and impact and individual.

Recent Films About Eating Disorders

Six movies about eating disorders from 2006-2017 are Thin (2006), Disfigured (2008), Starving in Suburbia (2014), Little Miss Perfect (2016), To the Bone (2017), and Feed (2017). Thin started a new era of eating disorder films, being the first film about eating disorders not made for television. It is a documentary showing four women with anorexia and bulimia in an inpatient treatment center in South Florida. With unrestricted access to the facility the directors Greenfield and Micheli filmed the four women over a six-month stay. The movie was part of a campaign to explore eating disorders and body image issues (topdocumentaryfilms.com). Disfigured is a movie about an unusual friendship between a “fat girl” and a “recovering anorexic.” Moreover, as the writer/producer/director says, “It is a movie about women and weight.” Famous film writer, Glenn Gers, says he wrote Disfigured because it is a movie he wanted to see- raw, honest, and without Hollywood drama. Because of this, no one would pay for it so he self-directed and produced the film in 15 days with a crew of 6-8 people (http://www.disfiguredmovie.com/home.html). Both of these movies are low-budget films made by people who wanted challenged the dramatized depictions of eating disorders given in T.V. movies and send a message through an honest and realistic depiction of women’s struggles with weight, food, and body image. However, these films still focus on women, all of whom were white and financially-well-off.

Starving in Suburbia and Little Miss Perfect tackle the issue of prevalent proanna communities and the role of social media in eating disorder development. Starving in Suburbia is another Lifetime movie that wanted to paint the horrors of anorexia. The movie is criticized for is horror-like fashion and ending the was resolved too quickly and neatly (Fagg). It is also feared that it’s explicit images can be triggering for people at risk (Howard). However, others say the movie is a much needed representation of how serious and danger anorexia is, and it helps open up dialogue about the important issue of online eating disorder communities (Fagg). Little Miss Perfect is roughly based on the storyline of Beauty and the Beast (imdb.com). It is about a 14-year-old high school freshman, Belle. Belle is a straight-A student and the class president, but is struggling with family issues and the growing academic pressure. After seeing a blog promoting anorexia, Belle turns to weight loss as a way to seek control. The purpose of the movie was to bring attention to people’s inner struggles with self-acceptance and to de-stigmatize mental health as a whole. They producers of the film teamed with the National Eating Disorder Association to the start the #FACEYOURBEAST campaign to raise awareness that everyone has struggles and no one is alone. They also put together an educational kit for academic and institutional use to facilitate conversations from the movie. Little Miss Perfect received a lot of positive feedback for being an accurate and relatable depiction of eating disorders, and for diving into the dangers of online communities and social media that promote eating disorder behavior (littlemissperfectmovie.com). Schwartz says that the movie shows risk factors and the first steps in getting treatment. The director of the movie, Marlee Roberts, says that online eating disorders communities thrive because of the secretary around eating disorders. Educating people and bringing eating disorders into the mental health conversation is important to combat the impact of these communities. Roberts created the movie hoping it would help teenagers see their own self-worth and get the help they need (Schwartz). However, despite the positive reviews given, this movie received very little publicity compared to the next big movie about eating disorders- To the Bone.

To the Bone received a lot of controversy even before it was released. People feared that it is an inappropriate and potentially triggering representation of eating disorders. Others complained that it was yet another film about a young, white women from a privileged yet dysfunctional family (Gilbert). Despite, the flood of negative opinions about the movie, To the Bone is revolutionary in the sense that it is a high-profile Hollywood production. The movie challenges the idea that “movies about eating disorders are cheap melodrama that only deserve to be shown on women’s channels” (Gilbert). Moreover, the film is the first to have a male character and a person of color with eating disorders. Gilbert believes that To the Bone is a step in the right direction because it is not about a girl who has anorexia because she wants to be thin or pretty. It shows that eating disorders are more complex than that. It also draws parallels between eating disorders and addictions which can be useful in helping people understand the disease. I think that To the Bone was overdramatized at times and gave some unrealistic depictions of eating disorder treatment. I also see how some of the images and behaviors shown could be triggering to at risk audiences. However, overall I think it is honest in ways that other films have been afraid to be, and it has the potential to start important conversations about the dangers of eating disorders. More about the potential benefits and harms of To the Bone and my opinions of the controversy can be found in “To the Bone”- A Conversation about the Portrayal of Eating Disorders in Film.

