Rebecca J. Lester’s illuminating Famished goes behind the scenes at an eating disorders clinic to present its operations in direct terms. Its picture of the delicate maneuvering that clinicians perform in order to save lives is astounding.
The book begins with a thorough breakdown of past and present theories on eating disorders before moving into its consideration of Cedar Grove, a residential eating disorders clinic in the Midwest. There, the repetitive, paradoxical fight with insurance providers takes center stage, as the level of care that patients receive—residential, partial hospital, or intensive outpatient—comes to depend on their insurance policies. Lester reports that Cedar Grove’s clients must be simultaneously sick enough for care and able to demonstrate that they are not beyond help, forcing clinicians to “package” clients’ stories and medical histories in an ethical way that aligns with the provider’s priorities, but still advocates for the sick person.
Clinical terminology and research-dense writing balances with relevant patient case studies, delivered with empathy. These stories demonstrate the multitude of ways that eating disorders show up in people’s lives and challenge myths about vanity-based and cookie-cutter behaviors. Patients’ personal relationships are shared in a poignant way, as are the ways that relationships impact eating disorders. Interviews with clinicians result in an inside look at practices and perspectives within the industry.
An eating disorders survivor herself, Lester reveals parts of her personal struggle in several short scenes. These stories, set outside of the book’s chapters, escalate until an impactful life-or-death decision is reached on a college campus. This pivotal moment underscores what can be achieved if help is available. For all of those struggling with eating disorders, it also asks what more can be done.
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