Over the last few years, most eating-disorders researchers have begun to think that there is no single cause of anorexia, that maybe it's more like a recipe, where several ingredients -- genetics, personality type, hormones, stressful life events -- come together in just the wrong way. Maudsley practitioners say that focusing on the cause is secondary, ultimately, because once the physiological process of starvation kicks in, the disease takes on a life of its own, unfolding with predictable symptoms, intensity and long-term consequences. Anorexics become almost uniformly depressed, withdrawn, enraged, anxious, irritable or suicidal, and their thinking about food and eating is distorted, in part because the brain runs on glucose, and when it has been deprived over a long period of time, when it's starved, it goes haywire. It's important to get the patient's weight up, fast, because the less time spent in starvation, the better the outcome. Adult anorexics who have been chronically ill for years have much poorer prognoses than teenagers.

I called Daniel Le Grange, an associate professor of psychiatry at the University of Chicago, who directs the eating-disorders program there. Le Grange spent five years training at Maudsley Hospital in England, and he and James Lock, a professor of child and adolescent psychiatry and pediatrics at Stanford, have written Maudsley treatment manuals for physicians and therapists and a book for parents. The two are in the middle of a $4 million N.I.H.-financed study designed to measure the effectiveness of the Maudsley approach. Le Grange compared anorexia to cancer. "If you leave it, it's going to metastasize," he said. "You need to figure out an aggressive way to eradicate it as quickly as you can. You're not going to hear an oncologist say, 'Oh, it's Stage 0 cancer, let's wait till it becomes Stage 3.' "

I asked Le Grange what he thought about a critique of Maudsley: that it violates the usual boundaries between child and parent, derailing the adolescent work of separation and individuation. "If your child has diabetes and doesn't check her blood sugar often enough, you'd make sure she did," Le Grange reassured me. "What we're trying to achieve is taking anorexia away so the child can go on her way unencumbered by the eating disorder. What could be more respectful of adolescent development?"

There were no local Maudsley therapists, so my husband and I lined up a pediatrician (in whose office Kitty was weighed weekly), a psychiatrist (whom she saw weekly, then twice a month), a therapist (weekly) and a nutritionist (two or three visits). We didn't know if Maudsley would work. We didn't know if it was, objectively speaking, the best choice. But anything was better than watching Kitty disappear, ounce by ounce, obscured by the creature who spoke with her voice and looked out through her eyes. Anything.

On Day 2 of refeeding Kitty, our younger daughter, Lulu (also her nickname), turned 10. We had cake, a dense, rich chocolate cake layered with raspberry filling -- one of Kitty's favorites. Of course she refused it. I told her that if she didn't eat the cake, we'd go back to the hospital that night and she would get the tube. I hated saying this, but I hated the prospect of the hospital more. The tube felt like the worst thing that could happen to her, though of course it was not. Five minutes after Kitty was born, I fed her from my own body. Now the idea of forcing a tube down her throat, having a nurse insert a "bolus" every so often, seemed a grotesque perversion of every bit of love and sustenance I'd ever given her.

She sat in front of the cake, crying. She put down the fork, said her throat was closing, said that she was a horrible person, that she couldn't eat it, she just couldn't. We told her it was not a choice to starve. We told her she could do nothing until she ate -- no TV, books, showers, phone, sleep. We told her we would sit at the table all night if we had to.

Still, I was astonished when she lifted the first tiny forkful of cake to her mouth. It took 45 minutes to eat the whole piece. After she'd scraped the last bit into her mouth, she lay her head on the table and sobbed, "That was scary, Mommy!"