Sunday, October 14, 2007

Thin (HBO), documentary on treatment for anorexia

Thin (2006, HBO Documentary Films, dir. Lauren Greenfield, 102 min, TV-MA corresponds to PG-13) covers the problem of anorexia nervosa, in a manner similar to HBO’s coverage of other medical issues like irreversible coma (covered in the June movie blog). The film traces four young female patients at the inpatient Renfrew ( treatment center in Conconut Creek, Florida.

The treatment is very intrusive, and patients are monitored all the time. There are no bathroom breaks during meals. Patients may not wear certain kinds of clothing that could hide food in the dining room.

Patients, however, often try to “break the rules,” sometimes smoking near vents in bathrooms. But there is a “smoke porch” where apparently smoking is permitted and some kinds of confidential discussions are permitted among patients.

There is, around the middle, a scene where a somewhat elderly male father talks to a young male counselor. The parent asks the center employee, "Do you have kids?" and the answer is, "No, but..."

Late in the film, one patient is told she will be discharged for breaking the rules. She calls her mother, and admits that she “lacks integrity.” The mother is on the speaker phone, and begs for her to be allowed to stay. The film shows her purging on camera. The mother cannot afford to pay for the treatment, and the father will not. Later she says she is 28 with no period, and her boy friend fears she will not be around in a few years.

This is a very difficult film to watch, and would probably be hard to work with in a theatrical, instead of cable TV, release. I tended to feel angry at the patients for their self-destruction, which seemed self-indulgent in the wake of so many other needs. But then I thought, maybe what these young women are really resisting is the their perception that they face future use as psychological "slaves" to men.

When I was growing up, I (as a male) had some of these preoccupations with “fat” and body image, and it got in the way of my social development, especially in the early to mid teen years; however my “symptoms” were nothing on the scale of the subjects in this film. During the six months at NIH (in 1962, when I was 19, an episode discussed elsewhere in the blogs), I recall other patients had some issues like this, and the staff was always concerned about the possibility of weight loss and they even wanted to “fatten me up.”

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