The Earth, My Butt, and Other Big Round Things was a very good book. The narrator was easy to relate to, interesting, and not whiny (which was what I expected).
I found myself in tears a few times during the book, as Virginia deals with more than just her weight, but also an over-achieving family, romantic hardships, isolation, and a crime that her brother commits.
I picked up this book because it was on a banned book list. I have a hard time recommending this book for high-schoolers, even though Virginia (the narrator) is in high school.
I would, however, recommend this book to any girl (probably aged 17 and up) who has ever dealt with being overweight. Virginia handles many facets of being heavy in such a short time span/length of a novel.
So yes, not a 'clean read', but one that I would recommend none-the-less.