Writer-director Marti Noxon's deeply moving feature debut, "To the Bone ," isn't just about a young woman confronting anorexia; it's a story about coming to terms with the ridiculous, awkward, beautiful and painful realities of adult life.
Without judging or romanticizing, Noxon presents a heartfelt and heartbreaking portrait of a 20-year-old girl trying to cope with the challenges of growing up by obsessively restricting calories.
Noxon and star Lily Collins — who both have personal experiences with eating disorders — have created an indelible character in Ellen/Eli, the eye-rolling, over-it millennial at the heart of the film. Like a next-generation "Juno" steeped in bitters, Eli is all fragile vulnerability and stubborn defiance — a sneering mix of fear, arrogance and angst, simultaneously yearning for and fearing adulthood.
Eli has been in and out of treatment for her eating disorder. She's so skeletal and drawn, her eye sockets seem oversized and her skin looks gray. But she insists everything is under control. Like, get over it.
Her family begs her to try yet another inpatient program, and she agrees to join a group home where half a dozen other young bulimics and anorexics ("rexies") are living in various states of recovery. The house's lone male resident, Luke (newcomer Alex Sharp) takes an instant liking to her.
Her formal treatment includes a disastrous family therapy session with her new-age mother (Lili Taylor) and well-meaning but often inappropriate stepmother (an outstanding Carrie Preston). Informally, it includes a fledgling romance with Luke and a bizarre bottle-feeding ritual with her mom.
The film presents eating disorders almost like a form of addiction. Keanu Reeves plays Dr. Beckham, whose approach is to encourage patients to decide for themselves what their future lives should look like. In one of the film's most poignant scenes, he reveals one of adulthood's great and troubling secrets.
"Things don't all add up," he says. "But you are resilient. Face some hard facts and you could have an incredible life."
And right there is why this film is universal, even if you're not a young person with an eating disorder. Growing up means realizing that life isn't always fair and there's no guarantee that everything will be all right. Eli literally shrinks away from this truth.
Collins and some of the other actresses are so painfully thin that parts of the film are uncomfortable to watch. It's also hard to see the young characters so tormented and consumed with body image. One describes a famous (and unquestionably thin) actress as "kind of fat, don't you think? Like at least a size 6."
But the story is not all bleak. Noxon, a veteran writer and producer of such TV hits as "UnREAL," ''Mad Men," ''Glee" and "Buffy the Vampire Slayer," deftly manages her film's tone, blending humor and heart without being saccharine or trite. She treats Eli's struggles seriously but not too earnestly, a delicate balance obviously aided by the loving perspective of personal experience.
The film's optimism shines through in a magical sequence set inside the Los Angeles County Museum of Art's "Rain Room" exhibit. Beckham takes his patients on a field trip there, and their experience of the space where water miraculously rains down from the ceiling but doesn't get visitors wet is a cinematic metaphor for the delicious thrill of discovery — a perk of being alive.
"To the Bone" is a beautiful achievement. It illuminates the compulsions and dangers around disordered eating — a potentially deadly condition that affects 30 million Americans — and the struggles of so many teens and adults who channel their concerns and fears about life into hatred of their own bodies. It gives voice to the experience of girls, who are rarely prepared for the onslaught of male attention that comes with puberty and adolescence. It underscores the importance of family, however dysfunctional. It's a story about the difficulty of being human and the bravery it takes to grow up.
"To the Bone," a Netflix release, has not been rated by the Motion Picture Association of America. Running time: 107 minutes. Three and a half stars out of four.
Follow AP Entertainment Writer Sandy Cohen at www.twitter.com/APSandy .