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Red Band Society’s portrayal of Anorexia Nervosa

Berta Vidal Carnero

Psychology Department, Catawba College

PSYC 3480: Abnormal Psychology

Dr. Klebaur

November 18, 2021

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Red Band Society’s portrayal of Anorexia Nervosa

Information is absorbed twenty-four hours a day, seven days a week. Information

comes from different media sources such as magazines, television shows, movies, Instagram,

TikTok, and many others. All these media sources impact everyone’s lives and thought

processes. In a westernized culture, media sources are likely going to link thinness to success

and promote extreme dieting as well as standards of ideal body sizes that are impossible or

very difficult to achieve. This may lead people to engage in unhealthy behaviors to meet

those standards, so it is also important that media sources accurately portray Eating Disorders

(EDs), to prevent people from engaging in such. One of the media sources that accurately

portrays and gives its viewers an accurate representation of an ED, more specifically

Anorexia Nervosa (AN) is the show Red Band Society. Red Band Society portrays AN

symptoms and the criteria that an individual need to meet to be diagnosed with AN according

to the DSM. Even though some scenes may not be very realistic and some of the symptoms

may be left out, Red Band Society is a somewhat accurate representation of Anorexia

Nervosa (AN).

To be able to understand if Red Band Society is a good representation of AN, it is

essential to know the basics of this particular disorder. Anorexia Nervosa is described in the

DSM (2013) as an eating disorder. Cultural influences, in addition to genes and other

biological factors, contribute to the development of the disorder. AN occurs when an

individual restricts its calorie intake so harshly that it causes the individual to be at a weight

significantly under what would be expected considering factors such as height, age, sex,

physical health, and developmental trajectory. On top of that, AN involves an extreme fear of

adding weight or becoming fat that encourages restriction of calorie intake even when at a

significantly low weight. This extreme fear is experienced because an individual suffering

from AN has a distorted image of what their own body looks or their weight (American
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Psychiatric Association, 2013, p.338). As complex as AN is, it must be difficult to portray

appropriately in a media source. Nevertheless, Red Band Society, through one of its main

characters, Emma, does a pretty good job at it. The show is set in a hospital, and it displays

different teenagers battling with their illnesses and disorders, among which AN is found.

Emma is one of the main characters trying to recover from AN. Through Emma’s character,

the show allows its spectators to gain a good comprehension of the disorder, since a lot of the

symptoms of AN are portrayed, and Emma meets all of the criteria that a person needs to

meet to have an AN diagnosis. Therefore, even though there is only one character portraying

AN, Red Band Society achieves to give the public a realistic depiction of what individuals

suffering from the disorder go through in many scenes.

Emma’s characteristics align with those of the individuals that are most affected by

AN, white teenage females. Emma is from a middle-class family that wants her to be

successful and strive for perfection. Emma, as it is usual in individuals with AN, has a very

rigid thinking style, and wants to feel in control all the time. Emma developed anorexia when

she was fifteen after her best friend moved away. Her best friend moving away left Emma

experimenting with a series of new feelings and situations: she was depressed, lonely, and

struggling to make new friends. That made her lose the sense of control that she was always

pursuing. Apart from feeling a lack of control, Emma was under a lot of stress, because she

was hiding her struggles from her parents so that she could feel that she was meeting their

expectations. Emma’s coping mechanism to forget about all those negative feelings was to

stop eating. The food that she ingested was the only thing that Emma felt was under her

control, so she made it her goal to not eat, and her body weight became under 85% of what

would be expected for her fast. Having a bodyweight under 85% of the expectations for one’s

age, height, and sex is one of the criteria that need to be met for an individual to be diagnosed

with Anorexia Nervosa.

