At the beginning of "To the Bone," Ellen (Lily Collins), a moody 20-year-old struggling with anorexia nervosa, is kicked out of a Los Angeles inpatient treatment center after expressing her brutally honest thoughts about a fellow patient. It's the fourth such facility from which she's been dismissed, and neither her health nor her outlook has improved much by the time she enters the fifth: By that point, she's seen and endured too much to get her hopes up.
"To the Bone," the first feature written and directed by television veteran Marti Noxon ("Girlfriends' Guide to Divorce," "Unreal"), affects a similarly sardonic, seen-it-all attitude. It does this in part to inoculate itself against the charges of cloying earnestness and maudlin sentimentality that can plague so much disease-themed film and TV fare.
But the movie, which Noxon based partly on her own history with anorexia and bulimia, also wants to seem sufficiently authoritative on a tough and relatively underdramatized subject. It means to convey some essential, hard-won truths about the experience of those who struggle with eating disorders, even as it filters that experience through one not-so-ordinary young woman's story.
To tell that story, Collins, who incarnated the radiance of a classic Hollywood ingenue in movies like "Mirror Mirror" and "Rules Don't Apply," has undergone the sort of startling physical transformation that usually winds up being praised for its bravery or dismissed for its awards-baiting self-regard. Both reactions are understandable, even if neither, in this case, seems entirely adequate.
Collins, who has spoken out about her own experience with eating disorders, reportedly took special care in slimming down into the skeletal presence we see on-screen, her emaciated frame not quite concealed by loose knitted sweaters and baggy overalls. Noxon's camera accentuates the visible evidence of her star's weight loss — gaunt cheeks, stick-like limbs, sharply protruding bones — with a gaze that can be clinical but never fetishistic, and which scrupulously avoids telling us how we should feel about what we see.
"Do you think that's beautiful?" asks Ellen's overbearing, well-meaning stepmother, Susan (Carrie Preston), perhaps not realizing the double-edged nature of her question. You may recoil from Ellen's sallow complexion and ravaged physique, and still be struck by Collins' beauty — a beauty that, according to some early critics of "To the Bone," runs the risk of glamorizing her struggle and turning Ellen into an avatar of what is known online as "thinspiration," an anorexic's physical ideal.
At one point, we learn that Ellen, a gifted artist, recently posted some drawings of her body online, with controversial results. You can read a hint of defensiveness into this subplot, as if the filmmakers were preempting attacks on their own representational choices. Yet one of the movie's insights, tossed off in a group discussion between Ellen and the other patients, is how deeply eating disorders are rooted in psychology and perception. The gravely ill Ellen may be a gorgeous ideal to some and a grotesque aberration to others, but the filmmakers, to the best of their abilities, try to see her clearly for who she is.
They are also keen to suggest, and then immediately discard, some obvious root causes of Ellen's struggle — particularly in her family life, which is tumultuous in ways that flirt with cliché. Ellen used to live in Phoenix with her mother, Judy (Lili Taylor), and Judy's partner, Olive (Brooke Smith), but then moved to L.A. to be with her stepmother and half-sister, Kelly (Liana Liberato). Ellen's father lives with them too but is almost entirely absent from the picture — a decision that pointedly keeps the many women in the story front and center.
Most of Ellen's fellow patients are young women roughly her age, though there are a few men in the mix as well. Some levity and romantic interest are provided by the center's sole male patient, Luke (English actor Alex Sharp), who has a sufficiently firm grip on his demons to be able to mock the center's various rules and restrictions while still basically upholding them. The doctor who heads up the facility is also a man, one apparently renowned for his unconventional treatment methods, though apart from the fact that he's played by Keanu Reeves, nothing about his live-your-best-life bromides seems especially radical.
"To the Bone," for its part, hews closely to formula in a way that's easy to forgive, in part because Noxon hits even her most obvious notes with a light, sure touch. Part character study, part PSA, the movie chronicles a brief but meaningful period in its protagonist's healing journey, and if there are few surprises along the way, there are equally few easy answers or miraculous breakthroughs. In a different film, Ellen's sharp tongue might have made her an insufferable fount of wisecracking negativity — picture a hungrier, angrier Juno — but Collins' performance is subtler than that, and the script gives her ample opportunity to reveal the character's more complicated, vulnerable edges.
"I'm sorry that I'm not a person anymore," she says during an especially fraught family-therapy session. "I'm a problem." To some extent, the movie agrees with her — there is calculation aplenty in its empathy — but it also has the wisdom to leave that problem unsolved.
‘To the Bone’
Running time: 1 hour, 47 minutes
Playing: iPic Theaters, Los Angeles