You’re wrong about anorexia
And so is Lily Collins, probably.
Forgive me for the clickbaity title. Perhaps you’re not wrong about anorexia. But lots of people are. I know I was, before I went through it myself. The biggest problem, to my mind, is the emphasis we place on being thin.
You’d be forgiven for thinking this, given that anorexics themselves place emphasis on being thin. The diagnosis, too, emphasises being thin. Anorexics are thin. Not exactly a controversial statement.
But low body weight is a symptom of anorexia, a side effect. It may determine the treatment needed, the priority given during triage, but it isn’t the illness itself. Most of us recognise anorexia as a mental illness with physical repercussions — but we then become preoccupied by these repercussions, paying less attention to the behaviours that preceded them.
Rapid weight loss has different consequences for different bodies. Suppose I had a BMI at the upper end of healthy, and I barely ate anything in a bid to lose weight, and I spiralled down to the lower end of healthy in a matter of months. I wouldn’t be the extreme picture of anorexia that’s bandied about by the media. In fact, I might not be diagnosed with anorexia at all. Other EDs exist.
I’m not going to share numbers here — it would kind of defeat my point — but a few pounds away from my lowest weight, I went to see the university mental health advisor. She was surprised to know I had an eating disorder and told me I didn’t ‘look thin’. I thought, ‘Oh, so you want me to lose more weight? Challenge accepted!’
Because if that’s the threshold for being taken seriously, what’s the implication there?
You’re not sick enough.
Come back when you’re dying.
Anorexia is characterised by drastic weight loss, and yet even in the most severe cases, this weight loss does not happen overnight. It’s a journey, not a destination! And on this journey, you are tired, cold, moody, insecure, and potentially jealous — all in the name of eventually being thin. The goalposts move, and you chase a comparative word, thinner, from which you will never be exempt because didn’t you get the memo? You can always be thinner. ‘I’ll stop when I’m skinny!’ is the rallying pro-ana cry — but why would you stop? Wouldn’t stopping make you gain weight? You don’t stop, you don’t settle, you don’t win, and on and on the journey goes. You never reach that destination.
The reality of eating disorders is a far cry from media stereotypes, which cherry-pick the most sensationalist aspects purely for the shock factor. You know the ones: trashy magazine stories about THE DIET THAT SPIRALLED OUT OF CONTROL! or I WAS GIVEN A WEEK TO LIVE! or I GOT PREGNANT WHILE ANOREXIC — MY BABY WEIGHED MORE THAN ME!1 So little attention is given to the opening act, and it all seems to imply that we just wake up one morning and find we’ve transformed, Gregor Samsa style, into stick insects.
I’m not denying that many, many anorexics get very, very thin. I’m simply asking: how do you think that happened? Don’t you think they might have been less thin at some point? Doesn’t the problem exist before they ‘look thin’?
So non-anorexics are wrong about anorexia. You’d think anorexics themselves would know better, but we don’t! I attended an outpatient therapy group, and I remember thinking the other patients were thin, sure… but if we weren’t all discussing our eating disorders, if I’d just seen them in passing, I don’t think I’d have known they had a problem. (Almost like you can’t judge these things on appearances alone.) In the early 2010s, Lady Gaga opened up about a lengthy battle with both anorexia and bulimia — and yet in the late 2000s, as she danced around in underwear and skintight bodysuits, I thought she looked normal. Because in the late 2000s, that was normal. Realistic portrayals of anorexia were your bare minimum beauty standards.
Actor Lily Collins has a history of anorexia, and starred in Netflix original To the Bone, in which she played a young anorexic woman. Having made a full recovery, Collins chose to lose rather a lot of weight, stating, ‘I knew that hair and makeup could only do so much. And that to pay tribute to the girl that I was when I was younger, and also to the character, I wanted to do it in a way that really went there.’2
Right. So. An actor, previously suffering from an eating disorder, draws on her own personal experience (we’re off to a good start!) and loses weight (oh) to play an anorexic (so, perpetuate the myth that eating disorders are only worth talking about when you’re skinny). The moral of the story? Anorexia is only really a problem once you’re as thin as a thinner-than-usual Lily Collins.
Collins was quick to point out that she had a nutritionist on hand at all times, and that she lost weight in a healthy way. I would love to know how she starved herself the healthy way. You can’t ‘do [anorexia] in a way that really went there’ and brush it off as healthy.3 Which is it?
Now, if Collins has lost just a small amount of weight, or preferably none at all, I might think more highly of the film. Imagine if it had explored subclinical anorexia, or EDNOS, or bulimia. Suppose we met her character after her initial treatment, after weight restoration. Instead we get another tedious, sentimental tale of how starving makes you skinny. Groundbreaking.
Eugenia Cooney, a severely underweight influencer, is unmistakably anorexic. She is ‘bonespo’, as the pro-anas might say, or even ‘deathspo’. So malnourished she can barely string a sentence together, Eugenia retains a loyal following of the morbidly curious, fascinated by the fact she’s even alive. Every so often, someone will compare Eugenia’s heavily made up ‘ana face’, with its hollowed out eye sockets and too big teeth, to her younger, fuller face. These people have good intentions, but they fail to recognise that the younger, fuller Eugenia could have had an eating disorder back then. The deathly sick Eugenia we see on our screens is the result of prolonged starvation and extreme weight loss — meaning she had to have been starving herself long before it showed.
The fact of the matter is that very few anorexics even come closer to Eugenia’s lowest weight. Some people have died at higher BMIs. Others make a full recovery. Some of us don’t ‘look’ thin; if we do, we are congratulated and told it’s not a problem. Is it any wonder that so many sufferers feel they’re not sick enough?
If you need help
Always seek medical advice in an emergency. In the UK, you can call NHS 111 option 2 for mental health support. Find a list of helplines around the world here.
I made that one up.
Eating Disorder Hope highlights a similar concern here: https://www.eatingdisorderhope.com/blog/to-the-bone-controversy-eating-disorder-hope
This is so important!!! The part about being told you don't look thin hit me hard. That's the credibility gap in action. You're experiencing the illness but because your body doesn't fit the media stereotype, you're not sick enough to deserve care. And worse, that becomes the goalpost. Come back when you're dying. I see this same mechanism constantly, women's lived experience dismissed when it doesn't match what we're told to expect. The threshold keeps moving. Not thin enough, not sick enough, not struggling enough, not polished enough. Lily Collins losing weight to play an anorexic just reinforces the idea that eating disorders are only real when you look skeletal. But the behaviours, the mental warfare, the exhaustion, all of that exists long before it shows on your body. Thank you for naming this.