THIN: The HBO Documentary

thin-posterA part of me fears the following post might be too sensitive or hit too close to home for some readers. I say this because I know my audience ranges from people without any eating disorders and weight issues; people with eating disorders and weight issues; people trying to lose weight; people who have lost weight and kept it off; disordered eaters … friends, family … my readership is all over the place and I love the variety.

I deeply respect and admire the women in this film who sought help, whether it was for the first time or the fifteenth time … and I wish everyone with an ED could do the same: get help. It takes a ton of courage to make that call or visit, and so I have utmost respect for these ladies. And so the readers I’m mostly concerned about in this post are those currently in the throes of their eating disorders; I don’t want to upset anyone — hence today’s pre-post note.

Personally, I don’t know what it’s like to starve myself, and I don’t know what it’s like to binge or purge … I don’t pretend to know what it’s like; for all my disordered eating behaviors, I’ve never dealt with anorexia or bulimia. Though I am coming at this film more as someone perpetually struggling with her weight/body acceptance more than as someone with a clinical eating disorder, I do realize just how serious these diseases are.

Please know I’m not judging anyone; I simply care. My blog is about transparency and being honest, and I can’t sugarcoat how I felt after seeing something so moving.

That said, here is my review of the HBO documentary THIN (2006) which I finally saw for the first time Wednesday night.

THIN: The Documentary
Lauren Greenfield’s gut-wrenching, raw glimpse inside an eating disorder clinic (Refrew Center, in Coconut Creek, Fla.) was enough to make my head spin, my heart ache and my breathing labored.

When it was over, all I wanted to do was cry — seeing such pain and agony these women are dealing with every day, every minute.

If you haven’t seen it, it’s one of those films you just “have to” sit through; it’s like a car crash that you don’t want to see, but can’t take your eyes off.

If you’re currently battling an ED, you might love or hate this film and its characters — you might empathize with them, you might find them out of control. If you know someone with an ED, you, too might cry watching it — it might inspire you to reach out. And if you don’t know much about EDs, you might come away from this movie feeling completely overwhelmed … or numb.

In THIN, we meet Shelly, Polly, Alisa and Brittany, the four girls whose lives are documented as they move through various levels of treatment at Renfrew.

Shelly is in her mid-20s and is so sick that she has had a feeding tube for the past five years — her feeding tube viewed as “a badge of honor.”

Alisa is a single mom in her 30s with two kids who has battled EDs for decades.

Brittany is a 15-yr. old battling her ED that has been fueled by the behaviors of her mom (who has an ED) –they used to chew-and-spit together for “fun.”

Polly, who is the furthest along in her treatment and is maintaining her weight when we meet her, is the “ring-leader,” if you will, of the group.

The four women are the primary characters, but we see lots of faces we aren’t introduced to, lots of women looking on the brink of death. This is not an exaggeration; people die as a result of prolonged anorexia and bulimia. And many of these women look a heart-beat away from it, draped in loose, sagging clothing, wrapped up in blankets galore (mind you, the documentary is filmed during summertime in Florida).

We watch these girls weigh in each morning (80, 90 lbs) … and see their faces, the wrinkled noses as they see the numbers going up. (I found this particularly hard to deal with, realizing that, at my heaviest, I was almost double their size).

Some are progressing and stabalizing their weights but for the most part, they look so frail, so sad, so angry, so empty … so anything but happy. Anything but healthy.

Some of the girls claim death would be welcome; my heart lurched at that one.

And the plain truth is … I just don’t get it. No matter how hard I try to wrap my head around it, I just don’t understand what makes one person go down this path and not another. I know it happens all the time, but I just can’t fathom it. I just don’t have the brain for it … and maybe that’s ok. (Please don’t flame me for that; I genuinely can’t imagine it.)

I’m not here to question the “whys” — that’s up to the experts to ponder, as every person’s situation is unique. But I do want to put it out on the table that, for all my disordered eating behaviors, I just can’t imagine getting to that point where death would be welcome. Psychologically, it just doesn’t compute.

In the Director’s Interview, Lauren seems to share my inability to comprehend anorexia or bulimia.

HBO asks Lauren, “You said there’s something “unfathomable” about eating disorders. What did you mean by that?”

