THE ART OF STARVATION

British novelist MacLeod suffered from anorexia nervosa as a teenager (a relatively mild case), and in this earnest, plain-spoken book she moves back and forth between memories of her own illness and a review of the major anorexia nervosa studies thus far. Those experienced in the literature, then, will find few surprises here: MacLeod sees anorexia as ""a positive strategy aimed at establishing autonomy,"" a response to ""helplessness and hopelessness""; but she also ends up echoing the more standard descriptions--anorexia as a refusal to grow up, to be sexual, to face mortality, to conform to society's image of what a female body should be. (Throughout, the feminist viewpoint is brought to bear intelligently, always with reservations.) Nor does MacLeod's personal story offer anything startling or particularly involving: ambivalent, achievement-demanding parents; isolation at school; horror of menstruation; a sibling's death; 18 months of off-and-on starvation; and a sudden, spontaneous recovery (""without the aid of any sort of therapy""), triggered by her mother's recitation of a Blake poem. Still, MacLeod does a solid job of summarizing the applicable work of Hilde Bruch, Mara Selvini Palazzoli, Salvador Minuchin, Peter Dally, and other specialists--along with references to Freud and Erikson. And she is perhaps strongest in her critiques of therapeutic approaches, with skepticism about most family therapy and enthusiasm (not entirely convincing) for ""existential analysis."" Overall, then: little that's fresh or significant for readers familiar with the area--but, notwithstanding its occasional insularities, repetitions, and lapses in objectivity: a sturdy enough layperson's introduction to a complex clinical subject, with a bit of a personal angle to keep it all from becoming too academic or dry.