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Worried about your odour? At least a machine will tell you straight | Nell Frizzell

Nobody, apart from maybe my mother and Jefferson Hack, will ever tell you that you smell. I know, because following a particularly graceful, bike helmet-splitting fall on to against a piece of New Zealand road back in 2014, I lost my sense of smell for a full year and a half. I was as anosmic as the joke dog with no nose; and spent the ensuing months furiously washing already-clean clothes, avoiding lifts, dousing myself in perfume that could have been a mix of WD40 and TCP for all I knew, showering religiously, studiously avoiding high shelves and silently quaking with an unquenchable fear that I stank.

So, it is with some interest that I read that those former archdukes of the photocopier, Konica Minolta, have recently developed an app that will allow you to test yourself for three categories of smell. The device, which looks like a 1982 Hitachi beard trimmer, called Kunkun Body, connects to your smartphone, takes a reading from your skin and reports back any dangerous levels of ammonia, 2-nonenal, and isovaleric acid – the chemicals associated with the smell of urine, sour old age and smelly feet respectively. (Precisely the combination I imagine the 1922 Committee to smell of.)

Of course, it would be easier than falling off a Glade PlugIn to see this as yet another harbinger of mankind’s technological isolation, subservience to capitalist fearmongering, social dislocation and inane love of gadgetry. It is a harnessing people’s of fear and discomfort with being, essentially, mammals, in order to sell small plastic devices that remove the need for human interaction. Except, as I say, only your most brutal critic, most sensitive loved one, or most coked-up party guest will ever actually summon the glands to tell you to your face that you smell. Like asking someone if you look stupid in your new cowboy hat, the answer is either in the question (we all smell of something) or the asking proves more embarrassing than the answer.

During my scentless 18 months – a time when I felt like I was living in emotional Tupperware – my home became just a building, lovers became skin-wrapped objects, hugging my mother could have been moving a mattress in a wig, and dinner became a joyless exercise in munching. I whispered frantically to friends: “Do I smell? Honestly?” Only for them to smile benignly, shake their head and point blank refuse to actually nuzzle their nostrils into my armpit like I was hoping. Not only will they not tell you; they won’t even check.

According to the journalist Daniel Hurst, there is a Japanese word, sumehara, that pretty much translates as “smell harassment”. Apart from North Sea fishermen, most of us will know the particular disquiet of working alongside a real honker. The person who glides through meeting rooms exhaling a unique combination of cheddar and burnt onions; the one who fills a lift with the yellowish air of sour milk; the colleague who leaves a trail of malted sebum and eau de carpet tiles in their wake.

But imagine, for a second, spending your work day gripped with the fear that you are that olfactory hooligan. That, unknowingly, you smell overpoweringly of basements, bacon fat or Bovril but nobody is going to threaten a workplace lawsuit by ever mentioning it. Instead, you will find yourself simply edged out of tea rounds and workplace drinks until, finally, you get the message and go back home to Pariah Avenue.

Anosmia (loss of smell) and its bitter bedfellows, parosmia (to experience smell and taste distortions) and phantosmia (being haunted by smells that are not there), affect about 5% of the population in the UK, yet most of us know, or care, very little about them. Times without number I was told, cheerfully, that at least I hadn’t lost my sense of hearing, or sight. Which may be true, to an extent: you are certainly less disabled by society’s infrastructure when you have no sense of smell than if you have no sight. But the emotional consequence of losing this most basic, most bestial form of navigation, connection and communication, is significant.

As a species you cannot rely on us to always be honest. So no wonder that, when faced with the big questions – am I ugly? Am I stupid? Do I smell? – we put our faith in machines. And while sliding a small plastic box behind your ears, across your toes and around your armpits won’t make your home smell like home any more, at least it might temporarily quell the fear that you’re polluting other people’s lives.

Worried about your odour? At least a machine will tell you straight | Nell Frizzell

Nobody, apart from maybe my mother and Jefferson Hack, will ever tell you that you smell. I know, because following a particularly graceful, bike helmet-splitting fall on to against a piece of New Zealand road back in 2014, I lost my sense of smell for a full year and a half. I was as anosmic as the joke dog with no nose; and spent the ensuing months furiously washing already-clean clothes, avoiding lifts, dousing myself in perfume that could have been a mix of WD40 and TCP for all I knew, showering religiously, studiously avoiding high shelves and silently quaking with an unquenchable fear that I stank.

So, it is with some interest that I read that those former archdukes of the photocopier, Konica Minolta, have recently developed an app that will allow you to test yourself for three categories of smell. The device, which looks like a 1982 Hitachi beard trimmer, called Kunkun Body, connects to your smartphone, takes a reading from your skin and reports back any dangerous levels of ammonia, 2-nonenal, and isovaleric acid – the chemicals associated with the smell of urine, sour old age and smelly feet respectively. (Precisely the combination I imagine the 1922 Committee to smell of.)

Of course, it would be easier than falling off a Glade PlugIn to see this as yet another harbinger of mankind’s technological isolation, subservience to capitalist fearmongering, social dislocation and inane love of gadgetry. It is a harnessing people’s of fear and discomfort with being, essentially, mammals, in order to sell small plastic devices that remove the need for human interaction. Except, as I say, only your most brutal critic, most sensitive loved one, or most coked-up party guest will ever actually summon the glands to tell you to your face that you smell. Like asking someone if you look stupid in your new cowboy hat, the answer is either in the question (we all smell of something) or the asking proves more embarrassing than the answer.

During my scentless 18 months – a time when I felt like I was living in emotional Tupperware – my home became just a building, lovers became skin-wrapped objects, hugging my mother could have been moving a mattress in a wig, and dinner became a joyless exercise in munching. I whispered frantically to friends: “Do I smell? Honestly?” Only for them to smile benignly, shake their head and point blank refuse to actually nuzzle their nostrils into my armpit like I was hoping. Not only will they not tell you; they won’t even check.