Lauren Greenfield responds, “I feel like one of the things about an eating disorder that makes it hard to understand by family members and friends and by the culture is that it looks so similar to what we see every day, which is this kind of obsessive dieting that many, many people participate in. And I think sometimes it gets trivialized as an illness. And that’s what I hope people really get out of the film and the book is how serious it is. And the reason I say it’s “unfathomable” is because it makes no sense. I mean, within the framework of the values of our culture, it makes sense to want to have a better body, or want to be in a smaller size.”

She then goes on to say (and I’m leaving it all here for context, bear with me):

But what you see with the women at Renfrew, and the women who are suffering with a true eating disorder, is that they are committing a form of suicide. And that for many, it has nothing to do with the way their body looks or vanity; it really has to do with control, and it’s really a coping mechanism for whatever they are going through. And that people may come to an eating disorder for a lot of different reasons, and may have it because of many different things in their lives. But for all of them, it functions as a kind of coping mechanism; allowing them to numb out to their feelings and to the things that they don’t want to think about.

It’s really impossible to understand unless you are inside the illness. And that’s why I really wanted to spend a long time at Renfrew, and film it cinema-vérité style, so that you really could kind of understand what is so hard to understand.

As a photographer, one of the reasons I was interested in making the film was, it’s a kind of unique situation where the mental illness has a physical manifestation, and recovery has a physical manifestation, because as they recover, they gain weight if their illness is anorexia. If it’s bulimia, maybe it expresses itself in different ways. But you do see the body shape change as recovery happens. And so for me, that was a really unique opportunity, and one of the things that intrigued me about making a film about this.”

Lauren doesn’t shy away from what is really going on in these womens’ lives. As viewers, we’re shown an insider’s perspective of what life is like at an in-patient clinic: the weigh-ins and vitals, the meals, the “resource” shakes given to the girls when they aren’t gaining weight, the therapy sessions, the family therapy sessions, the community meetings, the nutritionist meetings, the profound impact the diseases have on their families who feel so helpless, the girly antics in their bedrooms that make us giggle, the friendships and alliances … and the mistrust among staff and the community.

We witness the agony of patients forced out before they’re stable, simply because their health insurance ran out and they couldn’t afford Refrew’s costs. (Having just watched SICKO, this resonated immensely — these women needed treatment and wanted it, and couldn’t continue because of insurance. THAT’s sick, that we turn people away like that).

Toward the end of the film (spoiler alert!), the director journeys with Alisa back to her home after she leaves treatment. The cameras roll: after a good-bye dinner out with Shelly (who is moving back to Utah) Alisa purges in the bathroom … with her young children watching TV in the next room.

It made me want to hit the screen; I was so sad, so mad, so frustrated. I wanted her to succeed; she’d come so far! I wanted her to beat this!

But life isn’t that easy … it doesn’t necessarily fit into the confines of a 2-hr documentary. Through the THIN site, we learn that Alisa relapsed but she went back to Renfrew for a time and has been in recovery ever since.

Over the course of Shelly’s treatment, we see her get better … and learn from a post-film interview she, too goes home and relapses.But fortunately, like Alisa, she is in recovery now.

In fact, Shelly guest-blogged about her progess and recovery at MamaVision in February 2008, following Polly’s death (at age 33), and what she has to say is really remarkable.Check it out here; Shelly’s a true inspiration.

I am so happy to hear these two women are doing so well. Likewise, I know there are plenty of bloggers out there talking about their recovery, and plenty of people who keep their struggles private but are taking action, too. Keep up the good work and fight the good fight — you’re absolutely, positively worth it!

The THIN site offers great resources, but as Lauren notes in the Director’s Interview, the truth is, unless someone is truly ready to begin treatment and wants to recover, they are prone to relapses.

She says, “… you can get better, and some people do get better; one doctor told me “around 50 percent.” But you do have to want to get better.”

So there is hope, but it’s up to the individual … and hopefully a lot of support from loved ones. But most importantly, the desire to change has to come from within: a desire to heal, to get better, to confront their ED head on.

The film left me with a ton of questions. If there’s someone you care about, how do you reach out to them? What can you do? What makes recovery “click” for someone, like Shelly said it did for her, and why do others, like Polly, lose their battle? It just seems horribly unjust that someone so full of life would be robbed by her ED.

