Powerful. I don't love poetic writing, probably because I have little to no use for most poetry. Poetic writing is designed to make you think as well as feel and the combination is often too much for me (polar opposites?). But Anderson's writing does more. She is able to spin a world far better than most writers with an adult audience, and perhaps it is because her works are for a more juvenile audience, but I don't think so.
It isn't the fact that she's a YA author, it's the fact that she understands her creations, gets under their skin (and in this case inside their bones), and makes you feel everything they feel. Which is completely and utterly harrowing.
I did not want to know what it felt like to be anorexic, to be so close to death most hours of the day! Or to be so afraid of life that you would want to cut it out of you. But in terms of understanding what many girls (way too many girls) are doing to themselves, it's a needed piece of literature. In fact, it should be on every high school curriculum.
Except that I think Anderson falls short towards the end. I would think a big component to understanding anorexia and bulimia is to learn what girls can do to counteract their fears and get back to eating again. There is little of that in the book, and I worry that girls looking for some hope and understanding won't find what they need here.