According to the journalist Daniel Hurst, there is a Japanese word, sumehara, that pretty much translates as “smell harassment”. Apart from North Sea fishermen, most of us will know the particular disquiet of working alongside a real honker. The person who glides through meeting rooms exhaling a unique combination of cheddar and burnt onions; the one who fills a lift with the yellowish air of sour milk; the colleague who leaves a trail of malted sebum and eau de carpet tiles in their wake.

But imagine, for a second, spending your work day gripped with the fear that you are that olfactory hooligan. That, unknowingly, you smell overpoweringly of basements, bacon fat or Bovril but nobody is going to threaten a workplace lawsuit by ever mentioning it. Instead, you will find yourself simply edged out of tea rounds and workplace drinks until, finally, you get the message and go back home to Pariah Avenue.

Anosmia (loss of smell) and its bitter bedfellows, parosmia (to experience smell and taste distortions) and phantosmia (being haunted by smells that are not there), affect about 5% of the population in the UK, yet most of us know, or care, very little about them. Times without number I was told, cheerfully, that at least I hadn’t lost my sense of hearing, or sight. Which may be true, to an extent: you are certainly less disabled by society’s infrastructure when you have no sense of smell than if you have no sight. But the emotional consequence of losing this most basic, most bestial form of navigation, connection and communication, is significant.

As a species you cannot rely on us to always be honest. So no wonder that, when faced with the big questions – am I ugly? Am I stupid? Do I smell? – we put our faith in machines. And while sliding a small plastic box behind your ears, across your toes and around your armpits won’t make your home smell like home any more, at least it might temporarily quell the fear that you’re polluting other people’s lives.

Worried about your odour? At least a machine will tell you straight | Nell Frizzell

Nobody, apart from maybe my mother and Jefferson Hack, will ever tell you that you smell. I know, because following a particularly graceful, bike helmet-splitting fall on to against a piece of New Zealand road back in 2014, I lost my sense of smell for a full year and a half. I was as anosmic as the joke dog with no nose; and spent the ensuing months furiously washing already-clean clothes, avoiding lifts, dousing myself in perfume that could have been a mix of WD40 and TCP for all I knew, showering religiously, studiously avoiding high shelves and silently quaking with an unquenchable fear that I stank.

So, it is with some interest that I read that those former archdukes of the photocopier, Konica Minolta, have recently developed an app that will allow you to test yourself for three categories of smell. The device, which looks like a 1982 Hitachi beard trimmer, called Kunkun Body, connects to your smartphone, takes a reading from your skin and reports back any dangerous levels of ammonia, 2-nonenal, and isovaleric acid – the chemicals associated with the smell of urine, sour old age and smelly feet respectively. (Precisely the combination I imagine the 1922 Committee to smell of.)

Of course, it would be easier than falling off a Glade PlugIn to see this as yet another harbinger of mankind’s technological isolation, subservience to capitalist fearmongering, social dislocation and inane love of gadgetry. It is a harnessing people’s of fear and discomfort with being, essentially, mammals, in order to sell small plastic devices that remove the need for human interaction. Except, as I say, only your most brutal critic, most sensitive loved one, or most coked-up party guest will ever actually summon the glands to tell you to your face that you smell. Like asking someone if you look stupid in your new cowboy hat, the answer is either in the question (we all smell of something) or the asking proves more embarrassing than the answer.

During my scentless 18 months – a time when I felt like I was living in emotional Tupperware – my home became just a building, lovers became skin-wrapped objects, hugging my mother could have been moving a mattress in a wig, and dinner became a joyless exercise in munching. I whispered frantically to friends: “Do I smell? Honestly?” Only for them to smile benignly, shake their head and point blank refuse to actually nuzzle their nostrils into my armpit like I was hoping. Not only will they not tell you; they won’t even check.

According to the journalist Daniel Hurst, there is a Japanese word, sumehara, that pretty much translates as “smell harassment”. Apart from North Sea fishermen, most of us will know the particular disquiet of working alongside a real honker. The person who glides through meeting rooms exhaling a unique combination of cheddar and burnt onions; the one who fills a lift with the yellowish air of sour milk; the colleague who leaves a trail of malted sebum and eau de carpet tiles in their wake.

But imagine, for a second, spending your work day gripped with the fear that you are that olfactory hooligan. That, unknowingly, you smell overpoweringly of basements, bacon fat or Bovril but nobody is going to threaten a workplace lawsuit by ever mentioning it. Instead, you will find yourself simply edged out of tea rounds and workplace drinks until, finally, you get the message and go back home to Pariah Avenue.

Anosmia (loss of smell) and its bitter bedfellows, parosmia (to experience smell and taste distortions) and phantosmia (being haunted by smells that are not there), affect about 5% of the population in the UK, yet most of us know, or care, very little about them. Times without number I was told, cheerfully, that at least I hadn’t lost my sense of hearing, or sight. Which may be true, to an extent: you are certainly less disabled by society’s infrastructure when you have no sense of smell than if you have no sight. But the emotional consequence of losing this most basic, most bestial form of navigation, connection and communication, is significant.

As a species you cannot rely on us to always be honest. So no wonder that, when faced with the big questions – am I ugly? Am I stupid? Do I smell? – we put our faith in machines. And while sliding a small plastic box behind your ears, across your toes and around your armpits won’t make your home smell like home any more, at least it might temporarily quell the fear that you’re polluting other people’s lives.

