Louis Theroux’s new documentary, Talking to Anorexia, opens in the wan corridors of an inpatient clinic called St Ann’s in north London. Theroux asks a skeletal woman what it’s like living here. “Like prison!” we hear, from a voice off-screen. In his trademark affably curious way, he searches the other woman’s face for confirmation. “Is it really?” She nods her delicate head.
Let me tell you: Inpatient clinics for eating disorder patients are absolutely like prison. Or, as Louis’ acquaintance points out, like the military. I spent a couple of months in one as a teenager – at Greenwich hospital in Sydney, Australia – and the nurse in charge was a former prison warden who ran the ward with a somewhat terrifying discipline.
It makes sense: Eating disorders teach their victims to lie to everyone they care about – perhaps the only way to tame them is to be adamantly strict about it. There are rigid schedules to be adhered to, rules to abide by, CCTV and constant supervision to make you feel watched. The daily regime is dictated by mealtimes (three meals, three snacks) and therapy sessions. Exercise rights must be earned, as with the right to leave the ward to visit family or friends. Privileges like those are typically only given once you’ve put on a certain amount of weight, which you’ll find out when you enter a sallow hospital room with a single set of scales in the middle and learn your fate for that week. Toilets are locked after mealtimes and patients are supervised for the hour after they’ve eaten, to make sure they keep down their food. At my clinic, with its pallid pistachio-green walls and daily blood tests, you had to sing to a nurse if you needed to go to the bathroom within an hour of digesting your dinner (to prove you weren’t retching). If you were unable to stomach a meal for whatever reason – the tuna pie still haunts me – you had to sit at the nurse’s station and slurp down a thick, gluggy meal replacement.
Having lived like this myself, it is confronting to see Louis Theroux visit places just like it. He spends time at St Ann’s and another clinic called Vincent Square, in west London. As is his MO, he gets close to his interview subjects by asking them a series of personal questions, at once cautiously and directly. They are all honest with him – who wouldn’t be, looking into that open, baffled, bespectacled face? He gives several of the women heartening pep talks about their value beyond weight and sits with them during weigh-in, medical consultations, blood tests, and home visits. It is, as always, a diligent, warm investigation of a topic.
But anorexia documentaries are complicated – even ones made by Louis Theroux. This one exposes some of the painful truths of living with anorexia: that it can deplete you physically until you are close to death, that it is more than a diet, that it is the psychiatric disorder with the highest rates of fatality.
He makes the vital point that recovery is a matrix of doubt, pain, relapse, danger and fear, and that sometimes, it doesn’t happen. We meet, for instance, 63-year-old Janet, who has had anorexia since she was 18 and frankly shows no real signs of letting go of the illness. She has been engaged several times throughout her life, but each time anorexia has won over love and so, here she is, alone in her flat with a Tupperware container of broken biscuits and four decades’ practice in starvation. Janet’s is an important story to tell because it demonstrates how the illness can steal an entire lifetime. Janet has been killing herself slowly for 40 years and she tells Louis she often wishes she’d succeeded already.
The other women Theroux meets are courageous and broken, trying to recover but desperately addicted to an illness that has consumed them. Their stories are important but I despair that, yet again, we have a documentary that features predominantly white, young, underweight women with anorexia. It is a missed opportunity to demonstrate the diversity of experiences when it comes to eating disorders.
We have actually seen this more: emaciated women hovering near death because they’ve deprived themselves of food. Where are the black women with anorexia, the women with bulimia, the overweight women who struggle with binge-eating, the obsessively fit women with orthorexia? Where are the different physical manifestations of this heinous curse of an illness, an illness that does not exclusively attack young, white women? Though I love Louis Theroux enough that a friend once Photoshopped me into a picture with him for my birthday, it is frustrating to see one of the great documentary-makers of our time choose to retell the story on anorexia we already know, one we desperately need to expand.
The documentary also commits some concerning sins when it comes to the way we speak about and show anorexia. It has a strong preoccupation with weight loss and gain, which suggests that the illness is largely defined by that. It shows ‘before’ photos of the women affected by the illness, which goes against general professional advice on how the media should present anorexia. It allows several of its interviewees to share details of what they eat and how much exercise they do – how many star jumps one woman does in a day, for example – which is dangerous for anyone vulnerable watching the show and could be instructional on how to lose weight. Emmy Brunner, CEO of The Recover Clinic and founder of the app Recover Me, spoke to me on these points.
“’Before’ photos perpetuate a misconstrued understanding of recovery and a focus on the physical aspect of an eating disorder and neglect to demonstrate the emotional progress someone may have made during their recovery. These photos can also be extremely triggering for those who are questioning whether they are deserving of receiving help,” she said. “You do not have to be underweight to have an eating disorder, and these photos can give the opposite impression. I feel concerned that sufferers are still requested to ‘prove’ how unwell they were by providing before and after pictures and this isn’t helpful.”
Brunner also reiterates how important it is that we see a multitude of experiences in documentaries about eating disorders. “Our patients are very diverse. The prevalence of white, skinny, western women in the media merely serves to fuel this idea that eating disorders only impact a certain demographic and this is untrue. An eating disorder will try its hardest to stop you from reaching out for support, and this is only made harder when you are unable to identify with the people who seem to represent the issue you’re dealing with.”
And so, tonight, you can watch an adequate but flawed Louis Theroux documentary about anorexia. Please know, if you do, that the women Theroux meets are not the only ones suffering, not the only ones dying, not the only ones gradually vanishing from their own lives. Anorexia and other eating disorders affect many different types of people – I keenly await the day we get a documentary that shows us that.