Why We All Need to Read Carolyn Costin's Review of To the Bone

Watch this week's recovery video in which I share my thoughts on To the Bone.

Below you can read Carolyn Costin's official review of To the Bone:

"I was hesitant to see the new Netflix eating disorder movie, To The Bone. As someone recovered from anorexia and an eating disorder therapist, author, educator and spokesperson I generally do NOT like eating disorder movies, documentaries, TV specials, “reality shows” or even autobiographical books about eating disorders and tell my patients to steer clear of them. However, when asked by Project Heal to attend the screening and moderate a panel discussion afterward, I agreed.

The film stirred up controversy even before its release and because of its significance as the first major film on eating disorders with the potential to be seen in 100 million homes, I wanted to ascertain the situation for myself. Did To The Bone have something of value or was it going to end up on the “do not watch” list with so many others.

To The Bone is based on a true story about a young woman with anorexia nervosa, and brings viewers into the eating disorder world, including interactions her family, her doctor, and a variety of other patients in a treatment center. The patients are portrayed realistically, without showing gratuitous scenes of behaviors such as wretching into a toilet while at the same time not glamorizing the illness by avoiding anything that could be potentially controversial or disturbing.

This is a film based on what happened in the life of one individual, not a movie about understanding, preventing or treating eating disorders. It’s not meant to educate the public on the causes of the illness, or how best to treat it. It is writer/director Marti Noxon’s autobiographical story (with some artistic license thrown in). Marti felt her story was important to tell in order to raise awareness about a misunderstood subject.

To The Bone will, for sure, raise more questions than provide answers, and that is exactly what Marti had in mind. Her hope is to promote a conversation about an illness that is still not well understood by the public and does not get appropriate coverage or concern.

The film’s main character, Ellen, has anorexia nervosa, from which more people die than any other mental illness, yet no one has taken it seriously enough until now to put resources into a major film. Marti felt compelled to make a film and make a difference and faced many obstacles along the way. For example, several people whom she tried to get interested in the project told her they did not think the eating disorder topic was a big enough issue. She knew, and many of us know, better.

Are there things I dislike about the movie? Yes. Do I think there were unrealistic parts? Yes. Would I have done things differently? Yes. As an eating disorder treatment provider, educator and activist, I wish there ha been more explanations given about the disorder and that the movie had shown more about how treatment helps people recover. I would have included much more and much different therapeutic dialogue and I would not have depicted the eating scenes at the treatment center in the same way.

Much of the controversy surrounding the film comes from the fact that Lily Collins, who played the part of Ellen, also suffered from anorexia as a teen and yet she lost weight to authentically play the role.

I too was concerned and unsettled upon hearing the leading actress had suffered from anorexia in the past yet lost weight to play the part. As a therapist I certainly would not recommend any of my clients do this. But after meeting and talking to the real person, Lily, her mom and Marti, I learned about the care and thinking that went into her decision including the medical and nutritional monitoring that took place. But even that is not the most important thing here. What is far more important is that Lily is fine. Not only did she not relapse, she found the entire experience “insightful” and “therapeutic” learning many things she did not know or understand when she was 16 and suffering from her eating disorder.

To those who express their anger and boycott the film, I wonder what would they suggest as an alternative? As far as I know, no one has yet offered a better solution for Ellen’s character. Should Marti have found an actress currently suffering from anorexia to play the part? Should some other actress have lost weight for the part? Should she have hired a normal weight actress to play the part of someone with severe anorexia nervosa? All of these alternatives would have brought their own problems, concerns and controversies. To avoid all potential problems or criticism, no movie could be made at all.

You can’t make a film about a troubling topic without troubling people. There is no way to deal with a sensitive, disturbing, and difficult subject, such as eating disorders, without upsetting or “triggering” a sub set of individuals most closely associated with the issue, whether professionals, patients or their families. If no one was disturbed by this film, there would indeed be something terribly wrong. Eating disorders are disturbing, confounding illnesses. Would I advise patients to go, no, they don't need to see it, they already know what the movie is trying to reveal.

