The novel delves deep into the raw, messy nature of grief, particularly within a family that has lost a central figure. Jo's struggle to accept Audrey's death, opting instead for a horrifying version of life, highlights the dangerous lengths we go to avoid confronting pain and loss. The story becomes a cautionary tale about the importance of processing grief in a healthy way and learning to let go.

Audrey's return unveils a web of secrets and lies that existed beneath her "perfect" facade. Jo's interactions with Audrey's friends and boyfriend expose the unhealthy dynamics that defined their relationships. This theme explores how appearances can be deceiving and how toxic behaviors can fester even in seemingly idyllic settings.

On a literal level, the novel explores the insatiable hunger of the returned Audrey. Yet, this hunger acts as a metaphor for the yearning and desire that permeate the lives of all the characters. Jo hungers for her sister, for a return to normalcy, for a chance to fix things. This theme examines the different faces of desire and the lengths we go to satisfy our deepest cravings.