Thin

Thin is a documentary following several women at Renfrew Center in Florida who are being treated as inpatients for eating disorders.  The main ones are Shelly, Brittany, Alisa, and Polly, and they range in age from 15 to their thirties.  We see some other women at the Center who are older, but for the most part it seems that most of the patients are in their teens or twenties.  In 2004, director Lauren Greenfield followed them in psychotherapy sessions, nutritional counseling, group counseling, meal times, family visits, talking on the phone, measuring weight, visits to doctors, and socializing together with other patients.  For the patients to be at the Center, they clearly have to have very serious disorders: their weights are dangerously low and their lives are at risk.  Some of them have attempted suicide or seriously contemplated suicide.  Indeed, much of their behavior seems self-destructive.  The film shows very clearly how difficult it is to cope with the disorder, and how difficult it is to treat it.  We see the women disobeying the rules of the Center, lying to therapists and each other, being unpleasant to other patients.  Especially striking is how difficult the patients find it to accept that are thin enough already and that they need to gain weight.  They feel that being forced to eat food is torture, and will make them fat.  So while they have agreed to be at the Center, they are extremely ambivalent about being there, and often want to leave.  We see meetings where the staff talk about the patients and try to work out who is lying and being manipulative, and who is really making an effort.  The overall impression given by the documentary is that for most of these women, controlling their weight will be an issue that follows them through the rest of their lives, and as with alcohol and substance abuse treatment, a great deal of treatment has virtually no beneficial effect. 

As the documentary progresses, we get a sense of the immaturity of the patients, and their unwillingness to face their serious situation.  Some of the most striking scenes are where the staff confront the patients about their immature behavior and their untrustworthiness.  At the same time, it seems clear that much of the time, this immaturity is part of their condition, and this raises a worry that the staff, in confronting patients, are blaming patients for their condition.  We also see how in the group meetings, the emphasis is placed on the whole community and the responsibility of the members of it to respect each other.  The power of the documentary is its ability to sympathetically bring out these tensions and how the staff and patients try to resolve them.

Greenfield is a photographer, and although she is not the cinematographer for this documentary, the film is still full of powerful visual details.  In the dining room, the camera zooms in to the plates and showing the tiny mouthfuls of food they take.  Amazingly, the participants in the documentary seem to forget the presence of the camera and we get close ups of their facial expressions as they talk to each other.  Thin is a gripping piece of work, which repays repeated viewing.  As with any documentary, it tends to focus on the most dramatic episodes and so does not give such a strong sense of the routine nature of life in such an institution, and it make underestimate the importance of the drudgery of everyday life and working through issues in therapy.  It will provide an excellent introduction to those who find it difficult to understand the seriousness of eating disorders and the challenge of treating them, and it will give insight about treatment to those who are all to familiar with the dangers of anorexia.  Highly recommended.

Links:

• The Renfrew Center’s Position on “Thin”
• Review of Lauren Greenfield's Girl Culture

© 2006 Christian Perring. All rights reserved.

Christian Perring, Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Reviews.  His main research is on philosophical issues in medicine, psychiatry and psychology.