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According to the BMI calculator of the Centers for Disease Control and Prevention

Emma’s normal body weight would be 97.1 or over. However, in Red Band Society, episode

1 (2014) Emma is going to check her weight with the doctor, and she is only 70 pounds

which, is a bodyweight way under 85% of the minimum expected weight of 97.1 pounds, for

a girl her age and her height, implying that she indeed meets one of the criteria to be

diagnosed with Anorexia (Nagle & Ensler, 2014). Throughout the show, several examples

portray Emma’s low body weight and how incredibly skinny she is. Another example is when

in episode 4 (2014) when Emma goes to a high school homecoming and two girls approach

her asking for the diet she had been following to be a double zero, referring to Emma’s jean

size because of how thin Emma’s legs and hips were (Krebs & Rosenbaum, 2014). Thus, Red

Band Society does a good job at representing this specific criterion that needs to be met to

have AN. However, bodyweight is not the only feature that it’s taken into account to

diagnose AN.

To help us understand whether an individual has AN, other criteria have to be met,

such as a really strong fear of adding weight or becoming fat. People suffering from AN fear

weight gain when at really low weight. Surprisingly, they may not even be aware that they

have this fear and that it is stopping them from being healthy. Accordingly, it is essential that

a general assessment of the individual is conducted before making any diagnosis, so that it

can be assured that the irrational fear is the only explanation as to why the individual is not at

the expected weight. Several scenes in the show demonstrate Emma’s fear of adding weight,

including scenes already mentioned, such as when she obsessively writes the calories in her

diary to make sure she is staying in a calorie deficit. Likewise, Emma’s fear of adding weight

is reflected in episode 10 (2014), when only by looking at all the food on his plate she gets

overwhelmed and refuses to eat it (Mimoun & Holland, 2014). As a result of having these
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scenes, the public watching the show will understand that a fear of weight gain is very

present and persistent in an individual with AN.

Along with low body weight and significant fear of gaining weight, another criterion

that a person has to meet to be diagnosed with AN is a misinterpretation of their body shape.

Individuals with AN show a disturbance in the way they see different parts of their bodies.

Even though they may be skeletal, they will always see themselves as fat, or feel like they

could be thinner. This relentless pursuit of thinness makes them forget about the fact that they

are engaging in unhealthy behaviors to get there. Red Band Society does portray the

misinterpretation of own body shape and how difficult it is for AN patients to accept their

disorder. An example is that Emma never accepted she was very thin and therefore sick until

the episode … after about a year and a half of her suffering with the disorder. Also, while all

of Emma’s friends, family, and even strangers when she goes to one of her friends’

homecoming are telling her she is skinny, she does not appear to think so, considering that

every time she looks at herself in the mirror and does not feel content. She tries to grab fat in

her arms and her thighs, but that fat is not there, since there is barely any muscle. So, once

again, the Red Band Society represents competently a very important criterion of anorexia.

No matter how well Red Band Society does at portraying the criteria for AN, such as

having under 85% of expected body weight, unfounded fear of gaining weight, and a

disturbance in the way one’s own body is seen, the show also lacks to accurately represent

some aspects of AN, including its subtypes. There are two subtypes of AN, the restricting

type, in which the person achieves weight loss through dieting, fasting, and/or excessive

exercising; and the binge-eating/purging type, in which the individuals feel they have eaten a

little bit too much, although they probably have not, and to avoid the weight gain engages in

purging behaviors such as misuse of laxatives or inducing vomit. According to the Eating

Recovery Center (2021), AN is the mental illness with the highest mortality rate (National
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Eating Disorders Association, 2021). Even though females are more prevalent to be affected

by AN, since they represent 75% of the population affected with the disorder, everyone can

be affected by it. AN usually develops at the beginning of adolescence and it tends to be

chronic unless caught early. While the show does contain a good representation of AN and its

onset age, if the spectator wants to gain profound knowledge about the two subtypes, Red

Band Society may not be the best media source to refer to. In several episodes, Emma’s

character has that restrictive and obsessive mindset and she writes down every bite she eats,

and how many calories it is. Additionally, in episode … characteristics of the binge-

eating/purging subtype are displayed, since Emma purges after her parents force her to eat.

However, purging is not seen again in the show, and it is not mentioned as prevalent in her

struggle with the disease. The show references and represents some of the characteristics of

the two subtypes, but further examples should be included in it for a more accurate portrayal

of those.