To the Bone confirms there are (almost) no good movies about anorexia

‘No talk about food. It’s boring and it’s unhelpful,” announces Keanu Reeves playing (hold on to your hat) a doctor specialising in eating disorders in To the Bone, the much-discussed upcoming film about anorexia, starring Lily Collins and distributed by Netflix. And this is excellent advice, but it can be hard to see beyond the surface issues when you are dealing with someone who is literally starving themselves to death: the shoulder blades jutting out like birds’ wings, the food hidden under place mats, the limbs so wasted you can circle them with your fingers. It is even harder if a part of you is turned on by skinny, self-destructive women, as the movies invariably are, and this one definitely is.

It’s not easy to make a good movie about anorexia, which is why almost – almost – none exist. How to depict a mental illness that – unlike, say, schizophrenia or bipolar disorder – has such a well-known and hard-to-fake physical manifestation? To the Bone’s writer-director, Marti Noxon – who based the movie on her own experiences with the illness – got around this by getting Collins, who has spoken about her own struggles with eating disorders, to lose an astonishing amount of weight so that she looks credibly anorexic on screen. Given how thin female actors now have to be just to look “slim”, your heart breaks at the thought of how much weight she must have lost to look so painfully ill.


Ellen and her fellow patients are styled in the universally recognised signifiers of crazy-but-sexy young women

To the Bone has been wildly praised since it debuted at Sundance in January, and I can only assume this is because critics get weirdly overexcited when actors undergo physical transformations. The truth is To the Bone is not a good movie about anorexia. In fact, it is a bad one. We could talk all day about the ethics of hiring a young woman who is known to be vulnerable to eating disorders, and then telling her to lose weight to look anorexic, but let’s give Collins the benefit of the doubt and say she is an adult woman who is free to make her own career choices. Instead, let’s talk about To the Bone’s real problem, which is that it is shallow, sexist and sick.

The only justification for making a movie like this is that it is going to provide some insight into a much-discussed if little understood problem, a requirement Netflix’s earlier and similarly exploitative foray into self-destructive young women, 13 Reasons Why, notably failed to meet. But from the very first scene it is obvious that To the Bone leans on some wearily outdated tropes. We first see Ellen (Collins) in an in-patient unit, in which she and her fellow anorexia patients are beautifully styled in the universally recognised signifiers of crazy-but-sexy young women: heavy kohl eyeliner and mascara, Tank Girl-esque distressed clothing and biker boots. We have gone from 1999’s Girl, Interrupted to 2017’s Meal, Interrupted.

[embedded content]
Click here to watch the trailer for To the Bone.

From there on, the anorexia stereotypes are ticked off with the regularity of hospital mealtimes. The movie disregards its own advice almost immediately about not focusing on the food and does so with voyeuristic intensity, without ever asking why so many women feel so unhappy, and why they then turn this unhappiness on themselves. All the anorexia patients, with one male exception, are young, attractive, middle-class white women, when the illness affects a far broader demographic. Reeves, as Ellen’s psychiatrist, Dr Beckham, is a self-described “unconventional” doctor, who proves his unconventionality by swearing occasionally and insisting his methods are totally different from anyone else’s (they’re not: they rely on therapy and healthy eating, as almost all eating-disorder treatments do). He also clearly enjoys his power over his mainly female patients and a braver, less conventional film would have explored this more. Instead, To the Bone merely accepts the doctor’s version of himself as the brilliant, patriarchal medical professional who can fix women.

I am going to show my cards here and say that I am undoubtedly biased on this issue, because I had a doctor similar in some regards to Beckham during my first three hospitalisations: Dr Peter Rowan, then based at the Priory in Roehampton. I was only 14 when I first met him but even then it seemed to me that he revelled too much in his authority over a ward of vulnerable women, who in turn viewed him as god-like. In 2011, 18 years after we parted ways, he was struck off when it emerged he had what was described as “a blurred and secretive” relationship with a female patient, who left him more than £1m in her will.

Now, clearly, there are plenty of excellent male psychiatrists who work with eating disorders, and my experience was an outlier. But given that anorexia is often a form of rebellion against gender norms, with female and male sufferers rejecting, respectively, sexualised femininity and macho masculinity by starving themselves, it is ironic that a movie should re-enact such gender cliches. The doctor is a man, the nurse is a woman, the women in Ellen’s life (her mother, stepmother and her mother’s girlfriend) are all self-obsessed and bitchy, her father is absent but hard-working. The one male anorexia patient is wise and selfless in a way none of the female patients are, and – spoiler alert – he, along with the male doctor, helps to save Ellen. Many brilliant women are now the leading lights in eating-disorder treatment, not least the woman who treated me through my last three hospital admissions, Professor Janet Treasure, now the director of the Eating Disorder Unit at the Institute of Psychiatry at King’s College, London. So the idea that all that these hysterical female anorexia patients need is a couple of calm men to save them from themselves is, to put it mildly, grating. The film even tacks on a frankly ludicrous romantic subplot, and anyone who thinks patients with eating disorders are making out with one another on hospital wards has clearly never bothered to Google what starvation does to a person’s libido.


Representations of anorexia are a mix of prurience, spectacle and aspiration. Its glamorisation online is notorious

There is currently a petition online demanding that Netflix pulls the show for two reasons. The first, that it might trigger sufferers, is a point I feel sympathy for but cannot agree with. Legislating against anything that might trigger the mentally ill or vulnerable is an impossible game of Whack-a-Mole. But the petition’s other complaint, that it glamorises anorexia, will be less easy for the film-makers to dismiss. Contrary to what the character of Ellen might suggest, anorexia is not all thigh gaps and eyeliner. By the time I was admitted to hospital for the first time when I was 14, most of my hair had fallen out, I could barely walk because I was so cold and my knuckles bled constantly due to extremely dry and cracked skin. Instagram-ready, I was not. There is a line between rendering a complex subject filmable and sexing-up a serious illness, and To the Bone crosses it from the first scene. And when all a movie about anorexia tells you is that people with anorexia have issues with food, and that this makes them thin and unhappy, you have to wonder what the point of the movie is.