And the million dollar question: Is one ever truly cured?

How about you? Have you seen THIN? What were your thoughts?


29 thoughts on “THIN: The HBO Documentary

  1. I have not seen Thin. But from what you are describing, and what the director has said I can certainly understand and relate to both sides. I’ve been in recovery from anorexia for one year and one week. When I first began treatment my weight was so low, that my doctor wanted me to go inpatient, but I promised that I could do it and that I didn’t want that. It’s true. when EDs become that severe it is no longer about looks. It’s about numbers, the clock, obsessions, compulsions, and isolation. It couldn’t have been about vanity, I never saw anyone.

    I think this is a great post today, and I’m glad you brought it up. I’ve learned from both my family and those around me how difficult it truly is for others to understand what and why EDs are.

  2. Wow, I really want to see this. I wasn’t an inpatient, even though the doctors pushed for it, insurance wouldn’t allow it. Even though I was purging every single thing I ate, I wasn’t underweight my numbers didn’t prove any ED.

    Treatment seems like it was a lifetime ago, even though it was just a little over a year. It’s such a bubble, so self-contained. I haven’t read phrases like “weigh-ins, family therapy sessions, community meetings, nutritionist sessions,” in a long time. It almost brought tears to my eyes.

    I don’t know if anyone is truly ever cured. Currently, I don’t think so. I think that we just have to learn how to successfully manage the cards we’re dealt. As you would say, how we’re “hard-wired.” 🙂

  3. Hi Jenn, congrats on your recovery!! That’s a huge accomplishment. Vanity definitely doesn’t seem to be the reason in so many cases — that’s I think a big misnomer.

    Thank you and I am glad this was a good post to share; I was nervous about it.

    Thanks Run4Change. The documentary was quite eye opening, into a world I might never truly understand … but that we should all acknowledge exists. Denying it doesn’t make it go away. It’s just so sad how many people’s insurance stands between them and the help they need.

    Hi Kristen, I Netflixed it — I hope you can see it. Your instance sounds like so many I’ve heard; people who weren’t underweight “enough” to be diagnosed yet still had a serious problem and needed help. I am glad you got the help you needed.

    I like to keep the “hard-wired” mentality in mind in terms of managing the cards we’re dealt; it just hurts to think that lives are on the line … that’s what makes me saddest of all.

  4. This looks really interesting, I will give it a watch.

    I have struggled with eating disordered behavior, such as bingeing and purging at times when I was stressed but it never got really bad. I extensively read about eating disorders in college as I was fascinated by them and it kind of fit with my major of psychology. I’m guessing you know about this but have you read Wasted by Marya Hornbacher? It is a great first hand account of an eating disorder and it feels like you are in her head. Some people think it’s bad because it’s kind of like a “how to” do eating disorders but it is very honest.

  5. Thanks for posting this. I saw a similar documentary in college and it really hit home. It’s important to look at eating disorders as what they are – disorders – not weaknesses or strengths of character (which is definitely how the person living them can perceive them!!)

  6. Hi Fitforfree — exactly, it’s a clincial disorder, and that’s why I think Lauren’s point made so much sense — we hear SO much about dieting/obsessivness with being thin, and for some it might be an issue of vanity but for so many it’s NOT … and so as she says, it gets trivialized … such a sensitive topic and I thank you all for your input today. I saw from the blog stats that this post got 103 page views today … so people are reading, even if not commenting. And I hope it raises awareness … and inspires hope.

  7. Hi Jill, I had never heard of that book — wow. It sounds brutally honest – I thought THIN was too. In fact, I watched it with my husband tonight who was deeply, profoundly disturbed. He recognized some of my behaviors (changing clothes 2 milion times, chewing-and-spitting, being unhappy with my body sometimes, picking apart my food, ordering really specifically — though in my defense that is not new and in fact is something I have always done, being as picky as I am) but he was also extremely relieved to see my behaviors aren’t as extreme as the girls in the film. I think it was a good experience for us to share. Best wishes to you in your recovery, Jill!

  8. Great post. AHhh…where to start.

    I have lived and breathed hard core EDs for the past 2 1/2 years through my blog. I have lost regular readers and community members who drop dead of heart attacks in their teens and early twenties.All of this is unfathomable to most people and the light shed on the disease through THIN is monumental.

