The Eating Disorder Association is preparing for an influx of people reaching out for help with today's release of the Netflix film, To the Bone.
Lily Collins is Ellen, a woman who has anorexia nervosa and goes on a "harrowing, sometimes funny journey of self-discovery at a group home run by an unusual doctor," according to Netflix. Photo: Netflix
The president of the not-for-proft organisation, Nicki Wilson, said the phone had already been ringing hot after the release of the trailer.
Ms Wilson said they had recieved many calls from people with eating disorders or caring for someone with one who expressed their "dismay and distress and concern," she said.
Hundreds of people access its services each year and the indication was that the access to evidence-based treatment wasn't good enough, Ms Wilson said.
"People are either being turned away due to not being sick enough or treatment not working for them - [some] treatment does fail patients. We need more options and we need better treatment and better access to treatment. Our understanding is that there is not enough of a service out there for people. And that is largely about information and training and education," Ms Wilson said.
Both the Auckland District Health Board and the Capital and Coast District Health Board refused to comment on this story.
But Ministry of Health statistics over the past five years show people accessing specialist eating disorder services had risen from 934 in 2012 to 1356 in 2014 and 2015. It had however dropped slightly to 1289 last year.
For each of the past five years nearly half of the people who accessed the services were 19 years old or younger.
Chief censor David Shanks has given To the Bone a RP16 rating, meaning anyone under the age of 16 should watch it with a parent or guardian.
The film follows a 20-year-old woman called Ellen who has anorexia nervosa and goes on a "harrowing, sometimes funny journey of self-discovery at a group home run by an unusual doctor," according to Netflix.
Actress Lily Collins, who plays Ellen, has been vocal about suffering from an eating disorder in the past.
Mr Shanks said the film came with the warning of "shows realistic harmful behaviour with risk of imitation".
"This is a production that deals with serious mental illness, serious issues, serious behaviours, that if imitated could be harmful. So we called in some experts and watched the film with them and took a cue from them as to what would be appropriate here."
Mr Shanks said the feedback was that some young people could be triggered and imitate the behaviours but there were also opportunities to engage in a discussion on the topic.
One of the leading experts on eating disorders, Roger Mysliwiec, said anorexia, bulimia and binge eating disorder have a strong genetic component - 50 to 70 percent for anorexia.
"[For] people with anorexia and that genetic predisposition what seems to happen is that certain genes get switched on and basically they end up [with] weight-loss behaviour that increasingly gets out of control. Also a bit of the illness is that they themselves lose that kind of perspective and become identified with the disorder."
Dr Mysliwiec agreed the film was controversial and said the fact the lead actress lost weight for the film sent a very problematic message.
"[It's] the one behaviour - weight-loss or dieting - that someone with anorexia should definitely stay away from. So that already in itself is of concern because in some ways it sort of sends the message: 'You can do that and be okay'. She possibly might be okay but it's definitely at-risk behaviour."
Nicki Wilson said anyone who wanted to watch the film and was in a vulnerable position should view it with a support person.
It was important to note that not all people who have an eating disorder were thin, white, young woman - eating disorders do not discrimate.
But it was important to know that full recovery was possible, Ms Wilson said.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.