Anorexia’s physical manifestations distract even those of us who have suffered from it from grasping the internal issues. Indeed, that is the point of the starving: we don’t have to think about the unhappiness that led us to this point. In one interview, Noxon said that being around Collins and the other actors who were losing weight was difficult for her. “I started to need to turn to the other female producers quite frequently and say: ‘I’m going to need you to tell me that I don’t need to lose weight,’” she said. When there is a part of you that still gets turned on by not eating, you will not be able to discuss anorexia properly, because you are still preoccupied by the surface symptoms.

Lily Collins Netflix To the Bone


Lily Collins in Netflix drama To the Bone. Photograph: Gilles Mingasson/Netflix/Netflix

Even beyond the director’s own issues, it feels almost inevitable that anorexia should be glamorised in a movie made today. We have come a long way from 1983, when Karen Carpenter died of anorexia and people were shocked that someone could actually starve themselves to death, but despite the increased awareness, conversations about the illness still too often descend into voyeuristic fascination. Since the 90s, when skinny became the female beauty standard (a sharp diminution from the more Amazonian supermodels of the 80s), representations of anorexia in mass culture have come wrapped in a weird mix of prurience, spectacle and aspiration. The Daily Mail has a regular, long-running and wildly irresponsible column by a woman writing about her anorexia. The glamorisation of anorexia online is notorious by now, with the rise of “pro ana” (pro anorexia) websites, which pass on tips about how to avoid eating, and “thinspo” (thin inspiration) images on Instagram; anorexia has been reduced to an aesthetic expression and To the Bone reflects that.

In terms of art, there is remarkably little that is much better. Poor Richey Edwards, the late guitarist from the Manic Street Preachers, wrote probably the most brutally evocative song about it, 4st 7lbs (“I eat too much to die / And not enough to stay alive / I’m sitting in the middle waiting”). But he himself was so caught up in the illness he could only depict the immediate experience, not the larger overview. In books, there are plenty of anorexia memoirs now – both celebrity and non – most of which, to be honest, are little more than a mix of food diaries, pop-psychology and self-help.

By far, the best book on the subject is Jenefer Shute’s astonishing novel Life-Size, which captures the confusing early descent into the illness, the loneliness of it at its most extreme and the weirdness of hospitalisation better than anything I have ever seen or read. Noxon has responded to criticism of her movie by emphasising it is based on her indidvidual experience, but Life-Size reveals the laziness of this popular get-out clause. Everything is an individual experience, but if your re-telling of it strikes no general chord, the fault is in your telling. Life-Size is a deeply personal story, about a twentysomething with anorexia called Josie. But in its wholly original, quasi-poetic prose style that shifts between memory, the hospitalised present and Josie’s hallucinations, this is a book that eschews the cliches and, in doing so, touches a wider truth. No one thing can cure someone with anorexia and this book definitely didn’t cure me. But it did help me get a fix on my own experience as I was finally starting to recover and, in that regard, changed my life.

There have been only two good movies about anorexia: both treat the subject almost metaphorically and both were directed by Todd Haynes. Most obviously, there is Superstar: The Karen Carpenter Story, Haynes’s film about the most famous anorexia sufferer of all, retold with modified Barbie dolls, which perfectly captures the artificially perfect world that many with anorexia feel they need to embody. Then there is his 1995 film Safe, about a woman who seals herself off away into an antiseptic world. While not explicitly about anorexia, Safe evokes the real experience of the illness: the self-imprisonment, the illogicality, the sense you are being eaten up from within by forces you cannot control.

When I think back on my years of being ill, which went on long after I left hospital, I barely think about the food and the weight at all. Instead, I remember the cold, the isolation, the institutionalisation, the time lost and all the things Haynes’s movies and Shute’s book depict so well. Keanu was right: it’s not about the food. That’s just the boring stuff that distracts even those who should know better.

To the Bone streams on Netflix from Friday.

To the Bone confirms there are (almost) no good movies about anorexia

‘No talk about food. It’s boring and it’s unhelpful,” announces Keanu Reeves playing (hold on to your hat) a doctor specialising in eating disorders in To the Bone, the much-discussed upcoming film about anorexia, starring Lily Collins and distributed by Netflix. And this is excellent advice, but it can be hard to see beyond the surface issues when you are dealing with someone who is literally starving themselves to death: the shoulder blades jutting out like birds’ wings, the food hidden under place mats, the limbs so wasted you can circle them with your fingers. It is even harder if a part of you is turned on by skinny, self-destructive women, as the movies invariably are, and this one definitely is.

It’s not easy to make a good movie about anorexia, which is why almost – almost – none exist. How to depict a mental illness that – unlike, say, schizophrenia or bipolar disorder – has such a well-known and hard-to-fake physical manifestation? To the Bone’s writer-director, Marti Noxon – who based the movie on her own experiences with the illness – got around this by getting Collins, who has spoken about her own struggles with eating disorders, to lose an astonishing amount of weight so that she looks credibly anorexic on screen. Given how thin female actors now have to be just to look “slim”, your heart breaks at the thought of how much weight she must have lost to look so painfully ill.