To diagnose an individual with AN aside from recognizing the several criteria

mentioned above, doctors may also look for several physical symptoms that cause

impairment in the individual’s life. For example, people with AN usually feel cold all the

time, because starvation causes the body to drop its body temperature. If one pays close

attention, in Red Band Society, Emma is always wearing a lot of clothes and carrying her

blanket around. As well as portraying that coldness that anorexic people usually feel, Red

Band Society also illustrates other common physical symptoms such as lack of strength or

weakness, caused as a result of not eating. This weakness is seen in episode 10 (2014) when

Emma’s younger sister can make her fall just by grabbing her by the arm (Mimoun &

Holland, 2014). Looking at these scenes, it cannot be denied that the show accurately

displays some of the physical symptoms experienced by individuals suffering from AN that

may be helpful to determine the diagnosis or detect the disorder. However, Red Band
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Society is not perfect and it does not portray a few physical symptoms, such as the growth of

feathery hair all over the body to balance the drop of body temperature.

In addition to identifying the physical symptoms experienced by individuals who

suffer AN, to say Red Band Society accurately portrays the disorder, it also has to show the

feelings that these individuals most commonly fight, such as that guilt they experience after

eating and/or anxiety. One scene in which Red Band Society, it is in episode 9 (2014)

represents this extreme guilt is when Emma gets frustrated because she ate out with her

friends and has an anxiety attack when she gets back in the hospital room (Fattore & Brock,

2014)). Along with guilt, as seen in the show, anxiety is also very present in AN. Anxiety

may appear after AN is developed, but it is more common that the individuals were already

anxious, and then on top of that, they developed the eating disorder. So, although it is not

known if she was already anxious before she had AN, at least the spectators get to see that

anxiety is often present in AN.

The development of AN is highly influenced by the environment of the individual. In

Emma’s case, her environment at home was one of perfection and pressure, which was not

favorable at all, and probably contributed to her developing the disorder. However, further

examining Emma’s environments throughout the show it is noticeable that a healthy

environment is not everything, since even when in the hospital, with a new group of friends,

psychologists, and nurses taking care of her, Emma did not cope well with her disorder and

she kept getting worse. Nonetheless, the show not only takes into account environmental

factors but also biological factors, since in episode 10 (2014) the director makes sure viewers

know her grandmother also had AN (Mimoun & Holland, 2014). Red Band Society

mentioning Emma’s family history has to be taken into account towards evaluating the

accuracy at portraying the disorder, since it is proved that biological factors and genes also

play a role in the development of AN, accounting from a 50 to an 80% of the risk of anorexia.
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Other things that need to be taken into account when assessing the accuracy of Red

Band Society depicting AN are the behaviors of those affected by the disorder and how the

disorder is treated. In Red Band Society it is seen how Emma, like most AN patients, is in

denial and does not accept her problem. Moreover, she is far from accepting her mental

disorder. In episode 7 (2014), it is portrayed how Emma hides small weights into her bra to

pretend that she is getting healthier, when she is indeed not eating, and how she manipulates

her psychologists to make them think she is okay (Shukert & Dunne, 2014). And although the

nurses not catching her may not be very realistic, since they would control what Emma is

eating and check through her clothes for hidden weights, if Red Band Society’s main focus

was to show the manipulation and lies that may be encountered when treating with

individuals suffering from AN, it accomplished it.

Apart from portraying typical behaviors and patterns in AN, Red Band Society

portrays treatments of AN as well. Family therapy in AN is very common because of the big

impact the family has on the person affected with the disorder. The comments of family

members often have a bigger impact on people than comments coming from strangers. People

suffering from AN have such low self-esteem that comments or what strangers may think

already preoccupies them, so they don’t need their family judging them or making

inappropriate comments as well. This is why family therapy is so important, to not only

educate the patient on how a healthy relationship with food can be achieved, but also to

educate those who are going to be their main support, and it is very used when treating

adolescents (Mitchell & Peterson, 2020). Changing the thought processes of both the parents

of the affected person and such individual usually turns out in a higher likelihood of the

patient getting better. In the show, family therapy sessions are portrayed and turn out to be

helpful in the treatment of Emma’s disorder. For example, in episode 13 (Ensler, 2015) while

