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What The Crown Gets Right & Wrong About Bulimia

Photo: Courtesy of Netflix.
The following article contains spoilers for the fourth season of Netflix’s The Crown.
The Crown’s fourth season is no less riveting than prior iterations. But some (and not just those in the royal family) might argue that it’s more problematic, too. The episodes pick up in the late 1970s and depict the fairytale-turned-disaster union between Prince Charles (played by Josh O’Connor) and Princess Diana (Emma Corrin).
With the introduction of Princess Diana in the series, we're also introduced to a new storyline detailing her real-life experience with bulimia nervosa, which she spoke about openly in a BBC Panorama interview in 1995, after going public about the condition three years prior in Andrew Morton’s book "Diana: Her True Story.”
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In multiple episodes, you see vivid depictions of the Princess Of Wales’ eating disorder. Before each of these episodes, Netflix includes a trigger warning that provides a link to their own website, WannaTalkAboutIt.com, with resources. But after watching the season, you have to wonder if the warning alone is enough. 
The Crown’s depictions of Princess Diana’s bulimia are overt and detailed. This appears to have been an intentional choice. “[Princess Diana’s bulimia was] something I was determined to portray very well,” Corrin, 24, who also stars in Pennyworth, tells Refinery29. “I worked very closely with the script team on developing that storyline. I really cared that it was well represented. But I kind of underestimated how hard it would be to portray that side of it.” 
Corrin says she felt it was important to portray the eating disorder honestly. “I knew that it was something [Princess Diana] spoke very candidly about, which I was surprised about,” Corrin says. “In the ‘90s, that must have been huge to reveal something like that.” The actor worked with a movement coach and researched how to depict bulimia. She even encouraged the writers to include scenes that portrayed the eating disorder. “[I] said, ‘Please, can we include more, if that’s okay, because we really feel like this is central to her character and want to portray it well,’” she says.
However, showing eating disorder behaviors such as binging and purging on screen is something that The National Eating Disorders Association generally “wouldn’t recommend," Chelsea Kronengold, the communications manager for NEDA, tells Refinery29. NEDA partnered with Netflix after filming was complete to help provide resources to viewers who watch The Crown.
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Jennifer Lombardi, MFT, manager for the eating disorder program for Kaiser Permanente in the greater Sacramento, CA, area, agrees with Kronengold's sentiment. “Any time we portray eating disorders in media, it’s a delicate balancing act,” she says. “There’s the intention to educate and inform that can be positive, but there are pitfalls. One is normalizing the behaviours.” Lombardi says that showing eating disorder behaviors on screen often fails to “convey the seriousness of these disorders.” Binging and purging can have serious health ramifications, including leading to chemical and electrolyte imbalances that can impact major organs, including the heart. Between 1.1% and 4.6% of cis-women and 0.1% to 0.5% of cis-males will develop bulimia, according to NEDA.
Graphically showing behaviors like binging and purging can also be triggering for those who have eating disorders and who are in recovery, either because it reminds them of their own eating disorder or because it may cause them to compare themselves to the person shown. NEDA notes on its website that dramatizing eating disorders can "provoke a race to the bottom" among other survivors. It can trigger the sentiment: “They’re thinner than I am and she's still alive, so I should lose more weight; or I’m not that sick, so I don’t really have a problem.” 
What’s more, “[Showing specific behaviors] could backfire as a way to raise awareness and serve instead as a how-to guide unintentionally,” Kronengold says, speaking generally about media portrayal of bulimia and not specifically about The Crown. “It could also isolate people who might be struggling, but don’t look like the representation they see in the media,” she says. Princess Diana happened to be white, cis, and presents with a smaller body, but anyone can have bulimia, no matter their race, gender, or body shape. In fact, transgender people, Black teens, and Hispanic people may be more at risk for developing eating disorders, NEDA notes.“We welcome media coverage of eating disorders when it's done in a responsible way,” Kronengold says, but adds, “There’s a fine line to walk when you’re needing to convey a message.” 
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When asked for comment, a Netflix spokesperson said in a statement: "The Crown producers worked closely with the eating disorder charity Beat to ensure that their portrayal of Princess Diana’s bulimia was both ­accurate to the disorder and sensitively handled.”
In a statement to Refinery29, Beat said: “We were consulted by Netflix and Left Bank Pictures during the production of The Crown season four. We were not involved on set, but advised on how to portray eating disorders sensitively, including signposting to appropriate sources of help and providing trigger warnings where needed.” 
The organization also noted that eating disorders “thrive on secrecy, adding, “We believe that accurate and non-glamorizing portrayals of eating disorders in the media can be a helpful way to educate the wider public about the reality of them, as well as encourage anyone affected to seek help.”
While education is important, Kronengold notes it may be more effective to show eating disorder recovery than to spend excess amounts of time graphically portraying behaviors. As Kronengold says, “Instead of focusing on the actual behaviors in those graphic scenes and situations, it’s better to focus more on how the person is dealing with their disorder and how the eating disorder is impacting their day to day.” 
Lombardi says it can be more beneficial to correct folks on the misconceptions around eating disorders, namely that they stem from vanity or the “need to control.” Instead, studies have shown that they’re largely biologically based, and that people with certain temperaments are more likely to have an eating disorder. “That research gets me really excited as a clinician because it’s helped chip away at shame and blame,” Lombardi says. “We no longer say it’s an illness of vanity, and understand now that these people tend to have certain temperaments and biological traits.”
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The Crown doesn’t do much in the way of addressing science or recovery, but, to their credit, they don’t glamourize it — to the extent that could be avoided when showing the life of a royal.
The Crown did get some things right in their portrayal. For one, the show depicts Princess Diana’s bulimia over the course of multiple years, and eventually gives viewers something of a resolution when we see her stop herself from purging in the final episode. It doesn’t feel dismissive, like it was just a blip on the radar of Princess Diana’s life. And, of course, the series needed to address Princess Diana’s bulimia in some form, otherwise it would have been erasing a major part of her life. Some say after she opened up about her bulimia in 1992, there was a sudden increase in reported cases and more people got treatment. This was called the “Diana Effect,” according to a NEDA blog
However you feel about how The Crown handles the topic of bulimia, the trigger warning is there for a reason. Beat said that they wouldn’t advise anyone currently dealing with bulimia “to watch this or any other program which centers around eating disorders. If someone does choose to watch it, we strongly advise having a support network.” 
Lombardi, who hasn’t yet seen the show, agrees that someone in the early stages of recovery from an eating disorder should avoid watching shows that portray vivid depictions of eating disorder behavior.
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If you do watch it and are triggered by it, Lombardi suggests taking a moment of self care immediately afterwards to get yourself into a new headspace. Take a walk. Call a friend. Draw a bubble bath or read your favorite book. Different coping mechanisms work for different people,” Kronengold says. If you’re thinking of binging and purging, call someone instead or dial a helpline, such as NEDA’s. 
No matter what, after you’re out of the moment, talk about it with someone. “If I’m in struggle, sometimes the best thing I can do is get through that moment,” Lombardi says. “But afterwards, I need to share with someone, whether that’s a therapist, friend, or family member so that we don’t bottle it up and it doesn't need to be numbed out or doesn’t result in engaging in the behaviors to cope.”
If you are struggling with an eating disorder and are in need of support, please call the National Eating Disorder Information Centre hotline at 1-866-633-4220.
Anne Cohen contributed to the reporting of this story.
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