As usual, Ellen Hopkins touches on several tough subjects that face teens (well, and adults...but it's written about and for teens especially). Suicide, eating disorders, steroids, pursuing dreams that parents may disapprove of, sexual orientation, to name a few.
I liked how in this book it was 4 separate people (as is usual in her work), but that at first their connections weren't totally apparent. Of course Kendra, Cara and Sean knew eachother, but Andre was from a different school. It tied it all together, along with several other characters whose stories we read but not from their own point of view.
A big thumbs-up from me. Read Impulse, then read Perfect. The books actually run alongside each other, and I read Impulse so long ago that I had forgotten parts.