in family therapy, Emma recognizes she was not doing well, and that the only reason why she
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did not tell her mother was because she did not want to disappoint her. The mother then

comforts Emma and takes a part of the responsibility because she accepts that she already

knew Emma was suffering from AN, but she did not say anything because she felt ashamed

that Emma did not confide in her enough to tell her and because she felt responsible for not

having realized it earlier. The psychologist assures that those confessions are going to help

the family move forward and become stronger since at least they were communicating and

being, which was a sign of a safer environment. However, family therapy gains effectiveness

when a psychologist has previously worked one-on-one with the patient in cognitive

behavioral therapy (CBT). CBT is also portrayed in the show since in earlier episodes, the

therapist works through the disorder with Emma and how she feels about food, her own body,

and her weight. Changing those thought processes, as well as educating Emma on AN, before

involving the family may be very beneficial. Furthermore, it can be concluded that Red Band

Society offers a good representation of different AN treatments.

Taking into account the DSM V, Red Band Society does a somewhat accurate job at

portraying the main features of AN. In an era so full of media sources it is rare to find reliable

sources of information, especially as far as disorders are concerned. However, Red Band

Society through many episodes, several scenes, but only one character, accomplishes to give

its viewers a good grasp of the criteria and symptoms that need to be met to be diagnosed

with AN. Red Band Society portrays that people suffering from AN are under the expected

weight for their gender, weight, and height, as well as that they have a severe fear of

becoming fat, plus them having a distorted view of their own body. However, the show is not

faultless: the AN subtypes for example are not portrayed very well; and while it includes

most of the physical symptoms and feelings experienced by anorexic people as well as

treatments used with these patients, it does not mention all of them; besides, some scenes

may be a little unrealistic, such as the nurses not knowing that Emma is adding weight on her
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shirt to make the scale have a higher number. Consequently, Red Band Society may not

contain the perfect representation of AN, but it has a pretty good one that will make its

viewers understand Anorexia Nervosa a lot better.

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders: dsm-5 (5th ed.). American Psychiatric Association.

Fattore, G. (Writer), & Brock, T. (Director). (2014, November 26). How did we get here?

(Season 1, Episode 9) [TV series Episode]. In F. Daryl (Executive producer), Red Band

Society. ABC Signature.

Krebs, B. (Writer), & Rosenbaum, E. (Director). (2014, October 8). There’s No Place Like

Homecoming (Season 1, Episode 4) [TV series Episode]. In F. Daryl (Executive

producer), Red Band Society. ABC Signature.

Mimoun, R. (Writer), & Holland, T. (Director). (2014, December 13). What I did for love

(Season 1, Episode 10) [TV series Episode]. In F. Daryl (Executive producer), Red

Band Society. ABC Signature.

Mitchell, J. E., Peterson, C. B. (2020). Anorexia nervosa. The New England

Journal of Medicine, 382(14), 1343–1351. https://doi.org/10.1056/NEJMcp1803175

Nagle, M. (Writer), & Ensler, J. (Director). (2014, September 17). Pilot (Season 1, Episode 1)

[TV series Episode]. In F. Daryl (Executive producer), Red Band Society. ABC

Signature.

Renshaw, J. (Writer), & Ensler, J. (Director). (2015, February 7). Waiting For Superman

(Season 1, Episode 13) [TV series Episode]. In F. Daryl (Executive producer), Red

Band Society. ABC Signature.

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Shukert, R. (Writer), & Dunne, G. (Director). (2014, November 12). Know Thyself (Season

1, Episode 7) [TV series Episode]. In F. Daryl (Executive producer), Red Band Society.

ABC Signature.

Statistics & Research on Eating Disorders. National Eating Disorders

Association. (2021, July 14). Retrieved October 28, 2021, from

https://www.nationaleatingdisorders.org/statistics-research-eating-disorders. 

Sudduth, R. (Writer), & Lerner, D. (Director). (2015, January 31). The Guilted Age (Season

1, Episode 11) [TV series Episode]. In F. Daryl (Executive producer), Red Band

Society. ABC Signature.