Here's an interesting thought experiment. What is the relationship between Sabina's struggle with anorexia and her identity as a Colombian American? Well, there is at least one connection. Being unsure about her ethnic identity, Sabina is made to feel something is wrong with her. Since she knows that ethnic identity is partially about appearance, she simply can't talk herself out of the belief that it's because of how she looks. Since she has self-esteem problems that relate to her appearance, she is susceptible to an eating disorder, but luckily, she finds a way through those confusing questions.
The Barbies probably aren't helping though, especially not when Sabina decides that what she likes about them is how thin and gaunt they are. She wants to be skinny so people will be attracted to her, but it isn't even about sexuality. She just wants people to smile at her, but she lives around people who are unpleasant, and she interprets that unpleasantness as a personal reflection of her own self-esteem issues. In other words, "They're mean," becomes, "They don't like me," which becomes, "They don't like me because I'm Colombian," which becomes, "They don't like me because I'm only half-Colombian and half-white, and because I'm too fat—I should eat less." The development of anorexia is partially because of the standards of beauty she adopted in her playing with dolls.
That means that kids are interpreting reality in weird ways, privately, without adult supervision, so to speak. Surely the reader would like to grab little Sabina by the shoulders and smile and say, "You are valued and loved, and nothing about could change that," but Sabina doesn't ever share how she feels about herself. Her self-esteem issues go on privately, without anyone in her family getting a chance to help her. Surely that is the novel's way of saying that one the primary issues of life, or Vida, is to understand that children are answering very deep, dark, little private questions about themselves. Ultimately, the goal of the novel seems to be for people to grow up with a skill set around self-love and confidence.