The other controversy has so far sprung from those who have seen the trailer and complain that showing a white skinny girl is not fully representative of the spectrum of eating disorders and the scenes might be triggering for those who are vulnerable or already suffer from the illness.

They are right. However, the trailer is not representative of the movie. The movie portrays 7 patients with varying diagnoses, body shapes, gender and color. Particularly arresting is Alex Sharp’s portrayal of the male patient, Luke.

Will the trailer and the film trigger some people, yes, but I found this film less potentially triggering than most. The trailer shows perhaps one of the most triggering scenes of the film. But you can’t make a film about eating disorders without upsetting or triggering some people. During my own eating disorder just watching someone in a movie eat, get on a scale, go on a diet, or work out at a gym was triggering. Any program, of any kind, about eating disorders will trigger some and that will be the case withTo The Bone, but not such that is loses all value which will be as diverse as the people who go to see it.

With my 40 year history in the eating disorder field, I am passionate about anything that can be done to help understand, prevent and treat these illnesses and even though To The Bone has weaknesses and is not the movie I would make, it is still an important step in bringing eating disorders front and center. I can put aside my own biases both as someone who recovered and as a current expert in the field and see this movie for what it is, one woman’s story that is authentic, sad, realistic, disturbing, scary, and true. And as for hopeful, let me just say that the real Ellen, Marti Noxon, is recovered and here to say it is possible and that speaks volumes." - Carolyn Costin, July 14, 2017

Carolyn Costin - Angie Viets

Carolyn Costin, MA, MEd., MFT, CEDS, FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker. In her twenties, Carolyn recovered from anorexia and became a teacher and a psychotherapist. After successfully treating her first eating disorder client in 1979, she recognized her calling. In 1996, she created Monte Nido, the first licensed, residential eating disorder treatment facility in a home setting. Having left Monte Nido in 2016, Carolyn maintains her private practice and remains very active in the eating disorder field lecturing, training, teaching, writing and supervising. In 2017, Carolyn founded The Carolyn Costin Institute, which offers Eating Disorder Mentor and Coach Training, online and in-person Continuing Education for clinicians, and other specialized trainings.

Should You Watch 'To The Bone'? A Yoga Therapist Shares Her Hopes and Concerns About The Movie

Photo Credit: Netflix

Photo Credit: Netflix

When pictures and trailer clips of a disturbingly thin Lily Collins began to show up in my news feed the other week, I resolved to avoid the movie To The Bone and all discussions about it. I wasn't going to watch the trailer, read about the movie, comment about it on social media, or write a blog post about To The Bone, the first motion picture about eating disorders due out in the US on July 14 on Netflix. I was determined to sit this one out and wait for the buzz to pass.  

Collins plays a severely anorexic teenager named Ellen, and when I say "severely anorexic," I am not exaggerating. She's a haunting figure, barely there. She is painfully ill and her body is painful to take in. Even now, writing about her, I feel a pit in my stomach--a raw visceral reaction that comes from a sincere concern for the actress, the memory of and deep care for the women with whom I have been in treatment, and from an honest and personal knowing about the life she portrays in the film. Also unsettling for me is the fact that Lilly has a history of anorexia and bulimia. And now, here she is, as sick as can be again, reliving anorexia. For all these reasons, I was set on not getting caught up in To The Bone. I just couldn't see how this movie and the hype around it would support me in my life.

Low and behold, the very next day after explaining all of this to a friend, I received an email from The Renfrew Center of Philadelphia, asking me to appear as an alumna on a local news station with Samantha DeCaro, PsyD, Assistant Clinical Director at Renfrew to discuss my reaction to the 3-minute trailer for the film. Of course, I was excited (exhilarated really) and quite touched Renfrew invited me to do this. How could I not be? And I am grateful they did, because it turns out I do have some important things to say about the trailer, and I am actually a better woman, mother, yoga therapist, and member of the eating disorder recovery community for speaking out. 

