In Speaking in Hunger, Donnalee Frega confronts the growing tendency in both popular and scholarly studies to view eating disorders as a secret and private form of negative self-expression "suffered" primarily by women. Drawing on history, clinical studies, and literature, Frega's comprehensive study approaches anorexia not as an illness, but as a dangerous strategy employed by healthy young people of both sexes against unrealistic expectations of perfection.

Frega examines in depth the three areas in which eating disorders are most likely to flourish: the home and family; society, particularly through friendships and romantic relationships; and the religious or spiritual realm. She illustrates her discussion with a lively reading of Samuel Richardson's compelling novel Clarissa, the psychologically realistic story of a "fasting" girl that evoked international outrage when it was published in 1748 and continues to impress scholars and therapists today.

The author considers the broad range of social and cultural factors that have defined "abnormal" eating practices throughout history, and she convincingly argues that when anorexia is viewed as an effective language that is learned and shared through family interaction (rather than as a hopeless attempt to repudiate life), much of its mystery is dispelled.