A few years ago, the actress Anne Hathaway lost 25 pounds to play single mother turned consumptive prostitute Fantine in Les Miserables. The role earned Hathaway an Oscar. The crash diet earned her a broken arm; she was so malnourished that her bones became unnaturally fragile. During the film’s promotion, countless interviewers asked the actress how she had taken off so much weight. But, Hathaway refused to divulge her secret. She feared that fans, young women in particular, would try to emulate her.

Hathaway’s concern was well-founded. Whenever celebrities are celebrated for their thinness, it can trigger self-destructive behavior in those battling eating disorders. Online “Pro-ana” and “Thinspiration” communities worship ultra-skinny models and actresses, and are quick to share photos and tips. “It’s not a diet,” one popular site declares, “It’s a lifestyle.” Being thin is deadly seriously.

Writer/producer and first-time director Marti Noxon takes eating disorders seriously herself. Noxon, best known for her work on Buffy the Vampire Slayer, UnReal, Girlfriends’ Guide to Divorce and Mad Men (among dozens of other titles) began her own struggle with anorexia and bulimia as a teenager. In her new indie movie To The Bone, which premiered at Sundance and is available on Netflix, she draws on that experience, although she admits it took a long time for the project to come together.

“The first part is knowing that you have a story that you could tell, but not knowing how to tell it. That went on for a long time,” she recently explained to IndieWire. “Then, the second part of it: you write the script, and then putting the film together, especially a film about a topic that, in some cases it seemed like male producers didn’t understand. I was told a number of times that it was just too small a topic.”

Interesting (and myopic) reaction given that The National Eating Disorders Association estimates thirty million people in the U.S. will suffer from an eating disorder at some point in their life. In fact, Dr. Megan Riddle wrote about eating disorders in menopause for Women’s Voices for Change just last week. The various disorders affect women twice as often as men.

Lily Collins, the 28-year old actress and daughter of musician Phil Collins, also struggled with an eating disorder for five years, an experience she’s written about in her recent book Unfiltered. So, Collins was in a unique position to play Ellen, To The Bone’s anorexic heroine. On the one hand, she could relate to her character on a deep personal level. On the other, she would need to lose significant weight for the role, which in itself might reawaken her disorder. And, she worried that the film could encourage other young women to starve themselves.

Both Noxon and Collins approached the material carefully and compassionately. And, both felt To The Bone was an important look at a topic that hasn’t received the attention it should. So, they were surprised by the controversy and negative reactions that began flooding the media prior to the film’s release.

The CEO of Alliance for Eating Disorders Awareness Johanna Kandel told the LA Times, “There’s a very, very, very fine line between giving information about eating disorders and disclosing too much and being triggering for individuals who are currently struggling. The calorie counting, getting on the scale — all of those behaviors can bring everything back up and start that inner conversation ‘I should do this’ again.”

Collins, who did lose weight for the part (there are also prosthetics and special effects used) was taken aback when she received compliments on her nearly skeletal frame. The actress, who has put back on enough weight to be featured on the cover of this month’s Shape magazine, is adamant that healthy is about how you feel not how you look.