In the less than 48 hours I had to prepare for my 3-minute interview on Fox29, I watched the trailer several times, read articles about the film and its director and lead actress, had a heart to heart with my husband, and put out an inquiry on social media, asking people to tell me about their thoughts, opinions, and concerns about the trailer for To The Bone.

After hearing back from so many people, I felt secure in my initial reaction to avoid the film. Many people had similar responses to Collins' physical appearance. More than that, they were deeply disturbed that the actress has a history of anorexia and bulimia and reported she lost weight in a "healthy" way for the film. Like the others who wrote to me, I am very worried about the message this sends to the recovery community as well as teens and others who are vulnerable to messages about weight loss and the connection between one's self-worth and jeans size. After more than 20 years of healing from anorexia, I can say with confidence, that it is highly not possible to lose weight in a "healthy" way. And there is clearly nothing healthy about Collins' body, and I am worried about the state of her mind after embodying this role in such a dramatic way. 

Based on the trailer, anorexia is clearly front and center. I am concerned that anorexia has become the face of eating disorders in the media. The "thin ideal" has glamorized the disease, making it a one-dimensional disease about weight and food. I am hopeful (fingers and toes crossed) that To The Bone will give voice and attention to other types of eating disorders and that other bodies, genders, races, and a spread of ages will be represented. To exclude these bodies and voices would be a severe shortcoming on the part of the film and an enormous disservice to the eating disorder community, including the families and supports of those who struggle.

I am also hopeful that the movie will portray the complexity of eating disorders as well as capture the resiliency that is possible with proper treatment and dedication to one's healing. The joke in the trailer about "calorie Aspergers" is offensive, and not one appreciated by several of the people I corresponded with on social media. In the context of the movie, it may work. But as a one off, it makes me wonder if the complexity of anorexia will be brought to light. 

Another concern is that the movie's ending will suggest that Ellen gets to go home cured. This just isn't the case in real life, and to give families and supports such false hope could be devastating for all parties involved. Let's hope that recovery isn't itself glamorized as a mountain that is conquered after a few weeks or months away at treatment.

Although I value Collins' lived experience and dedication to her career and mission to, I am concerned that To The Bone will fall short in its efforts to accurately educate. I worry it will trigger many and even set off a desire to be "sicker" in others. Still, I am hopeful that this film will initiate important conversations about eating disorders and their prevention and treatment. I am hopeful that the recovery community will come together with honest feedback about whether or not a motion picture in the first place is helpful. As my husband shared with me, a documentary is much more humane and real; let the individuals who are living it share in real time about their experiences.

There are many more concerns and hopes I have about To The Bone, but I want to turn this blog post over to you now. I'd like to hear your thoughts and opinions about the trailer. Please share in the comments below or email me. It's only from learning from one another that we can grow stronger in our voice and more confident in our right to use it!

Sadly, the video clip of my interview is currently unavailable. Should it become available, this post will be updated!

Jennifer Kreatsoulas - Angie Viets - To The Bone Movie

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications.  Connect with Jennifer.

Danielle LaPorte’s White Hot Truth Soothes Self-Help Fatigue

Source: Unsplash/Annie Spratt

Source: Unsplash/Annie Spratt

Has your self-help turned into self-criticism?

The self-help struggle is real. Collectively we search for the truth, our path, and purpose from the outside in. We seek answers from psychologists, psychics, and priests without slowing and softening to the wisest guru of all: Ourselves. During my sultry conversation with Danielle LaPorte about her newly released book, White Hot Truth, she shed some light, because, as she says “it’s all about the light,” on how she became her own guru.

