Through Thick and Thin : LIFE-SIZE, <i> By Jenefer Shute (Houghton Mifflin: $19.95; 230 pp</i> .<i> )</i>

Anorexia is the perfect crime. The victim is also the perpetrator, who, in an effort to gain control over a life run amok, marshals the will to at least gain dominion over the increasingly narrow sphere of the body. It’s hard not to admire the protagonist who triumphs. Magazines and sound bites tell us what we should want to look like, what we should want to eat, what we should want to achieve and own. Dysfunctional families and failed relationships wreak havoc with the image of self.

“Life-Size,” Jenefer Shute’s first novel, contributes more to our understanding of the horrors and frustrations of anorexia than it does to the art of the novel. Josie, a graduate student in economics, has starved herself so successfully that her parents have her institutionalized in a clinic for people with eating disorders. This is her immediate universe throughout the novel, and she describes it in a voice that is unmercifully critical, sarcastic and ironic. The staff--”Miss Pert,” “Miss Squirt,” “Squeaky,” and “Dr. Frog”--are noted for their “sagging buttocks,” “Turkey’s tired wattles” and “baggy eyelids.”

The French have an expression: mal dans sa peau --bad in one’s skin. It describes a state in which one feels alienated from one’s self; body, mind and spirit all flail akimbo. The anorexic thinks she’s found the perfect way to rein them all in and tell them who’s boss.

Josie has sculpted, out of an unpleasant but fairly generic past, a self that she can control. “What lover,” she thinks, “in his urgent rush to ram himself into me, can properly appreciate what I have created here--the lean skid of the flank, the poignant ridging of the rib cage, the tiny bones of the feet.” But self-hatred, the Mr. Hyde of self-image, takes some of the fun out of the sculpting: “I’m ugly, ugly, inside and out.”

She can control but she cannot care for, and here’s one of life’s little razor’s edges, one that the anorexic straddles: between controlling and caring for. It’s the line between individual and lovers, friends and children; between functioning in a difficult world and enjoying life, between self-hatred and self-respect. “Don’t say, ‘I have a body,’ ” says Josie’s nurse, trying to bridge the gap. “Say ‘I am a body.’ ”

Full of descriptions of food that are more reminiscent of “The Cook, The Thief, The Wife and Her Lover” than of “Babette’s Feast,” the worst excretions of both food and sex are graphically juxtaposed in “Life-Size,” leaving the reader with no appetite for either pursuit. One meal consists of a “corpse and a tree; a fluid secreted by bovine mammary glands. Gobs of congealed grease.” Yum. You can just imagine what she does with sex (“9 calories per teaspoon”).

In between meals that serve as the battleground between patient and staff, Josie drifts in and out of flashbacks and daydreams. Memories of an overbearing mother, an ambiguous sexual relationship with her father, and an adolescent’s typically appalling first encounters with love and lust help to explain the cold detachment of the voice in the hospital bed, disembodied in every sense of the word. More discussion of these memories, and fewer descriptions of food, would help us to better understand her current condition.

Josie doesn’t seem to get better, just a little fatter. The memories don’t cohere into anything more than self-hatred. You get the feeling that once she’s back out in the primordial soup, studying economics’ most elegant and parsimonious theories, she’ll undo everything you’ve lived through with her. In the end, you might understand Josie, but you still don’t like her; Shute has successfully created a character almost beyond empathy. Josie is relentlessly mean-spirited, so alienated that you can hardly feel sorry for her in your haste to get away from her. She takes all the sap out of life, and she does it so actively and aggressively that it’s hard to see her as a victim. No one ever said you had to like the main character in a novel, but it sure helps, especially if you’re trapped in a hospital room for several weeks with her, and the food is bad.