Casey Powell, Jennifer Jason Leigh is a seventeen-year-old who moves through life with a quiet resolve: she does well in school, she dreams of becoming a professional ballet dancer, and she longs to be seen for who she truly is. Her world is quietly upended by the attention her 19-year-old sister Gail Powell, Lisa Pelikan receives after discovering she’s pregnant and has no plans to marry. Casey’s parents, Frank and Joanne Powell, shower Gail with focus and opinion, leaving Casey to feel overlooked and left to manage her own growing pains on the sidelines. The family dynamic tightens around Casey’s needs as she contends with a troubling sense of invisibility and a pressure to conform to expectations that don’t fit her.
At the studio, Casey’s desire to fit in collides with harsh realities. After a disappointing cheerleading audition and ongoing whispers about body image, her ballet teacher, Madame Seurat, Viveca Lindfors, hints that Casey might unlock her potential if she loses a few pounds. Those words become a catalyst for something darker: Casey’s earnest drive spirals into anorexia and bulimia as she tries to seize control over her life through her body. The family’s priorities remain outwardly focused on Gail and the path they’ve mapped for Casey—finish high school, get a steady job, and then pursue marriage and motherhood—yet Casey begins to slip away, step by step, as her health falters and her grades decline.
Over the next two months, the situation intensifies. Casey’s obsession with dieting and ballet deepens, and the pressure at home only grows. Gail’s concern deepens into fear for Casey’s safety, but every attempt to intervene triggers friction within the household. A party becomes a flashpoint; Casey lies about eating, her father Frank tries to force-feed her a sandwich, and Casey’s resistance turns physical when she bites him. The family’s attempts to mend cracks seem to miss the root of the problem, and Casey’s need for control intensifies as she hones her craft at the expense of her health.
When Gail notices how thin Casey has become, she speaks up with horror and urgency, and Casey is eventually placed under medical supervision. A doctor orders her to eat normally again, threatening hospitalization if she refuses. Yet Casey persists in secret, and the clash between desire and danger pushes her toward even riskier choices. In a moment of crisis, she is caught stealing from a pharmacy and ends up in custody; her parents bail her out, but a collapse outside the police station lands her in the hospital instead. She tries to run away from the consequences, only to be pulled back and faced with the stark reality of her situation.
Inside the hospital, Casey forms a fragile alliance with Carol Link, a fellow patient grappling with the same demons of anorexia and bulimia. Carol’s hard-won lessons about surviving the system offer Casey practical tricks to cope, but they come at a heavy price when Carol dies from a pill overdose. The loss devastates Casey and sends her into another collapse, forcing a reckoning with her mortality. It is here that she meets Dr. Clay Orlovsky, Jason Miller who becomes a steady, reassuring presence. He helps Casey confront the fear that haunts her—the fear of dying—and he encourages her to be honest about her feelings and to commit to a real, sustained recovery.
As Casey begins to show progress, the family’s dynamics come into sharper relief. Dr. Orlovsky observes the emotional undercurrents that drive her behavior and helps the family understand why Casey sought control in such a drastic way. He explains that Casey’s perfectionism and meticulous self-control were a response to feeling ignored and sidelined in a home where Gail’s needs often take center stage. This insight brings the Powell clan to a moment of honesty, allowing them to acknowledge their shortcomings and to begin healing together.
With time, Casey’s recovery gains momentum and she is eventually allowed to leave the hospital. She remains wary of fully stepping away from the care and the sense of safety she found with Dr. Orlovsky, but the final scenes promise a new balance. The family’s support grows stronger, and Casey discovers a gentler relationship with food and with herself. The story closes on a note of hopeful realism as she enjoys ice cream and begins to reclaim a life free from the grasp of the disorder, embracing small joys and the possibility of a future where perfection isn’t the sole measure of worth.
