Skeletons in the Closet

IMG_2792.jpgOne evening this past weekend I watched the indie movie “To the Bone” (2017) which deals with the topic of eating disorders, particularly anorexia nervosa—with the highest mortality rate of any mental illness. People waste away, become skeletal like concentration camp victims, and literally starve themselves to death. Unless, that is, they are fortunate enough to be able to access effective and compassionate health care and recover from this devastating illness. As does the 20-year old lead character in “To the Bon,” Ellen, as well as the actress, Lily Collins, who plays her in the movie—and as does the writer/producer of the movie, Marti Noxon. Both Collins and Noxon have struggled with anorexia and Noxon based the screenplay on her own experience.

I had read about some of the controversy surrounding this film, including critique that it glorifies thinness and eating disorders in general, as well as that it can tigger viewers into a recurrence or worsening of their own anorexia. Although I am not in favor of the over-use of trigger warnings, I did feel that the brief written warning at the beginning of the movie was tasteful and appropriate. As I remember, it stated something like “The following movie includes content that some viewers may find difficult to watch.”

Having lived through anorexia as a teenager, and having provided primary health care to many young people struggling with eating disorders (and across the socio-economic spectrum), I can say that “To the Bone” is an honest, nuanced, and not overly-sensationalized depiction of the lived experience of eating disorders. The movie does not glamorize thinness or eating disorders. It appropriately alludes to the linkage between eating disorders and childhood trauma, including sexual abuse. The supposedly unconventional heroic physician in the film, Dr. William Beckham, played by Keanu Reeves, is borderline obnoxious in that Robin Williams ah-shucks smiley face sort of way. And the group home eating disorder treatment center where the main character Ellen goes in a last-ditch effort to find a cure, is a gorgeous and expensive-looking setting. It helps that Ellen’s elusive father (he never appears in the movie even for a family therapy session) is portrayed as having a well-paying job in order to pay for that group home inpatient therapy. Even patients with relatively comprehensive health insurance often have difficulty accessing such treatment for eating disorders.

My assessment is that “To the Bone” is a good and honest film about an important mental health issue, and it is written/produced by a woman and features mostly women in the leading roles (luckily, Reeves has relatively little screen time). I can see this film being used effectively in nursing and other health professions educational programs for many years to come.

  • A good resource for more information on eating disorders (including a toll-free, confidential help-line) is the National Eating Disorders Association.
  • And about that actual skeleton in the closet included in this post… It is a human (not plastic) skeleton enclosed in its own wooden closet on wheels and is located in the University of Washington School of Nursing’s new simulation/learning lab. I took her photograph last week and am currently trying to discover anything more about who she was.

Pretty (Shouldn’t Have to) Hurt

Cover Girl lipstick ad/The Ladies Home Journal June 1964








Greeting me at my favorite local independent bookstore this past week was this interesting ‘Health’ section display:IMG_3203Being skinny (or at least dressing skinny), wearing dark red lipstick and super expensive perfume equals health for women? I realize the display is meant to cash in on popular New Year’s resolutions within our culture, but I still find it provocative on many different levels. I was sorely tempted to add ‘hazards’ under ‘health’ but didn’t want to get evicted from the bookstore.

By now the health dangers of the skinny woman syndrome are well known. Eating disorders such as anorexia, bulimia, yo-yo/extreme/bizarre dieting. Expensive, dubiously medically-regulated, and sometimes fatal cosmetic surgeries. Beautiful Beyonce’s song “Pretty Hurts” does a good job of summing up this topic.

Something seemingly simple and innocuous as lipstick… How many people know that lipstick is a public/environmental health issue? Many popular brands of lipstick contain lead and at least eight other metals known to be harmful to humans. The FDA does not have any regulatory authority over the cosmetics industry, leaving the the 58 billion dollar a year industry (in the U.S./estimate for 2014) to self-regulate. Deborah Blum wrote a NYT Well blog article on this: Is There Danger Lurking in Your Lipstick? (8-16-13). The Campaign for Safe Cosmetics has good, up-to-date information on this issue. And the health story on perfume is perhaps even more depressing, so I will skip it and let you read all about the petroleum products, allergens, neurotoxins, and synthetic musks here.

For some historical perspective (and some sad-funny stuff), I stumbled across my mother’s copy of The Ladies Home Journal, the June 1964 Special Issue. It features an article by Betty Friedan ‘Woman: The Fourth Dimension.’ Written a year after she published the now classic second-wave feminist book The Feminine Mystique,  her ‘fourth dimension’ of a woman’s existence is “woman as a person herself, employing all her intelligence and abilities in a changing world.”

The numerous ads for beauty products in this special Fourth Dimension edition are quite telling. Besides the one for lipstick I’ve included at the beginning of this post, here are a few that stand out as both Mad Men retro and disturbingly not-so-retro (and yes, there were only white people in this magazine): IMG_3214








Skin cancer anyone?






Here is a full-page fashion shot of a ‘four-dimensional woman’ as a beautifully coiffed and attired artist (my mother, who was a professional artist with an MFA dog-eared this page–hopefully only out of amusement): IMG_3221







But this photo and caption included in Friedan’s article puts a new spin on better living through chemistry and on the value of an education (the caption says “Velta Sparnins, mother of three children, attends college on a scholarship”): IMG_3219