Liesbeth and Angelique Raeven, working together as L.A. Raeven, make their unhealthy thinness into the subject of their art. In documenting perverse extremes of common desires for thinness and a ‘soul mate’, they claim that they want women to confront and moderate socially imposed insecurities. Undermining their stated goals, however, are concerns that they may represent the ‘pro-ana’ anorexic subculture, hijacking the language and attitudes of subversion, identity expression and activism to intellectualize their own mental illnesses. This article investigates their work within the contexts of their professed motivations, medical literature about anorexia and ‘pro-ana’ communities, feminist theory on these subjects, and contemporary art about and by mentally ill and self-harming artists. As a model for engaging art produced at high risk to the artists themselves, this article explores the role and responsibilities of audiences and professionals in creative fields to identify and address boundaries between self-expression and self-harm.