For her first feature film, director Marti Noxon drew on her own experiences with eating disorders. It shows, too, as the film doesn’t sugarcoat her protagonist’s dire struggle with anorexia. Harshly realistic, To the Bone is compelling, while equally hopeful and often funny.

Ellen (Lily Collins) has been in and out of in-patient facilities, her pessimistic attitude getting her into trouble along the way. Her stepmother, Susan (Carrie Preston), has been in charge of her treatment, as Ellen’s father is ignoring the issue by constantly working. Ellen’s mother, Judy (Lili Taylor), lives in Arizona with her partner, and she can’t emotionally handle Ellen’s illness. The only one the young woman is open with is her half-sister, Kelly (Liana Liberato), who is extremely worried that Ellen will soon die. With few options left, Susan signs Ellen up for an appointment with Dr. Beckham (Keanu Reeves), supposedly one of the best in the world for eating disorders.

Straight-shooter Beckham suggests Ellen immediately join his group home in Los Angeles, where six other patients reside. Reluctantly, Ellen agrees. The house is a bit more lax on rules than Ellen is used to: patients are encouraged to try things at their own pace and rewarded with nights out because of improvements. Luke (Alex Sharp), a former ballet dancer, stands out the most. He hilariously introduces himself to Ellen as a Raymond Chandler obsessive, speaking like a character out of film noir. It turns out he’s much more than that: he’s bubbly, optimistic, and succeeding in his recovery. He’s encouraging to his six housemates, and his positivity seems infectious.

Not that there aren’t heartbreaking stories in the house. Ellen struggles to find her own version of recovery while watching her fellow housemates grapple with theirs. Luke, however, cracks her cynical attitude, and slowly she comes to appreciate his upbeat way of looking at the world. Despite this newfound friendship and a place where she has support, Ellen’s story is about her finding her own personal motivation.

There are a lot of pointed questions and issues the film brings up, and it’s impossible to mention them all. One involves Ellen’s artwork, which, after being posted on Tumblr, is blamed for pushing another anorexic girl to her death. Each resident also has a unique story, including Megan (Leslie Bibb), who battles anorexia while pregnant in her first trimester. However, something gets lost in bringing up facets of Ellen and her fellow patients that aren’t really examined. Perhaps most glaring is Ellen’s artistic work. While she’s seen drawing a few times, her backstory relies on her impact as an artist, and it’s never really explored. Omissions like that makes one wonder what the movie might been as a miniseries or television show that dedicated more time to each character.

The cast, including the myriad of side characters, is wonderful. Collins is clearly dedicated to portraying Ellen as honestly as possible, and her co-stars shine as well: Preston stands out as a parent who is the most frustrated but also fighting the hardest for her stepdaughter’s health. Sharp, in his first movie role, is incredibly charming. He adds depth to what could come off as a one-dimensional sweet nerd. Reeves, too, gives a surprisingly subtle performance as Dr. Beckham, a caring and tough-as-nails mentor.

What’s most convincing is that the film presents recovery as a process that is thorny, doesn’t come easy, and takes a really long time. In a less than two hours, it’s easy to present recovery as deceptively quick. But with Ellen, and all the patients in the group house, her journey comes across as realistically complicated.

Written and Directed by Marti Noxon
Released by Netflix
USA. 107 min. Not rated
With Lily Collins, Keanu Reeves, Carrie Preston, Lili Taylor, Alex Sharp, and Liana Liberato