Why is it so hard to portray eating disorders on screen?

TW: Please be aware that this article contains an in-depth exploration of issues related to eating disorders and disordered eating.

Back in May, Club Zero opened at the Cannes Film Festival. The film, which follows a group of students at an elite boarding school who are encouraged to abstain from eating, received largely negative reviews. Branded as a “non-satire” that’s “starved of ideas”, Club Zero became just one more film that proved how difficult it is to portray nuanced depictions of eating disorders on screen. It might seem like a broad generalisation to suggest that mainstream films and TV shows are incapable of depicting eating disorders in an accurate and nuanced way, but the evidence speaks for itself.

One of the enduring issues is that these portrayals often aestheticise or romanticise eating disorders. Take Black Swan. With the unequivocally beautiful Natalie Portman as the vehicle, it’s not hard to see how her character’s anorexia and bulimia could take on an aspirational quality for vulnerable audiences. Add moody cinematography, her character’s hyper-feminine clothes and the glamour of the ballet setting, and it’s no surprise that stills from Black Swan have appeared on “pro-ana” websites.

“It wasn’t until I went into the hospital and another girl said ‘I used Breaking Dawn as ana-inspo’ that it really clicked that I was doing the same with Black Swan,” says Natalie, who was hospitalised for anorexia as a teen. “It’s all pink and cute and told in this palatable way”. Girl, Interrupted has this aestheticised quality too. “To see it hailed as ‘classy’ or ‘art’ was a motivating factor in how I framed my own eating disorder as aspirational,” says Kim, who struggled with an eating disorder for nearly 20 years. Both these films were banned at the hospital where Natalie was an in-patient.

In giving screentime to eating disorder behaviours and the emaciated bodies of those practising them, films like these can end up as a “how-to” handbook for some viewers. Kim says that she used To the Bone as a “reminder to restrict” during periods when she was feeling less motivated to do so. “At points, I would keep it on in the background for weeks.” These films also present a sanitised version of recovery and, in the case of To the Bone, a press tour where the weight loss required for the central role is discussed at length. “I read that Lily Collins crash-dieted for the film. Part of me thought if she can lose lots of weight, I should be able to,” says Sophie, whose eating disorders led her to being hospitalised on three separate occasions.

What complicates things further is that what’s triggering for one person might not be someone else; for some it might be an overly glamourised portrayal, for others it might be a hyper-realistic one. The character of Cassie from the TV show Skins proved particularly divisive. “Cassie is actually very well done: she’s clearly unhappy and they show how it’s stopping her from forming better relationships,” says Bee, who struggled with eating disorders for ten years. Ellie, on the other hand, felt Cassie was “heavily romanticised”.

Writer and director Marti Noxon was aware that her film To the Bone would be polarising too: she told me that “accepting you can’t please every viewer or reflect all experiences is just part of making art”. Despite her best efforts – she talked about the film’s autobiographical basis as well as the use of CGI to prevent actor Lily Collins from losing too much weight herself – the film’s reception suggests they didn’t translate onto the screen.

The risk of being triggering aside, there’s also something going on at a more formal level – how do you depict something which is so internal? “There’s a mismatch between the spectacular requirements of cinema and the invisibility of mental suffering,” says Emma Seaber, a lecturer at King’s College London whose research specialises in the subject. In other words, eating disorders are inherently un-cinematic. As well as being defined by unrepresentable psychological turmoil, they’re ugly and unglamorous – qualities that simply don’t align with film and TV’s visual medium.

Depictions of eating disorders also fall victim to mainstream media’s wider issues with representation. Eating disorders are overwhelmingly portrayed as an issue that affects white teenage girls, despite many studies not finding any significant ethnic differences in prevalence of anorexia, bulimia or binge eating disorders. In fact, some research found that Black teenagers are 50 per cent more likely than white teenagers to exhibit bulimic behaviour. Larger bodies, too, have been scrubbed from these narratives. Sharon, who struggled with binge eating, said that she “never looked like the stereotypical image of someone with an eating disorder.”

“There are certain things that films and TV will never be able to depict: the absolute pain, obsession and self-destructiveness of an eating disorder is one of them” – Bee

So what is the solution? Could introducing more concrete guidelines around the depiction of eating disorders help? It’s muddy waters – even those who’ve struggled with them feel like this wades into tricky territory around artistic expression. “Talking about mental health is a normal part of being human,” says Iona Holloway, who is in recovery from an eating disorder. “We can’t wrap art in cotton wool”. Given the high mortality rates in people with eating disorders, those wanting something more rigorous in place can’t be blamed either. 

For some, things feel rather hopeless. “There are certain things that films and TV will never be able to depict: the absolute pain, obsession and self-destructiveness of an eating disorder is one of them,” says Bee. But there are a few decent representations of eating disorders out there: Todd Haynes’ Superstar: The Karen Carpenter Story is an experimental short that uses documentary footage, as well as sequences acted with Barbie dolls, to depict singer Karen Carpenter’s struggle with anorexia. 

There’s also Swallow, a thoughtful account of a housewife with pica – a disorder characterised by eating non-food items –  that focuses on the isolation she feels. BBC Three’s Overshadowed deserves a special mention too: anorexia is portrayed as a human girl called ‘Anna’ who manipulates and distorts the protagonists’ thinking, as eating disorders so often do. Evidently, it is possible to create complex and non-discriminate depictions of eating disorders – there just needs to be more of them.

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, 365 days a year on 0808 801 0677 or at beateatingdisorders.org.uk