Eating disorder advocates like myself walk a careful line with the media: yearning for good coverage of the issue but wary of being used for sensationalist and harmful "entertainment."
Tracey Gold's new series, Starving Secrets on Lifetime, doesn't just walk that line; it actively exploits it. In an unashamed use of celebrity and desperate images, this series tries to vaccinate itself against the charge of exploitation by marking it "educational."
Controversy surrounds all eating disorder media because of strong conflicting opinions between advocates. While the National Eating Disorders Association head has been quoted as saying "We do not support putting people who are ill on television," a leading treatment provider who does appear in the show asserts "it's going to happen -- we're not going to stop reality TV -- and hopefully somebody with integrity will do it."
Starving Secrets does some things right. It fails, however, in revealing ways.
The series succeeds in ways that are probably only visible to those of us who know eating disorders well: it is free of some the most damaging stereotypes. Gone are the tired ideas about victimized, permanently damaged people who can never recover. Missing from the first episode, at least, are the tired and discredited ideas about pathological families and abuse.
Compassion shines through as well: the producers and treatment providers -- and the single family member shown -- are caring and optimistic. There is no pity or condescension. The perspective of each patient is clearly seen and well-illustrated. We see and hear the grueling and confused experience of the patients and there is absolutely no glamorization of their conditions.
What is notably missing, and painful to advocates like myself, is the absence of real information about what causes, and what treats, an eating disorder. This information is what would make this show go from exhibitionism to educational, and it fails. Despite recent advances in research and effective treatment absolutely nothing seems to have changed in the way the illness is approached since the 1980s. That is tragic lost opportunity in such a high-profile show.
Without any mention of the biological and neuropsychiatric underpinnings of eating disorders, the public is left as usual to assume that these patients chose and continue their symptoms willfully. Without explanation that low weight and bingeing and purging all create serious and overwhelming psychiatric symptoms, the viewer is led to believe that the patient's eating only matters when they are near death. By painting recovery as a process of self-knowledge and motivation, families are misled that their own ill loved one simply doesn't want recovery enough, or refuses to understand.
Also absent is family. The two women portrayed in the first episode are young adults. Taking these patients entirely out of the context of their families and those earlier interventions is a lie of omission -- because patients need treatment that works in the months after the cameras go away. These two patients have been treated in the past and that treatment has failed them repeatedly. Why? The elephant in the room is the question of why this period of treatment will be different, and whose responsibility will it be if it does not.
Filming and broadcasting mentally ill people is an unfortunate new and growing fad. There is no question that being filmed does change the outcome -- and being desperate enough to sell one's story has a coercive effect. Producers sell this kind of public exposure to patients and their families as free access to care, and due to the realities of poor insurance coverage in the US and demonstrably poor mental health care methods, there are countless patients who have run out of options and are on their "last chance" for intervention, over and over. We need to ask, is this really "free" treatment? Or is it exploitation of ill people which risks harm to the patient and to the majority of people who will not receive this exposure?