Ellen and her fellow patients are styled in the universally recognised signifiers of crazy-but-sexy young women

To the Bone has been wildly praised since it debuted at Sundance in January, and I can only assume this is because critics get weirdly overexcited when actors undergo physical transformations. The truth is To the Bone is not a good movie about anorexia. In fact, it is a bad one. We could talk all day about the ethics of hiring a young woman who is known to be vulnerable to eating disorders, and then telling her to lose weight to look anorexic, but let’s give Collins the benefit of the doubt and say she is an adult woman who is free to make her own career choices. Instead, let’s talk about To the Bone’s real problem, which is that it is shallow, sexist and sick.

The only justification for making a movie like this is that it is going to provide some insight into a much-discussed if little understood problem, a requirement Netflix’s earlier and similarly exploitative foray into self-destructive young women, 13 Reasons Why, notably failed to meet. But from the very first scene it is obvious that To the Bone leans on some wearily outdated tropes. We first see Ellen (Collins) in an in-patient unit, in which she and her fellow anorexia patients are beautifully styled in the universally recognised signifiers of crazy-but-sexy young women: heavy kohl eyeliner and mascara, Tank Girl-esque distressed clothing and biker boots. We have gone from 1999’s Girl, Interrupted to 2017’s Meal, Interrupted.

[embedded content]
Click here to watch the trailer for To the Bone.

From there on, the anorexia stereotypes are ticked off with the regularity of hospital mealtimes. The movie disregards its own advice almost immediately about not focusing on the food and does so with voyeuristic intensity, without ever asking why so many women feel so unhappy, and why they then turn this unhappiness on themselves. All the anorexia patients, with one male exception, are young, attractive, middle-class white women, when the illness affects a far broader demographic. Reeves, as Ellen’s psychiatrist, Dr Beckham, is a self-described “unconventional” doctor, who proves his unconventionality by swearing occasionally and insisting his methods are totally different from anyone else’s (they’re not: they rely on therapy and healthy eating, as almost all eating-disorder treatments do). He also clearly enjoys his power over his mainly female patients and a braver, less conventional film would have explored this more. Instead, To the Bone merely accepts the doctor’s version of himself as the brilliant, patriarchal medical professional who can fix women.

I am going to show my cards here and say that I am undoubtedly biased on this issue, because I had a doctor similar in some regards to Beckham during my first three hospitalisations: Dr Peter Rowan, then based at the Priory in Roehampton. I was only 14 when I first met him but even then it seemed to me that he revelled too much in his authority over a ward of vulnerable women, who in turn viewed him as god-like. In 2011, 18 years after we parted ways, he was struck off when it emerged he had what was described as “a blurred and secretive” relationship with a female patient, who left him more than £1m in her will.

Now, clearly, there are plenty of excellent male psychiatrists who work with eating disorders, and my experience was an outlier. But given that anorexia is often a form of rebellion against gender norms, with female and male sufferers rejecting, respectively, sexualised femininity and macho masculinity by starving themselves, it is ironic that a movie should re-enact such gender cliches. The doctor is a man, the nurse is a woman, the women in Ellen’s life (her mother, stepmother and her mother’s girlfriend) are all self-obsessed and bitchy, her father is absent but hard-working. The one male anorexia patient is wise and selfless in a way none of the female patients are, and – spoiler alert – he, along with the male doctor, helps to save Ellen. Many brilliant women are now the leading lights in eating-disorder treatment, not least the woman who treated me through my last three hospital admissions, Professor Janet Treasure, now the director of the Eating Disorder Unit at the Institute of Psychiatry at King’s College, London. So the idea that all that these hysterical female anorexia patients need is a couple of calm men to save them from themselves is, to put it mildly, grating. The film even tacks on a frankly ludicrous romantic subplot, and anyone who thinks patients with eating disorders are making out with one another on hospital wards has clearly never bothered to Google what starvation does to a person’s libido.


Representations of anorexia are a mix of prurience, spectacle and aspiration. Its glamorisation online is notorious

There is currently a petition online demanding that Netflix pulls the show for two reasons. The first, that it might trigger sufferers, is a point I feel sympathy for but cannot agree with. Legislating against anything that might trigger the mentally ill or vulnerable is an impossible game of Whack-a-Mole. But the petition’s other complaint, that it glamorises anorexia, will be less easy for the film-makers to dismiss. Contrary to what the character of Ellen might suggest, anorexia is not all thigh gaps and eyeliner. By the time I was admitted to hospital for the first time when I was 14, most of my hair had fallen out, I could barely walk because I was so cold and my knuckles bled constantly due to extremely dry and cracked skin. Instagram-ready, I was not. There is a line between rendering a complex subject filmable and sexing-up a serious illness, and To the Bone crosses it from the first scene. And when all a movie about anorexia tells you is that people with anorexia have issues with food, and that this makes them thin and unhappy, you have to wonder what the point of the movie is.

Anorexia’s physical manifestations distract even those of us who have suffered from it from grasping the internal issues. Indeed, that is the point of the starving: we don’t have to think about the unhappiness that led us to this point. In one interview, Noxon said that being around Collins and the other actors who were losing weight was difficult for her. “I started to need to turn to the other female producers quite frequently and say: ‘I’m going to need you to tell me that I don’t need to lose weight,’” she said. When there is a part of you that still gets turned on by not eating, you will not be able to discuss anorexia properly, because you are still preoccupied by the surface symptoms.

Lily Collins Netflix To the Bone


Lily Collins in Netflix drama To the Bone. Photograph: Gilles Mingasson/Netflix/Netflix

Even beyond the director’s own issues, it feels almost inevitable that anorexia should be glamorised in a movie made today. We have come a long way from 1983, when Karen Carpenter died of anorexia and people were shocked that someone could actually starve themselves to death, but despite the increased awareness, conversations about the illness still too often descend into voyeuristic fascination. Since the 90s, when skinny became the female beauty standard (a sharp diminution from the more Amazonian supermodels of the 80s), representations of anorexia in mass culture have come wrapped in a weird mix of prurience, spectacle and aspiration. The Daily Mail has a regular, long-running and wildly irresponsible column by a woman writing about her anorexia. The glamorisation of anorexia online is notorious by now, with the rise of “pro ana” (pro anorexia) websites, which pass on tips about how to avoid eating, and “thinspo” (thin inspiration) images on Instagram; anorexia has been reduced to an aesthetic expression and To the Bone reflects that.