Feed is about a high school senior who develops an eating disorder after the death of her twin brother. Her disorder is represented by physical manifestations and voices of her deceased brother. These manifestations tell her not to eat, to keep studying through the night, to hide food, and that she is nothing without him. Cohen believes that, unlike To the Bone, Feed does a good job showing the biopsychosocial factors that can play a role in the development of eating disorders. The movie illustrates how multiple factors contribute to the onset of an eating disorder. For Olivia these where the death of her brother, her perfectionistic personality, and her family atmosphere. Personally, I disagree that the movie did this. I agree that risk factors such as perfectionism and pressure from her dad were shown before the death of her brother, however, to the common audience it seems like a flip switched when her brother died. The movie seems to blame her disorder on this one traumatic event giving the idea that one must experience such an event to be justified in having an eating disorder. Cohen also likes how Olivia’s eating disorder was physically manifested in Matt. This helped the audience understand what it is like to live with this ‘invisible disease.’ She notes how the eating disorder is often externalized in treatment to help separate it from oneself and loved ones. It also drives home the idea of an internal voice telling a person not to eat and they are not good enough and so on. However, again, I think this was over-the-top. I think that it strengthens the misconception that Olivia’s eating disorder was solely because of the death of her brother, and it painted eating disorders as a psychotic illness. Lastly, Cohen applauded the ending of the movie where Olivia was out for lunch and she saw Matt in the background. When asked if she was okay, she replied, “yes, I’m fine.” Cohen say this as a way of showing that eating disorder thoughts still come up and a person is not cured overnight. I can see this interpretation, but it was not my original one. In my experience the phase “I’m fine” never means that a person is actually doing alright. It is a phrase the hides what is really going on, and it truly a cry for help. Therefore, I saw this scene as hinting that Olivia was still really struggling with her eating disorder, but she was putting on a facade. Though I agree that this movie can be helpful in increasing understanding of the inner thoughts of someone with an eating disorder and teaching that eating disorders are separate from the individual, I think that overall it was a stereotypical and overdramatized depiction that misrepresents eating disorders.

Why is it Challenging to Create Films about Eating Disorders?

A comprehensive understanding of eating disorders and mainstream education about the disease are only starting to emerge. As the illness grows in the public eye, Hollywood is trying to catch up and accurately show this somewhat enigmatic disease. However, as of now, depictions of eating disorders in film fall short (King). Why is it so difficult to make a good movie about this topic?

King suggests that perhaps movies about eating disorders are fundamentally uncinematic. “The reality of eating disorders does not lend itself well to script material… [This leads] Hollywood to gloss over some of the diseases’ deepest pains, and foreground unrepresentative characters” (King). Movies about eating disorders seem to all fall into the same trope of having a very thin, young, white female as the protagonist. This stereotype fails to show the reality that many people who suffer from eating disorders are not extremely thin, and that eating disorders affect a diverse population. The notion that one must be extremely thin to have an eating disorder is a dangerous one that can prevent people from getting treatment. The CEO of the National Eating Disorder Association, Claire Mysko, says that most of the calls to NEDA are “from people who aren’t sure if they have an eating disorders because they aren’t shockingly thin, anorexic, or bulimic, all of which overwhelm medical studies and pop culture depictions” (Cills). Also, symptoms of eating disorders would make for material that is not very entertaining. People with eating disorders are often withdrawn and fear social interaction. Additionally, behaviors of eating disorders are repetitive and risk-avoidant. Honestly depicting this reality would involve little dialogue and would be particularly monotonous. Instead of telling these stories of isolation, mistrust, self-hatred, and compulsions, Hollywood produces dramatizations that rely on cinematic shortcuts, stereotypical representations, and euphoric endings (King). This can give the irresponsible message that eating disorders can be fixed through a heartfelt journey of self-discovery, and that there is only one way to have an eating disorders. In reality, eating disorders impact individuals differently, they need professional treatment, and recovery is often a lifelong process.

Another difficulty with eating disorder movies is that honest and realistic depictions can be triggering to vulnerable audiences. A danger of realistic movies about eating disorders is that they can serve as ‘how to guides.’ Content from almost all movies and TV shows about eating disorders has made its way to proanna websites. It may be impossible to create films about eating disorders that avoid triggering susceptible viewers. Specifically about content depicting anorexia, Dr. Melissa Nishawala of NYU says, “Because individuals struggling with anorexia nervosa often have an extreme drive to the superlative- to be the best student, to feel the most valued, and to become the thinnest- any film depicting anorexia nervosa risks igniting the question towards starvation” (Gilbert). Cills also points out that creating characters with eating disorders that the audience likes can increase the risk of vulnerable viewers wanting to be like them and imitating harmful behaviors. Kopotsha interviewed Dr. Bryony Bamford, clinical director of The London Centre for Eating Disorders and Body Image, asking about the potential impacts of triggering material in films about eating disorders. Dr. Bamford believes that showing eating disorders in film is mostly positive because it can increase awareness and encourage people to seek help for themselves or people they care about. However, there are still downsides, epically with anorexia because it is such a highly competitive illness. It is because of the competitive nature of the disease, that depictions can teach or exacerbate harmful behaviors. However, Dr. Bamford explained that it is highly unlikely for a person to develop an eating disorder due to viewing a film or T.V. show. If a movie or show triggers the onset or exacerbation of symptoms, such was likely to happen anyways. Therefore, she believes that the positives of eating disorders in film outweigh the negatives. Kopotsha says a difficulty is that much of the general conversation about media and mental health is focused on the negative consequences. It is hard to establish where the line is between portrayals that promote healthful conversations about serious illnesses and more of the harmful depictions and standards that are prevalent in society.

