Examining Eating Disorders Through the Lens of “To the Bone”

As an adolescent medicine specialist, I help teens manage a wide range of eating habits, many of which can negatively impact their overall health and development. For example, I often hear teens say they’re skipping breakfast or trying to diet. Some have very rigid rules around food that alarmingly result in their bodies showing signs of starvation. Although these symptoms can rarely point to a severe eating disorder like anorexia and bulimia nervosa, when these disorders do take hold they can be life altering.

I recently watched a film on Netflix called “To the Bone,” which illustrated an example of one person’s struggle to recover from anorexia. Despite its dramatic portrayal for cinematic purposes, I was impressed with the truthful depiction of the emotional experiences the main character faced with her eating disorder.

Eating disorders affect about 0.5% of the population, but symptoms often start during the teen years. Complications of eating disorders can be severe and include shifts in electrolytes (like potassium, chloride and glucose), diminished hormone levels (estrogen and testosterone), decreased bone strength, poor concentration, and death.

In the film, characters represent many different versions of eating disorders, including anorexia, bulimia and binge eating disorder. The common thread is that they are all trying to determine, for themselves, if they want to recover. Each of the characters’ families is trying to balance feeling worn out and tired of fighting the disorder with wanting their child to survive and live a happy life. The emotions in the film — anger, denial, frustration, sadness, defeat, hope, joy — are all raw and real.

With treatment, the prognosis of recovering from an eating disorder is good. However, treatment is a journey that can involve many ups and downs. The journey may take years to complete.

At Seattle Children’s, treatment teams include the teen and family, a medical provider, dietitian, behavioral therapist, and sometimes a psychiatrist. The team members depicted in the film are a bit extreme — medical providers don’t typically curse or take patients on field trips! However, I did appreciate how it demonstrated that we, as a team, do have to meet our patients where they are. We cannot force change, but can work to encourage people to consider their actions and offer support towards health.

If you are concerned that someone in your family is suffering from an eating disorder, do seek help. Here are some tips to support your teen in healthy eating:

  • Avoid commenting that your teen “looks great” if they start to lose weight rapidly or resort to extremes to change their body, like rigid or fad diets.
  • Avoid negative body talk like “that cookie is going straight to my hips.”
  • Do encourage balanced eating, which includes three meals a day, an after school snack, eating foods from all the food groups in a meal, and avoiding fast food.

Are you a parent interested in learning about topics focusing on adolescent health such as social media use, mental health, drug use prevention, reproductive health, and general wellness and healthy habits for your tween or teen 11-18 years old?

Join Seattle Children’s Adolescent Medicine team as they discuss these pressing issues at Teenology 101 for Parents: Surviving the Teen Years on Saturday, October 28 from 9 a.m. to 12 p.m. at the Federal Way Community Center. It is a free event and pre-registration required, as seats are limited. Visit the event page for information.


  • Seattle Children’s Eating Disorders Resources
  • National Eating Disorder Association
  • Something Fishy