Lia lives in a world highlighted by food. Never mind her parent's divorce, or her friend Cassie's death of a ruptured esophagus for binging too much. None of that is important if she can control her food intake; hopefully, she will not pass out again at the wheel of a moving vehicle. Only problem is... her parents keep hospitalizing her. When she does not have enough energy to get medication for her sister; her stepmother shoves a gigantic oatmeal cookie in her face and tells her to stop being so selfish.

Along the way, at least she has a shrink, Dr. Parker, who seems to overanalyze every stray thought she has. Through the mist of her cloudy thinking, she realizes some of the dysfunction of her family and the "help" that the mental health community offers to her. Dr. Parker, her physician mother and professor father, who have million hour a week jobs, should be on the same page regarding her treatment. Lia slides down the precipice of drowning her mind in maladaptive thoughts to the detriment of her corporeal existence.

Wintergirls by Laurie Halse Anderson, 2009

The writing is quite lyrical with food always upstaging life. When discussing breakfast, Lia states:

"Here stands a girl with a knife. There is grease on the stove, blood in the air, and angry words piled in the corners. We are trained not to see it, not to see any of it."

Anderson 's use of crossing out words, as though editing the book, is a stark indication of Lia's constant self-censure. She does not want to think about closeness with her family or a ravenous appetite gnawing at her insides. She trains herself to think that she does not want food that is bad and dirty, and every food item is simply a caloric calculation. Her sister Emma is ashamed of Lia's appearance and actually told her soccer coach that Lia has cancer.

At 93 lbs, Lia passes out while driving and narrowly circumvented death. At 85 lbs, she grows lanugo, or "fluffy monkey hair" that appears on the faces and bodies of emaciated people to help retain body heat. At 105 lbs, she wants to be 100 lb; when she achieves 100 lbs, she wants to be 95 lbs, always less, the only acceptable weight for her is 00.00 lbs, size 0 - the land of nonexistence. Her problems will not disappear so maybe she feels that she needs to.

It does not help that her best friend Cassie is dead, the friend who understood her views about her body and food:

"The body of Cassandra Jane Parrish is in a cold silver box. They'll dig a hole in the ground and plant her on Saturday."

Cassie used to color code her binges (eg, Dorito orange) so that she could tell when to terminate her purges. Lia's mother told her about Cassie's autopsy; it revealed liver damage, and her stomach was distended to three times its normal size. Cassie's ghost still accompanies Lia on her journey through food.

Lia cuts food into tiny pieces and wants to be a puker but her obstinate throat closes and refuses the dirty task. When she is in a room and cannot achieve other goals in life, at least she is the thinnest one there. She is constantly assessing other people's body weight, as if that determines their worth in her eyes, as it does for her own. She feels superior to those who cannot lose weight; at least she can succeed at something. Everyone is defined by what they eat; she calls a person who eats thin noodles Spaghetti, and so forth. Food rules the world; food is something other than the problems she avoids.

Through body dysmorphic disordered eyes, Lia considers herself to be obese and disgusting. She attempts to hide her pathology from her parents and doctors by stating normal views about food and sewing quarters into the robe that her stepmother weighs her in. She purchases a killer accurate digital scale for herself. She spills food in the microwave to simulate meals that she never consumes. Thinness is equated with purity and cleanliness. She has lots of clothes and blankets on her but still feels a chill due to a lack of body fat.

In most novels that I have read, food is rarely mentioned, but Lia's brain cannot leave the topic. She fixates on every nuance that other people would not notice or consider significant. While she is talking with other people when they eat or drink, the food or drink is at the foreground of the conversation for her. Every sip of coffee, muffin crumbs, fried eggs, pieces of toast: she loves thinking about them, and equates her ability to resist as a strength unique to her, not a death wish. Lia dreams of gorging herself; she is so hungry that she could eat her right hand. Her grades drop due to her foggy brain and overemphasis on the subject of nutrition or lack thereof.

Anderson uses a remarkably stunning strategy of filling two pages of the novel with Lia's mantra:

Must. Not. Eat. Must. Not. Eat. Must. Not. Eat.

Food is a battleground in both her father's and stepmother's and her mother's house. Lia's parents try to control her food intake; Lia retaliates, and uses food to deal with pain. She fears losing control and eating everything. She uses laxatives and diuretics, and attempts to hide her condition with bulky winter clothes. The 18-year-old woman craves the epinephrine rush of caloric restriction; it makes her believe that she can do anything, but she feels sick and weak all of the time. After the forced weight gain of hospitalization, she always seems to near the danger point in a nonsensical suicidal cycle. 

The cover art on this novel depicts a sense of coldness and her nebulous sense of self. Cassie moved in across from her house the winter that they were in third grade, hence the title Wintergirls.

I have not found myself so riveted by an author since reading books by John Douglas, pioneer of the psychological profiling unit (Behavioral Sciences Unit) at the Federal Bureau of Investigation (FBI). I am blown away by Laurie Halse Anderson's works, and I will read every book of hers that I can get my hands on. (I even read her story of runaway hair in first grade: The Hair of Zoe Fleeferbacher Goes to School. ) She is fantastic, and a varied author. She does terrific research so that her books can be medically, psychologically, and historically accurate. Unlike many authors who tend to write many similar books, each of her books is unique and awesome. Interestingly enough, she attended Manlius Pebble Hill School (MPH) ; I used to ride the bus with MPH students on the way to my prep school.

I have a master's degree in psychology, and I find the subject fascinating. Wintergirls was the best fictionalized version of eating disorders that I have found. Anderson wrote this book because many girls wrote to her about their struggles with eating disorders, and a physician urged her to write it. She consulted with a psychologists who specialized in treating eating disorders for over four decades. It is rare that an author, especially one who may not have experienced the disorder herself or had a close family member with it, sets the tone of the problem exactly correctly. Lia is the natural personification of how a teen with anorexia thinks. This book is brilliant, and Anderson's research for it is superb. 

• Books by Laurie Halse Anderson
• Books on eating disorders
• Columbia Center for Eating Disorders
• Eating Disorders Resource Center NYC
• National Eating Disorders Association
• National Institute of Mental Health - Eating Disorders