Lastly, the constraints on the length of films also contribute to the difficulty of portraying eating disorders realistically. There is not enough time to show the slow onset of the disorder and the slow recovery (Cills). Overall, how to show eating disorders in film is a complicated issue, but it is one that we need to tackle if we want to debunk harmful myths and promote conversations about eating disorders.

Where Should Filmmakers Go From Here?

A survey conducted by the National Eating Disorder Association in 2010 found that 82% of participants believe that eating disorders are serious mental and physical illness. Only 12% of participants described eating disorders as afflictions of vanity (Gilbert). Nevertheless, when it comes to media illustrations of body image and eating habits, being fat is seen as a weakness, while being skinny and restricting food is seen as a strength. Gilbert says, “We understand, as cultural consumers, that anorexia is a disease, but we also, in some ways, admire it.” Moreover, despite the significant number of people in the U.S. who suffer from eating disorders, research on them is limited compared to other illnesses the affect a similar percentage of the population. Limited knowledge about eating disorders give movies more power over influencing public perceptions about who suffers them and what they are like (Gilbert).

It is time for filmmakers, professionals, and individuals with experience to come together to improve the way eating disorders are portrayed in film. The diverse population that eating disorder affect needs to be represented, realistic treatment needs to be shown, and the hard work of recovery needs to be illustrated. King suggests the filmmakers look to movies about addiction to learn how to honestly and cinematically portray eating disorders. Several organizations have developed guidelines on how media can responsibility represent eating disorders. Two examples are “NEDA Guidelines for Media or Sharing Your Story” and “Beat Media Guidelines for Reporting Eating Disorders.” Dr. Nishawala of NYU recommends avoiding emancipated bodies, and exhibiting interpersonal relationships and effective treatment. She says it is also important to combat the misconception that people of color and men cannot have eating disorders (Gilbert).

Still where the line should be drawn between positive and potentially harmful depictions is blurry and up for debate. Gilbert says the question is not whether movies about eating disorders will be triggering, but if the recovery narratives are worth the damage. Accurate depictions of eating disorders serve as dangerous inspiration for some people, but they can also spread awareness and communicate that recovery is possible which are important messages. Kopotsha says a significant issue with eating disorders is that they are often unseen and not talked about. This contributes to the loneliness and alienation people with eating disorders feel, and it can keep people from getting help. Keeping the reality of eating disorders out of movies can contribute to this loneliness and misunderstanding of the disease. Speaking about To the Bone, Lily Collins said, “I wish that I had a movie like this to explain it to me, to relate to – I think the more we talk about this subject matter, the less taboo it’ll become, and I think more help and change can occur” (Kopotsha).

So how do we make movies about eating disorders? Cills says perhaps we need to stop looking for one perfect unifying depictions, and rather focus on several personal stories. I agree with this. Every person’s struggle with an eating disorder is different so every movie about eating disorders should be unique. I think it is important to be respectful of the potential that some material can be harmful and to avoid excessive triggering content; however, I think the benefits of an honest portrayal of eating disorders are too great to dismiss them out of fear. Films about eating disorders should give insight into the disease and increase awareness and understanding. The more content about eating disorders that is put out to the public, the more material there is to talk about. It is from these conversations that learning will happen and stigma will be broken. I believe the next step is to use film as a platform for people to tell their stories.

Works Cited

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Cohen, N. (2017). Some Thoughts on the New Eating Disorder Film, “Feed”. Walden Behavioral Care. Retrived from https://www.waldeneatingdisorders.com/blog/some-thoughts-on-the-new-eating-disorder-film-feed.

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Guidelines for Media or Sharing Your Story. NEDA Feeding hope. Retrived from https://www.nationaleatingdisorders.org/tips-responsible-media-coverage.

Howard, C. (2016). Eating Disorders on Film. Eating Disorder Hope. Retrived from https://www.eatingdisorderhope.com/blog/eating-disorders-on-film.

Kopotsha, J. (2017). Is There Ever A ‘Right’ Way to Portray An Eating Disorder on Screen?. Grazia. Retrived from https://graziadaily.co.uk/life/tv-and-film/lily-collins-interview-bone-netflix-film.

King, E. (2017). Are Movies About Eating Disorders Fundamentally Uncinematic?. Pacific Standard. Retrived from https://psmag.com/social-justice/how-to-make-a-movie-about-a-lonely-terrible-experience.

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Strother, E & Lemberg, R & Stanford, S & Tuberville, D. (2012) Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eating Disorders Journal of Treatment and Prevention, 20, 346-355. DOI: 10.1080/10640266.2012.715512.

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