In terms of art, there is remarkably little that is much better. Poor Richey Edwards, the late guitarist from the Manic Street Preachers, wrote probably the most brutally evocative song about it, 4st 7lbs (“I eat too much to die / And not enough to stay alive / I’m sitting in the middle waiting”). But he himself was so caught up in the illness he could only depict the immediate experience, not the larger overview. In books, there are plenty of anorexia memoirs now – both celebrity and non – most of which, to be honest, are little more than a mix of food diaries, pop-psychology and self-help.

By far, the best book on the subject is Jenefer Shute’s astonishing novel Life-Size, which captures the confusing early descent into the illness, the loneliness of it at its most extreme and the weirdness of hospitalisation better than anything I have ever seen or read. Noxon has responded to criticism of her movie by emphasising it is based on her indidvidual experience, but Life-Size reveals the laziness of this popular get-out clause. Everything is an individual experience, but if your re-telling of it strikes no general chord, the fault is in your telling. Life-Size is a deeply personal story, about a twentysomething with anorexia called Josie. But in its wholly original, quasi-poetic prose style that shifts between memory, the hospitalised present and Josie’s hallucinations, this is a book that eschews the cliches and, in doing so, touches a wider truth. No one thing can cure someone with anorexia and this book definitely didn’t cure me. But it did help me get a fix on my own experience as I was finally starting to recover and, in that regard, changed my life.

There have been only two good movies about anorexia: both treat the subject almost metaphorically and both were directed by Todd Haynes. Most obviously, there is Superstar: The Karen Carpenter Story, Haynes’s film about the most famous anorexia sufferer of all, retold with modified Barbie dolls, which perfectly captures the artificially perfect world that many with anorexia feel they need to embody. Then there is his 1995 film Safe, about a woman who seals herself off away into an antiseptic world. While not explicitly about anorexia, Safe evokes the real experience of the illness: the self-imprisonment, the illogicality, the sense you are being eaten up from within by forces you cannot control.

When I think back on my years of being ill, which went on long after I left hospital, I barely think about the food and the weight at all. Instead, I remember the cold, the isolation, the institutionalisation, the time lost and all the things Haynes’s movies and Shute’s book depict so well. Keanu was right: it’s not about the food. That’s just the boring stuff that distracts even those who should know better.

To the Bone streams on Netflix from Friday.

The scariest thing about leaving home? My severe allergy

Moving away from home can be scary, but for me it meant more than just learning to wash and cook for myself. When I left for university last summer, it was the first time I’d ever had to deal with my severe nut allergy on my own.

I’m used to checking the back of food packets and carrying an EpiPen. But living with new friends and the pressure to try new things without my parents hovering meant managing the condition in a new way. Here are some of the things I learned.

1. Flatmates

Sharing a kitchen is much easier once you have got to know your flatmates. I read up on how other people had first mentioned their allergy through The Student Room, which made it easier to broach.

To my relief, my flatmates handled it maturely. We agreed to assign cupboards and clean surfaces thoroughly after making food, and it was their suggestion, not mine, that nut ingredients be completely avoided in the kitchen. With this worked out, I could relax.

2. Budgets

Since there are only certain brands of food I can eat – Kellogg’s cornflakes but not Sainsbury’s own, for example – my food bill was often a lot higher than my friends’. I had to make a monthly shopping list so I could get used to spending a set amount. I experimented, too: fruit and vegetables from a local farmers’ market will often be cheap and will encourage you to try out new recipes. I must have tried 10 different pasta recipes this year alone.

3. Labels

Food theft is rife in halls, so sticky labels to mark out allergen-free food is crucial. When I’m really concerned about my food being eaten – if it is significantly more expensive than everyone else’s, for instance – I store things in my room.

4. Doctors

Most universities have a GP surgery on campus, so it’s possible to sign up on the first day. Having all your medical records in one place is useful when it comes to prescriptions. It’s also reassuring to know someone who can deal with anaphylactic reactions efficiently or offer advice.

5. Eating out

A big part of having an allergy is feeling different. Often you find yourself in situations where you can’t eat what everyone else is eating and it feels uncomfortable. But I’ve not once been made to feel like that on campus because of how excellent the university catering staff has been. Campus open days are ideal for figuring out what food options the uni can offer.

6. Medication

Every NHS website will remind you of this, but once you are on a university campus you’re treated as an adult and are expected to carry allergy medication yourself. This is very different from school or college, where there will be spare EpiPens in the office.

While none of my friends had dealt directly with anaphylaxis before, they were eager to learn more, such as how to use EpiPens. It’s always reassuring that if one of them wants to go over what to do in an emergency, they don’t feel uncomfortable bringing it up. Knowing they have your back can make the day so much less stressful.

Follow Guardian Students on Twitter: @GdnStudents. For graduate career opportunities, take a look at Guardian Jobs.

My patient is 93 and has pneumonia. It’s time to talk about her death

Mrs S is 93 years old and has severe pneumonia. She is sitting up in bed, with a big unwieldy mask strapped to her nose and mouth like a facehugger from Alien. This device is all that keeps her from lapsing into a coma. I sit at her bedside. We have just met. I am here to talk to her about her death.