Danielle vividly explained the moment when she realized she was at a “jarring juncture: the conflict between sincere spiritual aspiration and the compulsion to improve.” As she opened her day planner and saw upcoming appointments with a shaman, psychotherapist, and astrologist, along with scheduled massages and yoga classes, she had a revelatory moment where she realized “all of this self-helping was becoming a bit of a burden and impinging on my ability to create with a capital C. Spirituality was becoming just another thing on my f*ing to-do list.”

Through breathy prose she broke down how she questioned her spiritual quest and transformed her to-do list, thus creating freedom and fluidity. With her lyrical lathering in full force (by the way, I highly recommend the audio version of the book; you can thank me later) I noticed my shoulders settling into their natural position, less like accessories for my ears, more gliding down my back like wings. My breath eased its way into a gentle rhythm as I physically released the anxiety of my own daunting self-help regimen.

What is this feeling overcoming me as this diva I’ve admired for years (and secretly channeled in moments of insecurity) – thanks to her rockstar books like The Desire Map and The Firestarter Sessions – reveals her process and progress (because, as she says in her Canadian accent, “everything is progress”) to me? Ah, yes, it’s relief! Relief that there’s another way. Relief that we can still be self-evolving, spiritual seekers, without stressing ourselves out on the regular. Without drowning ourselves in green juice cleanses and repeatedly clearing our chakras. We can liberate ourselves from the perpetual spiritual striving through discernment and self-love. Finally!

“It’s Not How We Seek Spiritual Growth; It’s Why We Seek It.”

Many of us, myself included, are drawn to the vast sea of self-help. Investing copious amounts of cash to feel free. We sign up for the lightworker retreat, past life regression, and some oh-so-necessary karmic healing. Yet, ultimately—I’m speaking from my own decades worth of psychotherapy, angel card readings, and psychic sessions—it wasn’t ever quite what my soul needed to truly heal. Why? Because everything I thought I could find ‘out there’ was already inside me. I’d become dependent, tethered actually, to the feedback from others that only I could best offer myself. What once was a young woman chained to an eating disorder like a dog on a leash, was now someone addicted to guidance from experts. Looking to strangers to tell me about…me. Someone who could only get quiet and still in a yoga studio. I was missing the point.

It’s painful to be lost, for sure. However, suffering is waiting for someone else to bring you home when you knew the way all along. You don’t need to wait until next Wednesday at 2 p.m., or head to an ashram to get clarity about your path, because, as Danielle says, “the best self-help is self-compassion.” Guess what, it’s free!

Self-Help or Self-Hate?

When Danielle described, in her alluringly poetic way, that underneath all of our self-helping is a whole hell of a lot of self-hatred I heard myself silently screaming, “Hell ya, sister! Preach!” I mentally scanned the thousands of self-help books I’ve purchased in an attempt to transcend whatever self-imposed trap I was caught in. Books with promising titles like, 10 Steps to Radical Self-Acceptance, left me feeling frantic as they gathered dust on my nightstand. Why do I continue to buy into the notion that a book, sermon, or healer holds the key to unlock the door to my evolution? Probably because it seemed easier.

Without question, I’m devoted to spiritual growth, healing suffering (my own and others), and tending to my psyche and soul. There’s nothing inherently wrong with these soul goals, unless, they disempower you, or require you to disown your deeply held inner wisdom. Seek the counsel of others as a conduit to connecting with your truth, not as a means to adopt others' truth about you.

Compulsive Self-Improvement     

Danielle believes, “We are driven by the compulsion to improve. We all look so healthy on the outside, but we’re really actually pretty neurotic on the inside.”

Danielle is clear that she didn’t ditch her spiritual to-do list entirely, she’s found a more useful sequencing of priorities. “Self-referencing is a lifelong journey. I meditate daily, pray, or engage in some sort of contemplation. It’s like brushing my teeth, it has to happen.” Therapy continues to be on her agenda, but it’s evident she’s no longer reliant on it to make a decision.