    It was an honor that Shelley reached out and wanted to guest post.She has evolved since Polly’s took her own life and is actively involved with helping others through NEDA.The two talked daily, they were very close friends and the loss of Polly was life changing for Shelley.

    This film is raw and real. Its a film you want to only see once though, its simply too unbearable to revisit.

    I’ve come to the conclusion that there are two types of anorexics/bulimics:

    Traditional: Disease stemming from mental illness, and genetic suseptibility. Issue is control and strive for “perfection” in a non-vanity way.It is natural to not understand this because it is a severe mental illness, and the mind of an anorexic/bulimic is not normal nor rational.

    Social: Disease stemming from societies influence and constant pressure to be deadly thin. Pro Ana’s fall into this category, as do regular girls who just want to be thin because thin=pretty.Some debate that this form does not exist, but to them I say read the hundreds of stories on my blog. If you could peer into my personal email, and see the unbelievable volume of messages received that speak of exactly this condition. And to think we have created it.We too are a part of this mess.What a crying shame.

    If you would like to see for yourself, take a deep breath, log in to youtube, and type in the word ‘thinspiration’- you will be absolutely frightened by what you find.

    To all of you struggling with an ED you must know there is hope. There is recovery, I am a shining example of it. Find a way to reach out to someone you trust and confide in them what you are feeling-they won’t let you down.

    Believe that there is a better life out there for you, because as you know-life with an ED is no life at all.

    1. I found Shelly to be very manipulative and worry that you tout her as “inspirational” on your website.

  9. Hi MamaV and thank you!! Your blog means so much to so many people; I am glad you were able to read and comment here because I know how influential your words can be.

    I think it’s amazing that Shelly reached out and I am so sorry for her that she lost her dear friend; that thought is just unbearable.

    And I think you are so right on the two types. I could be wrong, but I found Brittany and Alisa especially to be obsessed with the notion of thin. Shelly seemed to have issues related to being an identical twin, and Polly … I don’t know much about her background.

    I have seen some of this thinspiration stuff and it made me want to cry. I’ve found some pro-ana sites too and it was so upsetting to read/see; couldn’t look/read any more. I’ve also watched your videos where you’re trying to reach out to those girls … you’re doing an amazing thing out there.

    To all of you struggling with an ED you must know there is hope. There is recovery, I am a shining example of it. Find a way to reach out to someone you trust and confide in them what you are feeling-they won’t let you down.

    Believe that there is a better life out there for you, because as you know-life with an ED is no life at all. The biggest challenge appears to be the desire to change, to get genuine help. It seems all too often these women relapse and you have to wonder why. Is it because the facilities are so good at being watchdogs that the moment they’re on their own it all disappears? I don’t know. But a 50% relapse rate is very, very scary.

    Thaks for your inspirational post and hope … and for your blog!
    XOXO, Melissa

  10. I saw this movie around the time it came out, and I was really impressed with it. I struggle with disordered eating behaviors and have since I was very young, but I’ve thankfully never gone all the way to having an ED. It’s things like Thin that keep me from going there. I know I’m predisposed. My mom nearly died from her ED.

    I’m thankful for people sharing their stories and the pain that this illness causes. I know that hearing the stories of others has saved me. I’ve never binged and purged in my life, but I’ve come so close. I repeatedly find myself after eating something I feel guilty about, contemplating going there. But thanks to brave people who share their struggles, I know what lies down that road. And I know if I go there, I really may never come back.

  11. Hi Eliana — first off LOVE your name — just wanted to tell you. 🙂 I am so sorry about your mom and glad she didn’t die from hers — it must have been hard growing up with that situation. I too hope you don’t go down that path, it’s clearly a very slippery slope and the lines are more and more blurred the more I read/learn. Not in any way do I mean to trivialize EDs at all, but I liken it to being someone who “hooks up” but “doesn’t go all the way” … like I have boundaries with my DE; I’ve flirted with possibilites but never gone all the way — and hope I never do. And it sounds like you do too. But there’s only one thin little line standing between going down that road and not … and I can see easily how someone could cross it.