As the medical registrar for a big hospital, I am often called in to help by other specialties when trouble arrives. Some days, by the time I’m summoned, trouble has already got its feet under the table. On rare days, I really am there to save lives. Other days, I feel like the grim reaper, stalking the halls like death in a pencil skirt.

As our knowledge continues to advance, and the menu of available treatments continues to expand, we can do more and more to keep people alive. But every day in hospitals up and down the country, the debate continues to rage as to what we should do. It’s a discussion that sounds like it should have a simple answer. Patients want to live; families want to do their best for their loved ones; doctors don’t like to lose and it’s easy to default to a “Do everything that you can” mindset.

But doing everything doesn’t come without cost. There’s the downpayment of pain and suffering, whether in the form of gruelling chemotherapy regimes, or ribs cracked by CPR. Patients can end up sacrificing their comfort, their independence and their dignity, pursuing brutal treatments with slim odds of ever being well.

In my first year out of medical school, I worked for a bluff, take-no-prisoners surgeon and cared for Mrs L. Mrs L was tiny and bird-like but full of sass. She loved musicals and would sing snatches on the ward. Cancer was clogging up Mrs L’s guts like a clump of hair clogs a drain. There was no hope for a cure. Her operation was performed so she could eat.

The procedure went well, but in the days and weeks that followed, Mrs L became more and more tired. Her pain grew worse. She slept more and showed no interest in food. What she wanted, she confided in us, one morning, was to die.

“Nonsense,” the surgeon bellowed. “You just need to get up and about. Eat something!”

The surgeon refused to even consider Mrs L’s wishes or the possibility that her life might be coming to an end. If her heart were to stop, he instructed, we were to jump on her chest and do CPR. If she couldn’t eat, we could always tube feed her. Late one evening, I found myself, on his instructions, jabbing Mrs L over and over to try and get a needle into her vein. Mrs L cried, but I was too afraid of him to stop.

I swore right then that I would not become a doctor like him.

Now I’m here with Mrs S talking about what she wants.

She is one of the easy ones. She’s self-possessed, her family are all around her. There’s no weighing up of the possibilities, no grim calculation of risk versus reward. She tells us exactly what she thinks of the cumbersome ventilator mask, and she knows what she wants.

“I’m ready to go,” she tells us.

Later, she sends her family away. She says she is tired and that she can’t go properly when they are all here watching her. I meet her son in the corridor. I talk about what’s important now, about how best to maintain her comfort and her dignity. “Thank you, doctor,” he says, but he’s crying. I leave him and slip away. There are more patients to see and maybe some lives to save.

If you would like to contribute to our Blood, sweat and tears series about memorable moments in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

My patient is 93 and has pneumonia. It’s time to talk about her death

Mrs S is 93 years old and has severe pneumonia. She is sitting up in bed, with a big unwieldy mask strapped to her nose and mouth like a facehugger from Alien. This device is all that keeps her from lapsing into a coma. I sit at her bedside. We have just met. I am here to talk to her about her death.

As the medical registrar for a big hospital, I am often called in to help by other specialties when trouble arrives. Some days, by the time I’m summoned, trouble has already got its feet under the table. On rare days, I really am there to save lives. Other days, I feel like the grim reaper, stalking the halls like death in a pencil skirt.

As our knowledge continues to advance, and the menu of available treatments continues to expand, we can do more and more to keep people alive. But every day in hospitals up and down the country, the debate continues to rage as to what we should do. It’s a discussion that sounds like it should have a simple answer. Patients want to live; families want to do their best for their loved ones; doctors don’t like to lose and it’s easy to default to a “Do everything that you can” mindset.

But doing everything doesn’t come without cost. There’s the downpayment of pain and suffering, whether in the form of gruelling chemotherapy regimes, or ribs cracked by CPR. Patients can end up sacrificing their comfort, their independence and their dignity, pursuing brutal treatments with slim odds of ever being well.

In my first year out of medical school, I worked for a bluff, take-no-prisoners surgeon and cared for Mrs L. Mrs L was tiny and bird-like but full of sass. She loved musicals and would sing snatches on the ward. Cancer was clogging up Mrs L’s guts like a clump of hair clogs a drain. There was no hope for a cure. Her operation was performed so she could eat.

The procedure went well, but in the days and weeks that followed, Mrs L became more and more tired. Her pain grew worse. She slept more and showed no interest in food. What she wanted, she confided in us, one morning, was to die.

“Nonsense,” the surgeon bellowed. “You just need to get up and about. Eat something!”

The surgeon refused to even consider Mrs L’s wishes or the possibility that her life might be coming to an end. If her heart were to stop, he instructed, we were to jump on her chest and do CPR. If she couldn’t eat, we could always tube feed her. Late one evening, I found myself, on his instructions, jabbing Mrs L over and over to try and get a needle into her vein. Mrs L cried, but I was too afraid of him to stop.

I swore right then that I would not become a doctor like him.

Now I’m here with Mrs S talking about what she wants.

She is one of the easy ones. She’s self-possessed, her family are all around her. There’s no weighing up of the possibilities, no grim calculation of risk versus reward. She tells us exactly what she thinks of the cumbersome ventilator mask, and she knows what she wants.

“I’m ready to go,” she tells us.

Later, she sends her family away. She says she is tired and that she can’t go properly when they are all here watching her. I meet her son in the corridor. I talk about what’s important now, about how best to maintain her comfort and her dignity. “Thank you, doctor,” he says, but he’s crying. I leave him and slip away. There are more patients to see and maybe some lives to save.

If you would like to contribute to our Blood, sweat and tears series about memorable moments in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

My patient is 93 and has pneumonia. It’s time to talk about her death

Mrs S is 93 years old and has severe pneumonia. She is sitting up in bed, with a big unwieldy mask strapped to her nose and mouth like a facehugger from Alien. This device is all that keeps her from lapsing into a coma. I sit at her bedside. We have just met. I am here to talk to her about her death.