White Hot Truth is the permission we all need to check in with ourselves deeply, with reverence, and to listen to the wisdom of our bodies and souls. We don’t have to throw the baby out with the bathwater. Keep the yoga class if it serves you. Call the astrologist if you’re in the mood. But let’s stop the perpetual insanity of striving to perfect what was never intended to be perfect. Let’s greet ourselves—our messy, sometimes arrogant, or inconsiderate selves—with compassion, gratitude, and unabashed acceptance. We have everything we need. Already. We are wholly (or holy) enough even when we feel dreadfully inadequate. Beautiful even when we feel broken. The solution is not out there, my love, it’s right here inside. Go talk to the part of yourself that knows. Find her on the trail alongside the river. Find him in the pauses, those quiet moments in between. Sit in your own company and dwell there long enough to remember yourself. That’s the way home. Those are the moments where we hear the truth. Lean on others for support, yes, but don’t let their interpretation or analysis be your sole compass.

Get White Hot Truth!

Hungry for more?

*Part 2 in this blog series will be published on Tuesday, May 23rd, 2017

*I'd love to inspire you to take the next step on your path to recovered and send you my free weekly Recovery Tip videos. Please visit my website to sign up.

Angie Viets, LCP is an author and clinical psychotherapist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible! Read more.

Interview on the ED Matters Podcast

I got the amazing opportunity to be interviewed on the ED Matters Podcast, hosted by Kathy Cortese! We discussed the unique challenges for recovered therapists treating eating disorder patients. 

Getting excited? You can listen to the interview on Gürze-Salucore's website

For more inspiring interviews subscribe to ED Matters on iTunes, Google Play, or Stitcher.

Connect with me on:


10 Promises to My Children From Their Recovered Mother


Dear Beckett, Sophie & Sammy,

This is a special week for your momma and a lot of other people too. It’s a week where people speak up about a sickness that is very serious, but sometimes not talked about very much. You know I’m a psychotherapist (I know, I know, emphasis on psycho) and that I help people with eating disorders. I haven’t talked to you much about my work because it can...

be pretty hard to understand. When I come home tired, you make me smile as you remind me of your idea of what I do: “You just sit and talk to people all day! What’s so hard about that?” Daddy’s work is much easier for us to see as we can drive by the houses and businesses he has helped build. My work must seem sort of invisible when all you see is an office with comfy furniture. 

Since you guys are getting a little older, I wanted to tell you something that’s important about me. For seven years I had an eating disorder. I was very sick for a long time, mostly when I was in college, but I’m all better now. When I married daddy I was slowly getting healthier every day. Finally, I had something way bigger than my eating disorder to help motivate me - I wanted to be a mom. 

You see, I had been praying real hard to be a momma. It was my biggest dream since I was a little girl. I told my third grade class on ‘Career Day’ that when I was all grown up, I wanted to be a mom. When asked in graduate school what I planned to do with my degree, I pretty much answered the same way. I don’t think anybody was looking for that response, but it didn’t matter to me, because being your mom is my true calling (the thing I was meant to do while I’m here on earth). But I was really scared that, because I had been sick for so long, maybe my body wouldn’t work right anymore and that my dream might not come true. I promised myself that if I was able to get pregnant, I would lay down my eating disorder and fight as hard as I could, once and for all, to stay well for you guys and for myself. 

Want to know something really special?? The day I found out I was pregnant with Beckett, I committed to that big promise that I had secretly carried around in my heart. I’ve kept the promise for thirteen years and I’m really proud of myself for that, because it means I can really be here for you. 

Even though it was hard being sick for so long, something beautiful came from it. I learned that I have another very important calling that’s really meaningful to me. When I was sick, I had a hard time finding anyone to help me who really understood how to do so; eating disorders are tricky to heal. I wanted that to be different, even if only in a small way for other people. So daddy and I moved to the same college town where I was sick, and now, I help a lot of other college students get better. Every day I feel so lucky and blessed that I get to be your momma AND that I help other people get well.   

I’ve made some new promises along the way. Some of them may seem silly, but oh well, you know I’m kind of silly. 

