The morbidly obese Ethel Janowski, who is institutionalized due to her bouts of paranoia, depression, and violence, is released into the care of her grandmother, despite Doctor Gerard's unease regarding Ethel's discharge. Upon moving into her grandmother's San Francisco home, Ethel begins consuming massive amounts of food, repeatedly claiming that the employees of the institution were trying to starve her to death. In an attempt to stop Ethel's gorging, Mrs. Janowski empties the refrigerator and locks the cupboards. Ethel and her grandmother argue, and when her grandmother threatens to call Doctor Gerard, Ethel impales her, using a knife. She then mutilates the old woman's hand to get the cabinet key she was holding in a death grip.
Ethel locks her grandmother's corpse in a bedroom, and places an order for more food. When the delivery boy, Glen Dickie, arrives with the groceries, Ethel does not have nearly enough money, and stabs Dickie with a broken bottle when he tries to leave with the order. Ethel's prostitute sister, Rosalie, arrives, and announces that she will staying for a while. Ethel ignores calls from her doctor, and attempts to cover up the odor of her decaying victims when Rosalie complains about the smell coming from the locked bedroom.
While at a bar one night, Rosalie runs into John, her unfaithful and abusive ex-boyfriend, and pimp. John follows Rosalie home, and manages to get on her good side. The two have sex in bed, and John says "Rosalie, I'm gonna tell you the truth for once, okay? You need a good beating every once in a while. All women do. And you especially. Okay?"
Doctor Gerard visits, wanting to know why Ethel has been missing her appointments with him. Ethel bludgeons the doctor with a candlestick holder, and puts his body with the others.
Three days after the murder of the delivery boy, Detective McDonough visits to question Ethel about his disappearance, and leaves after Ethel gives a few evasive statements. That night, Rosalie and John, unable to tolerate the stink coming from Mrs. Janowski's sealed room any longer, decide to break down the door in the morning. After they go back to bed, Ethel murders them, using a cleaver.
Detective McDonough returns to re-interview Ethel, and even though Ethel gives contradictory information, the detective leaves without incident. Ethel proceeds to dismember her victims, stuff the pieces in sacks, and drive them out to a seaside area with the intent of dumping them in the ocean. Since there are too many witnesses present, Ethel is forced to return home with the bags, which she drags back into the house, forgetting to close the trunk of her car on the way in. A suspicious neighbor peers into the trunk, and calls the police after finding a severed hand in it. In the end, Detective McDonough walks in on Ethel eating one of her dead grandmother's arms.
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