Purely in terms of this being a novel about the mental and physiological effects of disordered eating, and the good or bad influence family and friends can have on recovery, it was a pretty good read. I liked the characters and the dynamic between them and the was the anorexics looked down on other residents of the treatment centre for their perceived 'lack of control'. Details like this made the book feel very realistic.
The reason this book didn't get a higher rating was the author's insistence on shoehorning a romance into the plot. There's this whole thing with a secret admirer who sends our MC gifts while she's in a treatment centre (I mean, seriously? If you've got a crush on the girl just hold fire and effin' well leave her alone until she's feeling better instead of bothering her while she's trying to get herself well.
At the risk of sounding flippant, the romance made the book felt a bit like 'Eating Disorders Lite' in some respects. I've never had an eating disorder, so I have no first hand experience, but I have read a number of books about EDs, and compared to others this book just seemed a bit too fluffy. Like, I think we can all agree that eating disorders are a horrific, life-changing thing, right? Well, because the author spent time and effort on including a romance it meant she had less space to talk about Elizabeth's recovery so it made her recovery seem a bit easy.
Elizabeth's family was a welcome inclusion, especially the way they were well-meaning but also deeply flawed. So often, parents are just portrayed as either totally awesome and supportive or else the root of all evil, so this was very realistic.
I'd recommend this book as a decent treatise on recovery after and eating disorder, but I wish I'd been able to give the romance aspect the swerve.