Understandably suppressed by Richard--I won't spoil it for you--it is at turns hiariously bitchy, grotesque, tender, and cruel. At the same time, it elevates the subject matter, leaving this viewer with a much deeper sense of appreciation for the Karen. I laughed at them, and it made my like both of them more.
The story is dramatized through carefully and minutely constructed sets populated by Barbie dolls clothed in carefully crafted period clothes. Karen's descent into anorexia is represented through whittling down the face and arms of the Barbie doll that portrays her, which has an effect both hilarious and disturbing.
All in all, it feels so much like a "real" documentary, I can't tell you that it isn't. It's treatment of the subject of annorexia and it's effect on Karen's life is at once silly and serious.
I saw it on DVD. The box had next to nothing printed on it. It was obviously bootlegged from somewhere, but the print I saw had good quality audio and visual.