This was a disappointing read. The characters were one-dimensional, so poorly fleshed out that it was impossible to relate to them or care about them. The main character, Lisa, had no personality outside of anorexia, and while I understand that eating disorders tend to take over the lives and identities of sufferers, there is still a person underneath the illness. And I think this is a point that all writers of eating disorder fiction and non-fiction need to drive home, so that people can see beyond the illness and reach the real human beings suffering from them. I did appreciate how the author tried to show the ugly side of eating disorders with the detailed descriptions of constipation, bowel movements, and vomiting, but because the characters were so flat, I can only read those scenes from a detached point of view and I feel like they would have been more powerful if I could better feel the characters' pain.
Because the book was so short, the plot moved fairly quickly from scene to scene that the story sometimes felt disjointed and many things were unexplained. The mythology of the four Horsemen was completely lacking. I would have like to know more about where they came from/how they do their jobs/how do they choose who to become a Horseman and why did they choose Lisa? The story was resolved too quickly and easily.
The writing was very uneven. I feel like there is way more telling than showing in the book. Kessler often tells us how a character feels, rather than showing us through the character's actions and behaviour. Occasionally though, Kessler shows that she has a knack for writing description. There are some really wonderful turns of phrase and beautifully-written paragraphs describing the famine-ravaged places that Lisabeth travels to, Lisa's kitchen and her mother. But then Kessler will randomly insert a joke or an awkward description ("..she'd just moved like some sort of ninja superhero. How freaking awesome was that?") which, for an overall very serious book, feels incredibly jarring and out-of-place in the narrative.
Overall I was rather bored with this book. I felt like I was reading a description of a story rather than an actual story. I felt no real emotion while reading this because none of the characters and their situations were really developed, and because of that, I couldn't enjoy it. It was an interesting concept but totally wasted, however I do think Kessler's writing has potential.