Book review: Enough to make you sick

THE QUOTATION from Sylvia Plath's "Lady Lazarus", used as an introduction to one of the chapters, says it all. Lady Lazarus, as well as being truly terrifying, is a bit of a show-off. She knows she is fascinating. She removes her shroud like a "strip tease" and is confident that "Dying / is an art, like everything else. / I do it exceptionally well."

Wasted is an account of the author's severe eating disorder: "I was never normal about food, even as a baby ... I have never been normal about my body." At nine, she starts throwing up and, with the onset of an early puberty at 11, develops bulimia. She is hospitalised, veers into anorexia, is incarcerated in a mental institution and by the time she is 19, weighs 55 pounds and is given a week to live.

It is painful and horrendous reading - she doesn't stint on detail - and you will feel the utmost sympathy for this woman. But there is rather too much inert, therapised philosophising and self-analysis interspersed with the gory decline of her body. Something of the performer about her and something suspiciously eager in her willingness to probe her wounds publicly leaves me uneasy.

Pride in your emaciation, your freakishness, your extreme and vigilant dedication to starvation is an intrinsic part of any eating disorder. But the high drama she evokes seems unnecessarily manipulative and, at times, turns the book into a sensational freak-show. There are far too many one-sentence paragraphs which are presumably intended to hit home the horror of her disease: "In the garish glaring picture book sun of that small town, I was carefully constructing my own private hell"; or "We are about to watch one person's systematic, total loss of any power at all." They have the opposite effect, making her appear self-indulgent, quite pleased with the whole spectacle, and - far worse - making her disease look rather glamorously dramatic. She underpins this by forever presenting herself as the tortured, highly-strung artiste: she goes on and on about how she fills her sleepless nights reading literature or writing poems, while wired on caffeine and starvation highs.

Anorexia is contagious and competitive. Hornbacher says as much herself: she describes the mass dieting that went on at her school and of the hospital, notes chillingly, "People on eating-disorder units are notoriously supportive of one another's recovery. Less competition." She is also aware of the danger of literature about eating disorders. After reading The Best Little Girl in the World, she decided she "wanted to be her: withdrawn, reserved, cold ... perfectly pure". There is even a grim footnote about how the film of the book is "often shown on eating-disorder units and never fails to bring a great many patients into a tizzy over how skinny the actress ... is, and how they now need to be as thin as her." It is crucial that literature about eating disorders treads that fine line of being educative and raising awareness, while not giving tips and ideas to potential sufferers. If she knows this then why does much of Wasted read like a how-to guide? Why give us handy hints on how to be absolutely sure you've vomited up the entire contents of your stomach? By doing this, her supposedly altruistic intentions for the book - "I would do anything to keep people from going where I went. This book was the only thing I could think of" - are completely undermined.

The most unforgiveable thing about the book is that we are given 274 pages on the horrors of her addiction, and 11 on her recovery. In relating her addiction to starvation she is unmerciful and unflinching; she is finally admitted to hospital on the brink of death. We then jump forward four years to "I am alive" and a stunningly vague ramble about her return to life. If she is trying to help people by writing this book, then why are we given no more on her route back than a few unspecific "I got tired of being so dull ... I took a leap of faith ... It's a fight"? By this point, I am screaming "how, how did you do it?" But she never gets close to telling us.

I am not, of course, suggesting censorship for this kind of "dangerous" book, when it is really the social and cultural environment that renders it so. But by writing what she has, she has carved out for herself a responsibility - and her final 11 pages do not even remotely fulfil it.