The documentary Thin delves into the minds and lives of patients at The Renfrew Center, a residential treatment facility for women with eating disorders. The Center’s ideology is that eating disorders are a deadly form of mental illness and one of the most complex to treat. Five million Americans are affected by eating disorders while one in seven people diagnosed with anorexia will eventually succumb to the illness.

The Center operates on a level system in which new patients begin at level one and work to level three. As they progress, become better, and consistently sustain weight they are promoted to a new level of the program and receive privileges determined by the staff. Should a patient do something to lose the trust of the Center’s employees, they will face restrictions on their freedom.

Shelly Guillory, a 25-year-old psychiatric nurse who has been receiving all her meals through a feeding tube for the last five years, admits she abused her position by stealing insulin to inject herself with as well as an assortment of pills to crush and put down her feeding tube. Fortunately, Shelly decided against these self-destructive plans after thinking about her nephew and other family members who might discover her. 

Polly Williams is 29 years old and in her sixth week of treatment following a failed suicide attempt. During childhood she was taught to cut her food into tiny pieces, take her time chewing slowly, and drink lots of water between meals to feel full. Polly has counted calories and fat since she was 11 years old and finds it ironic that these learned behaviors are now known as potential symptoms of an eating disorder. She also finds it difficult to offer 15-year-old Brittany Robinson support when the teenager asks her peers to help her gain added strength in order to get through lunch during a support group session.

Brittany has been in treatment for three or four weeks. During that time, she has offered up a ton of advice which she herself never followed. Polly thinks Brittany likes to act as though she were the sickest person in the entire treatment center. Brittany has had an eating disorder since she was 8 years old. She started dieting at 12, believing her peers to be thinner than she was. Brittany arrived at Renfrew with a low heartbeat, liver damage, and hair loss. Over the course of a year she dropped in weight from 185 pounds to 97 pounds.

Brittany's mother, who's also afflicted with an eating disorder, did not know how to help her daughter when she revealed she had been purging. This mother-daughter team used to buy hard candy in bulk and even created a game where they would chew and spit out the candy for their amusement.

Alisa Williams was 7 years old when a pediatrician told her mother that she had better do something about her daughter’s weight. Alisa found herself on a 1000 calorie meal plan monitored by a dietician. Alisa, hospitalized three times in the last five months, repeatedly binges and purges. She recalls  an episode where she ordered a dozen donuts for breakfast before proceeding to two fast-food outlets ordering several items of their breakfast menu. Alisa then drove to the grocery store where she bought whipped cream, pastries and two 2-gallon tubs of ice cream. After feeling chest pains and thinking she would die, Alisa purged -- only to head back to the same establishments for lunch.

Director Lauren Greenfield seems drawn mostly to the negative aspects of treatment for and recovery from eating disorders. Instead of focusing on how Renfrew’s program works to save lives, Greenfield prefers to show audiences intense sequences involving relapses, purging, the removal of a feeding tube, anger, struggle, doubt, secrets and lies.

Patient’s triumphs and victories are overlooked as is the intense bond between staff and patients and what drives them to excel at the work they do. However, I'm recommending Thin because of its ability to educate and inform audiences and its potential to save lives. If you know of someone in crisis and in need of guidance related to this subject, please visit http://www.renfrew.org/.

(Released by HBO Documentary Films; not rated by MPAA.)