  12. Pingback: Life « cbtish
  13. Hey, I’m a young woman (18 years of age) who has struggled with an eating disorder for 4 years; I have had disordered thoughts for close to 5 years. I also struggle with major depression and self-injury. I do know the pain of starving myself, the pain (yes, it is very unpleasant) of bingeing and purging. I have starved so severely that I was threatened with a feeding tube; I have cut so deeply I needed stitches.

    I have also felt the extreme pain that comes with misunderstanding. As I struggled with eating while in a psychiatric hospital, I had staff (who were supposed to help me) saying things like “Why don’t you just eat, don’t you know there are starving children in Africa who would kill for that food you just throw away?” I once was taunted by a group of boys who saw my scars; they grabbed my arm and pulled it towards them so they could laugh over it.

    But Thin, although not good for those with EDs to watch (it’s very triggering), finally got people to take a look into our world. There is a great video on YouTube with a young man who just says into the camera, “I just saw the HBO Documentary Thin and just…wow. I had no idea.”

    And I don’t mean to sound bitter here, either. Truthfully, these are baffling and difficult-to-understand illnesses. It’s not trying at all to understand that really causes such pain.

    Thanks for writing about the documentary and taking your time to share your struggles. Please stay strong in recovery, though I am currently not (I am going to be admitted residential myself sometime this summer).

  14. Actually, you should have good knowledge of what it’s like to have an ED. Anyone who would watch “SIcko” for facts about health care in this country (and then admit it in public), should have an intrinsic understanding of body dysmorphic disorder and being compelled to starve yourself to achieve “thin”. Really.

    “Sicko”. LOL

  15. I have had an eating disorder since I was 14 ( I am 22 now) and this documentary is slightly triggering to me, but I watch it often because I relate so closely to the things Alisa, Brittany and Shelly have said in it. It makes me cry so much each time I watch it. Just to know I wasn’t the only one who felt that way was encouraging to me.

  16. This documentary hits so close to home for me. I have watched it and also have the book. I have had an eating disorder for 7 years now and it’s so hard to get it treated. I have been hospitalized for many things not just an ED, but it was short term. I have had difficulty finding a professional to help me so I tried on my own. I am not as bad as I was eating 180 calories a day, going to school, working, and working out 3 or so hours a day. Or the other spectrum of my fight binging and purging 6-8 times a day.
    I see that treatment is necessary and have sought out outpatient therapy. It is helping, but also testing my limits and I have relapsed after a short time of not restricting or binging and purging. But I know there is hope and seeing this documentary helps me feel not so alone and isolated. There is hope for all of us!

  17. I can’t beleive that people watch THIN and applaud Shelly. It was her manipulations that got Polly kicked out. The whole situation with the anti-anxiety pills: If Shelly had needed them for anxiety SHE WOULD HAVE TAKEN THEM when Polly gave them to her. For Shelly, those puills were a symbol of how easy Polly was to manipulate. When confronted she could have told the staff, “I won’t tell you who I git them from but I’ll encourage the person who gave them to me to confess.” Instead, she turncoats on Polly to get brownie points with the staff.
    Shelly struck me as using her eating disorder as a form of maniulation, much like her drug use. It made me question if she really had anorexia or if she could turn her eating on and off for attention.

  18. Thanks for writing about the documentary and taking your time to share your struggles. Please stay strong in recovery, though I am currently not (I am going to be admitted residential myself sometime this summer).

  19. I’ve watched THIN many times. First recommended to me by a therapist while I lived in a psych- Ward endlessly. I become very attached to this documentary. So much so it merged in my (at that time 6 year) Anorexic diary. I’ve spent plenty of my time in Eating Disorder hospitals. Feeding tubes are no fun. And I hate pulling that iron tree with the machine that holds the bag of stuff like ensure with a timed pump.

    Anyone recognize my name they know I love Polly Ann.

  20. You seem like a horrid bitch and don’t give a fair description of the women the film followed. You’re response to it seems uneducated and judgemental. If you can’t understand it because “psychologically it just doesn’t compute” it’s because you don’t have an eating disorder, have never had one and clearly aren’t well enough educated to understand the psychology behind eating disorders. It’s like saying someone with severe schizophrenia “just doesn’t compute” – you would sound like the idiot, wouldn’t you? The documentary is well done but your “review” doesn’t seem to match.

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