The main character, "Ana", is a sophomore student and athletic track star who keeps a strict food diary and finds herself growing increasingly distant from her own family, while her own mother struggles with newfound morbid obesity and separation from her husband.

Ana begins keeping a food diary with a friend, wealthy fellow student Jill, and they both try to lose as much weight as possible for their track team, which transmutes into an obsession with getting on a ballet troupe's list and exploring thinspiration websites.

The family's money begins to dwindle, and Ana takes her mother's self-deprecating statements to heart, such as "nothing tastes as good as thin feels", and continues losing weight until she is admitted to a local hospital due to physical health complications.

Ana dies as her family cannot afford to send her to a special care facility for minor children suffering from eating disorders, while Jill, whose parents are rich, is able to recover in comfort.

"[2] Kirkus Reviews called the book "a disturbing tale that feels meant to titillate rather than caution... anyone familiar with the sensationalist pseudo-diary Go Ask Alice knows it won’t end well for an anonymous (fictitious) teen who chronicles her eating disorder.

For example, Karen Coats, writing for Johns Hopkins University Press, wrote that the book "echoes Go Ask Alice in presentation and appeal, but it's a sounder exploration of its focus problem.