Brave or dangerous? Graphic anorexia images in Netflix movie 'To the Bone' spark debate

Addie Gleekel wasn't sure what to expect from a Netflix movie about anorexia.

An eating disorder survivor who believes in speaking openly about the disease, she was curious to see how the new film, "To the Bone," would tackle the complex and often-deadly mental illness.

As she watched the trailer about a young woman's battle with anorexia, Gleekel, 18, became increasingly upset. Close-up shots of the young woman's bony spine were too much for her.

"I do think the images in it could be very triggering and could jeopardize someone's recovery," said Gleekel, a senior at Breck School.

Her concerns are shared by many in the eating disorders world, where debate is raging over the movie's impact on young people.

Some argue that the film glamorizes anorexia and could cause impressionable young viewers to develop eating disorders. Others applaud the spotlight it puts on eating disorders — the third most chronic illness among teen girls. But nearly everyone agrees that how the message is delivered is crucial.

"Entertainment has always been a platform for talking about the things that are big in our emotional lives," said Polly Conway, senior editor of TV for Common Sense Media, a nonprofit that encourages safe media and technology use for kids.

Shielding young people from "dark issues" isn't the answer. But entertainment companies like Netflix have "a certain responsibility when you are dealing with children who aren't fully emotionally developed and aren't able to process information the same way adults do," she said.

And Netflix often goes straight to children. The streaming entertainment behemoth, which is increasingly delving into controversial topics, reaches kids directly on their mobile devices. About 65 percent of Americans age 16 to 24 are Netflix users, according to Global Web Index.

That's raising fears about potential adverse effects. "To the Bone" comes on the heels of "13 Reasons Why," Netflix's provocative TV series on teen suicide.

"Kids are watching a lot of things on tablets and phones as opposed to the big TV in the living room," said Conway. "Things are less regulated in that space."

Without a parent or other caring adult to provide context, many worry that kids will get the wrong message.

"When I hear parents talking about watching it with a teenager and having conversations, that's good. Because I do think we don't talk about these things often enough," said Gabrielle Filip-Crawford, an assistant professor of psychology at St. Catherine University. "The question I run up against is: Is that worth potentially triggering or potentially glamorizing a suicide or disorder?"

Buzz about the film began at the Sundance Film Festival earlier this year and gained steam after the release of an edgy trailer that attracted millions of views on YouTube.

Both the director, Marti Noxon, and the lead actor, Lily Collins, brought their own past battles with eating disorders to the project. Collins told the Associated Press that the movie was meant to start a conversation.

Oh, how it did.

Even before its July 14 release, petitions were filed on Change.org demanding that Netflix pull the movie. Protesters railed against the film's potential to be used as "thinspiration" fodder (pictures of gaunt bodies shared online to encourage people to resemble them). Many critics also condemned what they see as a stereotypical presentation of a person with an eating disorder. The main character is female, white and from a family with means.

The controversy reached the young patients at the Emily Program, a national treatment center for eating disorders in the Twin Cities.

"All the kids were talking about wanting to see it," said Lucy Chermak, the center's clinical nutrition manager for adolescent services. "We knew they were going to watch it and they had requested to watch it as a group."

On the day the movie was released, the center set aside its regular schedule and hosted a "To the Bone" viewing with clients and staff therapists, who led discussions of the movie as they watched.

"To the Bone" accurately depicted known eating disorder behaviors, said Chermak. Scenes showing Collins' character overexercising and severely restricting the food she ate rang true.

"It's pretty eye-opening and shocking to see someone who is as malnourished and as ill as that client," she said, "so to be able to put context to what all symptom use is with an eating disorder was a benefit of the movie."

At the same time, she said that authenticity could pose a serious problem for those watching alone.

"People who are struggling with eating disorders cling to comparison. So somebody who may not struggle with eating or body [image] can say 'This is impactful' or 'This is scary or maybe life threatening,' " Chermak said. "Someone with difficulty with body image or who has a diagnosed eating disorder, they might look at that and think 'Why can't I be that way?' "

The movie does include a warning to viewers, and it offers insights into the disease for people who want to understand it better, Chermak said. But she doesn't recommend people with eating disorders watch it on their own.

"My take on it is it's going to be helpful for support people and for parents," she said. "For clients who are currently struggling or in treatment, it's probably a good thing to hold off on — unless they're in a supportive environment and can process it."

Officials at Park Nicollet's Melrose Center, another local treatment facility for eating disorders, said they would not allow patients to watch the movie because of the risk of triggering relapses.

Lee Wolfe Blum, 45, is a mental health practitioner at Melrose Center who suffered from anorexia when she was in her 20s. She watched the movie and was deeply disturbed by the images shown of the young actress' emaciated body and the details about how people with eating disorders try to hide their disease.

"I'm very scared about this show," she said. "What I worry about is a young teenager who turns it on, who maybe is dabbling with an eating disorder and learns from this show tricks to make themselves sicker."

Eating disorders are complex mental illnesses that stem from how the brain processes information, experts say.

"The brain of a person with an eating disorder is very distorted," explained Heather Gallivan, clinical director at the Melrose Center. "We may watch this movie and see the person portraying someone struggling with anorexia and think she looks too thin and unhealthy.

"They may view that as something to strive for and compare themselves to, or [say], 'Hey, I used to look like that or I would like that again."

Gleekel agreed.

It wasn't that long ago that she, too, struggled with distorted thinking about her body.

Seeing part of the trailer was enough for Gleekel. She doesn't have immediate plans to see the film.

"At one point I might watch it with my family," she said. "I also think it wouldn't trigger me in any way because I'm strong enough to know I'm not going to let myself get to that point again."

Allie Shah • 612-673-4488 • @allieshah