Member Review

Hadley Freeman's 'Good Girls' is a harrowing but illuminating exploration of anorexia, drawing on both her own experiences and those of her fellow patients as well as wider research.

Freeman chronicles her own illness, treatment and recovery with painstaking honesty; this frequently makes for raw and deeply uncomfortable reading as she describes the physical symptoms of anorexia, the effects on her mental health and relationships with others, and the treatment methods employed in the early 1990s (including one hospital where she spent months as an in-patient which resembled a 'Victorian asylum'). However, her openness offers us an invaluable insight into the perspective of someone suffering from anorexia and allows us to understand so much of what might otherwise seem totally incomprehensible: how an apparently innocuous remark may serve as the trigger for anorexia; the sense of pride in looking dangerously ill and total dread of 'looking well'; the effects of living alongside other anorexia patients in hospital. I found the chapter on 'anorexia speak' in which Freeman outlined how she would interpret various well-meaning comments from friends and family particularly enlightening. Freeman writes about her experiences with real insight and self-awareness, but also often with the acerbic humour with which devotees of her journalism will already be familiar; this feels necessary in a book which would otherwise become unbearably bleak.

One of the reasons it makes for such bleak reading is that there are still so few answers to this devastating illness. The book is subtitled 'A Story and Study of Anorexia', and the study part is just as important as Freeman's personal story. With a journalist's dogged curiosity, she investigates how treatments have evolved over the last 30 years, speaking to a wide range of scientists and clinicians. Although progress has been made, much remains unknown. Freeman asks a variety of questions, such as why this illness is one that overwhelmingly afflicts white female patients and the links between anorexia and other conditions such as autism and gender dysphoria. She presents the scientific findings in an accessible but authoritative format.

Another key mystery surrounding anorexia is which patients will recover and which won't - doctors still find it difficult to predict how different patients will respond to treatment. This is reflected in Freeman's inclusion of four stories of fellow patients she met during her illness, whose lives followed very different trajectories, including two who died. This underscores the gravity of this illness and avoids turning Freeman's personal story of recovery into a sentimental happy ending; instead, we realise that this is an outcome that is fortuitous but by no means pre-ordained.

More generally, as the title suggests, this is a powerful work of polemic on the social pressures that girls face as they grew up. Freeman writes incisively about the messages conveyed in literature and media, for instance the validation of sick children and the repeated depiction of 'bad children' as fat. The book ends with a final reflection on her hopes for girls in the future; as she observes, "We can't always change the world, and we can't shield girls from every potential influence. But we can equip them with tools to deal with the world as it is. I wish we were better at explaining to girls what growing up involves..."

This is a moving and necessary book on a hugely important topic. Thank you to NetGalley for sending me an ARC to review.