  1. You will never hear me order a ‘Skinny Latte’ from Starbucks. It’s just too stupid to say out loud and brings up unnecessary questions. 
  2. When you want to order pizza and have a picnic in the living room, I will be the first to get it all set up and eat with you. Always. Because pizza is delicious! 
  3. If you want to throw on swimsuits on the first warm day of summer and run through the sprinkler in our front yard, I’ll do it with you! I don’t feel the need to hide my body anymore. In fact, I’m really proud of the body I have, it helped me grow and feed you! 
  4. You will never hear me complain about the way my body looks. The way I feel in my body and how I talk about it, has an even bigger impact on you than what I say to you about your body. I wish more moms knew this – maybe they would talk more lovingly about themselves. 
  5. I refuse to be the mom who orders a salad, “Oh, and could you hold the croutons and cheese and put the dressing on the side.”  (If salads like this feel really nourishing and satisfying to you, great!  For me, a salad like this would feel restrictive.) Nor will I ever go on a cleanse, detox, or diet. I spent SEVEN long years doing that, and it’s so NOT FUN! What I eat, communicates a lot more to you than what I feed you. 
  6. We will talk about what ‘sometimes’ foods are and what ‘always’ foods are and you will know the difference. I added this as a new promise when you came home and told me one of your friends said that McDonald’s makes people fat and you didn’t want to eat there anymore. Wait, what?? Sometimes as a mom, you have to do some deprogramming because other people and the media don’t always convey the truth.   There is no restaurant, or food that can ‘make you fat.’
  7. I promise to show you that it’s important to move your body in ways that are fun and feel good to YOU. I won’t spend my time running away from myself in the form of over-exercising. It’s way more fun to play with the three of you anyway! But when you are upset that I’m leaving to go to yoga, I want you to know that it’s important for me to love and take care of my body, just as I love and take care of yours.
  8. I will share with you what a powerful messenger your body is and encourage you to listen to it – like when it tells you to rest when you are sick or hurt, and how hard it fights to get well, all on its own. Our bodies are really cool that way!
  9. Another new promise (as we pull through the carpool line after school). “Mom, what does it mean to have a six-pack?” (And yes, I needed to take a minute before we talked about this, because I was so upset that elementary-aged kids even have these conversations). You will be surrounded in this lifetime by conversations about weight and shape. It’s important for you to remember that we all have unique body types and comparing ourselves to others (really in any way) just doesn’t feel good. So, I will teach you how to turn the conversation away from this kind of talk, and move on to topics that relate to your friend’s insides, rather than focusing on their outsides.  Doesn’t that sound more fun?
  10. We are going to talk a lot about how we mess up – every day. All of us, it’s just part of life. We need to get cozy with the idea of imperfection! Most importantly, I want YOU to know, in your heart, how wonderful, special, and amazing you are – because I’ve learned it’s not enough for me to think that about you, you need to believe it too. 

So, my sweet loves, those are some of the promises I hold in my heart, so I could stay better, and to help protect you from this illness. I’m not going to get it right all the time.  And that’s okay, too. I never promised to be a perfect mother. I figured out as I got better, that there really is no such thing as perfect. But then I had each of you, and wondered if that was really true. As I got to know you, I realized that much like me, you are perfectly imperfect.
I’m so grateful that I have the three of you and that I’m all BEDR (pronounced better, Beautifully Eating Disorder Recovered)!!

Love you with my whole heart,


Dr. Phil: Please Stop Triggering People With Eating Disorders

Dr. Phil: Please Stop Triggering People With Eating Disorders

Dear Dr. Phil: Oh, how I’ve loved you since your early days on Oprah, but today, I’m writing you with a specific request. I watched this week’s episode, “Identical Twins Starving to Death: Who’s to Blame,” and I haven’t been able to get it out of my mind. So, since we’re both therapists and can appreciate the value of talking things through, I thought I’d start the conversation.