Skinny is the story of two sisters; Giselle, a college-aged med student who has anorexia, and her 8th grade sister, Holly. The chapters alternate narrators to the effect that you get a feeling for how Giselle's anorexia influences both her and those around her.
Giselle's chapters, interspersed with snippets from her med school textbooks, feature a person torn by her own desire for perfection and permanently wounded by a father who openly showed preference for her younger sister. The snippets from the medical textbook act almost as subheads for the pages that follow, and sometimes I found them to be too "artsy." Like something a grad student in a creative writing class would do to make her story seem "different" even if it doesn't really do anything to provide insight. I get the meaning they're often supposed to have, but that's kind of the point. Either the meaning was too obvious, and therefore cheap and unnecessary, or the snippets didn't really seem to have much of a purpose at all. I also failed to see the purpose in her new boyfriend who runs in and out of the book--the one who is so enamored by Giselle's anorexic face that he ignores a broken wrist to go get coffee with her. I feel like the author wanted me to like him, but I was repelled by his tendency for addiction and his dependence on someone who clearly doesn't have enough stamina to even stand on her own. I just kept picturing them, ten years down the road, living out of dirty motel rooms and trying to scrape together enough money for some meth, or something. Yeck.
Holly's chapters almost perfectly capture the inner struggles and angst of being a young teenager. Of course, Holly has a little more on her plate than most kids, her sister has an eating disorder, her father is dead and she is half-deaf. Regardless, the relationship she maintains with her sister is touching in its intimacy and realistic in its acidity.
Sometimes the father's preference for Holly seemed a bit extreme. Like he'd basically hurl Giselle in front of a bus because she was standing in front of Holly when he wanted to hug her. I guessed fairly early on why he was drawn to the younger sibling, but that still wouldn't account for a human being completely and brutally shutting out a child.
All-in-all I'd say this was a very well-written and engaging read. The only part I'm confused about is the ending. See, I read all the pages in the book, but I still didn't get to it. I don't need everything to tie up neatly, like Giselle gains 80 lbs and gets married and gets her doctorate and Holly becomes Student of the Year, but I just wished for a little more epiphany and a little less dreariness.