This book confronts a strange and remarkable issue—a person can misunderstand the truth about food and nourishment so completely that they inadvertently starve their self to death. What a horrific fate, but luckily for Hornbacher, anorexia and bulimia are only half of her story. There is the teenage Marya whose weight dwindled as low as 52 lbs, and there is the author Marya Hornbacher who is writing this book from a position of accomplishment. So the most important feature of the book is that Marya is living proof that these problems are not nearly as hopeless as they feel.
Part of the problem in treating eating disorders comes from the complex nature of their origination. For some people, eating disorders arise from crises in their self-esteem, when they start to believe that they don't deserve good things. For others, it is more obsessive-compulsive, when they start to fixate on weight-loss or something. For Marya it was untreated psychological trauma from her lonely experience of her parents fighting. They did not appreciate what their marriage represented to Marya's mental health, so they never thought to let her get therapy when they fought. This left young Marya in a childish hopelessness, not mature enough to describe the problems she was beginning to face.
Eventually those problems consumed her nearly to starvation. The doctors gave her weeks to live, and her internal organs began to fail, even though she was surrounded by food, by people urging her to just eat food and live. But that's exactly the problem; Hornbacher didn't need people helping her to eat, she needed a community of people to support her, and she needed to talk through her problems with someone she loves and trusts, but because these things happened at such a young age, she faced her problems without those advantages.
Ultimately, the main takeaway from the book should be to love people well, since open acceptance and positivity are not just important—they are vital. Also, Hornbacher's story is a story of a childhood trauma, it is a reminder that children experience reality differently than adults: without the experience an adult has, children are left to fend for themselves against the full weight of their emotions, so adults should consider themselves responsible for supporting their children emotionally.