As the medical registrar for a big hospital, I am often called in to help by other specialties when trouble arrives. Some days, by the time I’m summoned, trouble has already got its feet under the table. On rare days, I really am there to save lives. Other days, I feel like the grim reaper, stalking the halls like death in a pencil skirt.

As our knowledge continues to advance, and the menu of available treatments continues to expand, we can do more and more to keep people alive. But every day in hospitals up and down the country, the debate continues to rage as to what we should do. It’s a discussion that sounds like it should have a simple answer. Patients want to live; families want to do their best for their loved ones; doctors don’t like to lose and it’s easy to default to a “Do everything that you can” mindset.

But doing everything doesn’t come without cost. There’s the downpayment of pain and suffering, whether in the form of gruelling chemotherapy regimes, or ribs cracked by CPR. Patients can end up sacrificing their comfort, their independence and their dignity, pursuing brutal treatments with slim odds of ever being well.

In my first year out of medical school, I worked for a bluff, take-no-prisoners surgeon and cared for Mrs L. Mrs L was tiny and bird-like but full of sass. She loved musicals and would sing snatches on the ward. Cancer was clogging up Mrs L’s guts like a clump of hair clogs a drain. There was no hope for a cure. Her operation was performed so she could eat.

The procedure went well, but in the days and weeks that followed, Mrs L became more and more tired. Her pain grew worse. She slept more and showed no interest in food. What she wanted, she confided in us, one morning, was to die.

“Nonsense,” the surgeon bellowed. “You just need to get up and about. Eat something!”

The surgeon refused to even consider Mrs L’s wishes or the possibility that her life might be coming to an end. If her heart were to stop, he instructed, we were to jump on her chest and do CPR. If she couldn’t eat, we could always tube feed her. Late one evening, I found myself, on his instructions, jabbing Mrs L over and over to try and get a needle into her vein. Mrs L cried, but I was too afraid of him to stop.

I swore right then that I would not become a doctor like him.

Now I’m here with Mrs S talking about what she wants.

She is one of the easy ones. She’s self-possessed, her family are all around her. There’s no weighing up of the possibilities, no grim calculation of risk versus reward. She tells us exactly what she thinks of the cumbersome ventilator mask, and she knows what she wants.

“I’m ready to go,” she tells us.

Later, she sends her family away. She says she is tired and that she can’t go properly when they are all here watching her. I meet her son in the corridor. I talk about what’s important now, about how best to maintain her comfort and her dignity. “Thank you, doctor,” he says, but he’s crying. I leave him and slip away. There are more patients to see and maybe some lives to save.

If you would like to contribute to our Blood, sweat and tears series about memorable moments in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

My patient is 93 and has pneumonia. It’s time to talk about her death

Mrs S is 93 years old and has severe pneumonia. She is sitting up in bed, with a big unwieldy mask strapped to her nose and mouth like a facehugger from Alien. This device is all that keeps her from lapsing into a coma. I sit at her bedside. We have just met. I am here to talk to her about her death.

As the medical registrar for a big hospital, I am often called in to help by other specialties when trouble arrives. Some days, by the time I’m summoned, trouble has already got its feet under the table. On rare days, I really am there to save lives. Other days, I feel like the grim reaper, stalking the halls like death in a pencil skirt.

As our knowledge continues to advance, and the menu of available treatments continues to expand, we can do more and more to keep people alive. But every day in hospitals up and down the country, the debate continues to rage as to what we should do. It’s a discussion that sounds like it should have a simple answer. Patients want to live; families want to do their best for their loved ones; doctors don’t like to lose and it’s easy to default to a “Do everything that you can” mindset.

But doing everything doesn’t come without cost. There’s the downpayment of pain and suffering, whether in the form of gruelling chemotherapy regimes, or ribs cracked by CPR. Patients can end up sacrificing their comfort, their independence and their dignity, pursuing brutal treatments with slim odds of ever being well.

In my first year out of medical school, I worked for a bluff, take-no-prisoners surgeon and cared for Mrs L. Mrs L was tiny and bird-like but full of sass. She loved musicals and would sing snatches on the ward. Cancer was clogging up Mrs L’s guts like a clump of hair clogs a drain. There was no hope for a cure. Her operation was performed so she could eat.

The procedure went well, but in the days and weeks that followed, Mrs L became more and more tired. Her pain grew worse. She slept more and showed no interest in food. What she wanted, she confided in us, one morning, was to die.

“Nonsense,” the surgeon bellowed. “You just need to get up and about. Eat something!”

The surgeon refused to even consider Mrs L’s wishes or the possibility that her life might be coming to an end. If her heart were to stop, he instructed, we were to jump on her chest and do CPR. If she couldn’t eat, we could always tube feed her. Late one evening, I found myself, on his instructions, jabbing Mrs L over and over to try and get a needle into her vein. Mrs L cried, but I was too afraid of him to stop.

I swore right then that I would not become a doctor like him.

Now I’m here with Mrs S talking about what she wants.

She is one of the easy ones. She’s self-possessed, her family are all around her. There’s no weighing up of the possibilities, no grim calculation of risk versus reward. She tells us exactly what she thinks of the cumbersome ventilator mask, and she knows what she wants.

“I’m ready to go,” she tells us.

Later, she sends her family away. She says she is tired and that she can’t go properly when they are all here watching her. I meet her son in the corridor. I talk about what’s important now, about how best to maintain her comfort and her dignity. “Thank you, doctor,” he says, but he’s crying. I leave him and slip away. There are more patients to see and maybe some lives to save.

If you would like to contribute to our Blood, sweat and tears series about memorable moments in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.