The book starts out with fifteen year old, Francesca Dietrich, who already had issues with the way she looked.

Francesca is a ballerina and takes it very seriously. When her ballet teacher, Madame, made a comment about how Francesca had been improving with her dancing but would need to lose some weight if she wanted to get even better. After Madame’s words, she decided to set a goal and lose weight. When she first started to lose the first few pounds her ballet teacher her praised her and thought Francesca was on the right path. Francesca eventually turned to not eating at all.She would tell her parents that she had already eaten or that she didn’t like the food that was made.

She began to lose a significant amount of weight and started to like the feeling of it all. She created a new name for herself, which was Kessa. She considered Francesca to be the old fat girl and Kessa to be the new and improved, skinny girl. Her parents begin to notice her weight loss and become concerned. They start out by being very angry with her and trying to force her to eat but don’t realize she just goes and throws it up in the bathroom right after.

She goes to doctors but eventually stops seeing her first psychiatrist. The second psychiatrist, Sandy Sherman, actually creates a relationship with Kessa and she chooses to continue seeing him. She is later hospitalized but Sandy stays on as part of Kessa’s medical staff. She gets a feeding tube inserted for nourishment. While in the hospital, Kessa met two important people. One was her roommate, Lila, and the other was what the nurses referred to as a “skinny” as well, named Myrna.

“Skinny” was the nurses way of identifying an anorexic patient.Myrna is sort of a bad influence on Francesca. Myrna said she wants to be the best anorexic ever. She gives Francesca advice on how to hide food and also how to get out of the hospital. Kessa eventually becomes disgusted by Myrna and the way she looks so, overall Myrna had some of a good effect on Kessa’s illness.

It helped Francesca see how unappealing the illness was. Lila on the other hand thought the “skinnys” were crazy for not eating. She would discuss anorexia with Kessa because she had never heard of it before being put in the hospital herself for surgery.The psychiatrist, Sandy put together a family session while Francesca was in the hospital. This was a big step on the path to Francesca’s recovery.

Francesca got to express what she had been keeping inside and her family starts to realize how this illness came upon Francesca. Sandy stays a part of her path to recovery and helps her when let out of the hospital. The ending of the book kind of leaves you in a sense of wonder. It does not let you know if Francesca will live and surpass this or if she will fall to this illness.