Let's Talk About Eating Disorders, Addiction, and "To The Bone"

Eating disorders, as I have recently learned, are not necessarily about being thin or controlling weight.

I say “necessarily” because I am neither a doctor nor a therapist, I have no experience with eating disorders myself nor with people who have eating disorders, and the only source of information I have regarding eating disorders comes from what I’ve read in biographies and, as of last night, the new Netflix original movie, To the Bone, starring Lily Collins and Keanu Reeves.

My boyfriend and I are always looking for a new show or movie to watch. We stumbled across this one a few nights ago and thought it seemed interesting. Last night, we delved into it, and I was not prepared for it. Something particular about this movie hit close to home for me: at one point, Karen, the inpatient counselor played by Alannah Ubach, points out to her group of inpatients (and to viewers alike) that eating disorders are not always about numbers on the scale—they can, in fact, be a result of addiction.

Many people in my immediate and extended family have suffered some form of addiction. Some have died from it, others have gotten help, and others at this exact moment remain on the plunging slope of surrender to the monster that is addiction. The most painful truth about a person with addiction is that his behaviors are not limited to himself alone. His downward spiral is a tornado that sucks in those around him, threatening their lives and their wellbeing, too.

That is where I identified most with this movie. Halfway into the film, Ellen (Collins) sits through a family therapy session with her mother, her mother’s partner, her stepmother, and her half-sister. The immediate and explosive dynamic between these family members comes straight into the light. The mothers detest one another and blame each other for Ellen’s disorder. Her problem quickly becomes about them.

But when prompted by Dr. Beckham (Reeves), Ellen’s half-sister, Kelly (Liana Liberato), speaks the loudest truth about Ellen’s disorder, and addiction in general, in the most compassionate and honest way: Ellen doesn’t realize that her behavior, her sickness, affects more than just herself. Kelly doesn’t understand why Ellen won’t just eat.

Just like I don’t understand why my family member won’t just stop drinking, even though the doctor has told him he will die if he doesn’t.

Because it really should be that simple, shouldn’t it?

It's not, and that's something that I have come to witness. One family member of mine was tired of living a life of addiction. He’d had many near-death experiences, yet he always went back. Finally, he decided he would just do it. He would just quit.

It wasn’t as simple as it sounds, though. He went to an inpatient program, and the first six months of the program were, as he described, like boot camp. Inpatients were allowed limited outside contact with family. Television, personal phones, laptops, internet—all the luxuries of our modern life were denied to them. They ate three square meals a day, performed manual labor on what was essentially a farm, and attended Sunday church services. He lost somewhere around twenty-five pounds in the first week as his body learned to live, after decades, without the crutch of alcohol and pills.

So while the decision to quit was as simple as declaring it out loud, the process itself was not easy. I think that is what we as an outside audience do not understand about addiction, eating disorders, and any other disorders of a similar nature. This is partly because we have never physically, mentally, and emotionally depended upon something to keep us alive while it simultaneously seduces us with false comfort and destroys us.

For my family members, the crutch has always been alcohol, prescription pills, or both. For Ellen and the other inpatient characters of To the Bone, it is starvation or binging and purging. It is the thrill, the euphoria, as Karen describes it, of depending upon the thing that makes them feel safe, secure, and validated:

When the exercise and the rituals kick in and the cyclical thoughts about weight take over, everything else goes away. And starving yourself can make you feel euphoric, like a drug addict or an alcoholic. It’s not about “thin enough,” right? There’s no “thin enough.” It doesn’t exist. What you crave is the numbing of the thing that you don’t want to feel. And we give you a lot of rope here. It’s scary, but only you can decide…to see what’s good, to be alive.

I’ve recently discovered that there is a big debate within our society over whether addiction is a disease or a choice. The people who see addiction as a choice are the same ones who don’t understand why addicts won’t simply quit, who feel that addicts choose to destroy themselves whereas someone with, say, cancer does not have that choice. As far as this side of the argument is concerned, if an addict chooses to destroy himself, then let him. I don’t blame them for thinking this way. It’s not a lack of sympathy. It's a logical train of thought.

But those who believe addiction is a disease understand that addictive tendencies and behaviors do not always stem from the drug itself, but first from something deeper within the individual that inclines them, perhaps more than any other given person, to become dependent upon a substance.

I stand between these two sides. I don’t believe that choice and disease are mutually exclusive when talking about addiction. However, I do not believe that if addiction is a disease, then people with addictive tendencies and personalities are a lost cause, or that they must resolve themselves to a life of addiction with no hope. Furthermore, I certainly don’t see susceptibility as a valid excuse for dependency.

So while I believe that addiction itself is a disease, I also believe choice follows that disease. A person may be inclined, may be biologically predisposed, to pursue something dangerous, but it is then his choice alone—and his consequences that follow—if he puts himself in a position where he can become dependent upon something destructive.

This is why many people with addicts in the family choose to stay far away from that same substance, even legal substances like alcohol or cigarettes. They are making the choice to avoid it, regardless of any possible genetic or elective inclination. They do not want to live that life. It is completely possible to have one or two alcoholic drinks regularly, to occasionally take medication for migraines or severe health issues, and not become addicted. The difference lies between recreation (a drink at a party), necessity (prescribed medication), and dependency (shaking at three in the morning because he hasn't had a beer in six hours).

But those who have suffered from a loved one's addiction refuse to take that risk, and choose instead to eliminate the temptation by fleeing from it entirely. It is a choice that they have made. It is the choice that our loved ones, our addicts, have not made.

I pity addicts because I have witnessed firsthand, on multiple occasions, the way they destroy themselves. But as Karen pointed out, only the addict can decide if he or she wants to be and feel alive. I pity addicts because addiction is a lingering demon—but I will not pardon or excuse their self-destruction or the havoc they wreak on the people who love them and who depend on them.

Again, I know nothing of eating disorders besides what this movie has taught me. I cannot vouch for the accuracy of this film, but I can say that it struck a chord with me. I identified with these characters in ways I never thought I could. I learned, I understood, more about EDs than I ever had before. I think that in the end, that’s what director Marti Noxon, who has suffered from an eating disorder herself, was aiming for.