When Jennifer Shortis checked herself into the eating disorders unit of Walden Behavioral Care in Waltham, Mass., in July, she knew what to expect: weigh-ins, supervised meals and group therapy sessions. To her surprise, she also knew some of the patients. "Jen," said an anorexic woman she had met at another facility five years earlier, "I thought you beat this thing."
So did she. When Shortis first appeared in PEOPLE in 2001, she felt confident she had conquered an eating disorder that had consumed her since age 15. In her darkest moments, she had considered suicide rather than further burden her family with the cost of treatment. Between ages 15 and 20 she had 12 hospitalizations to stabilize her weight; she was also diagnosed with osteoporosis and low kidney function. Finally, spending a month as an inpatient and nine months as an out-patient at New Hampshire's Hampstead Hospital appeared to offer hope. Her 5'3" frame went from a skeletal 73 lbs. to 95 lbs. Said her mother, Marlene, at the time: "It was a hard road. But we're on the other side of it now."
Released from the center but still working with a therapist and a nutritionist, Shortis resumed her life—earning an associate's degree, taking a job as a teacher's aide for kids with special needs—and scoffed at the notion of a relapse. "I was so ticked at the suggestion," she recalls. "I said, 'No. That is not going to happen to me." But nine months after leaving the hospital, she began, imperceptibly at first, to slip. She would get a cold. Lose a little weight. And feel unable to put it back on. "I knew, rationally, I had to eat more," she says. "But I couldn't fight the thoughts telling me not to."
Within 2½ years her old ways of thinking began to take hold: foods that most people would crave appeared, once again, virtually inedible. "Cake was like seeing a can of cat food—just something you wouldn't eat," she says. She sometimes kept her weight stable, but the fact that her menstrual cycle had never returned—it often stops in anorexics—was a sign that her recovery had stopped progressing.
Unlike anorexics who blog about their celebrity "thinspirations" or wear signifying red bracelets, Shortis did not revel in her disorder. Why, then, did her initial recovery seem to fall apart in the real world? Relapse isn't unusual: Only a third of anorexia patients experience a full recovery (see box).
"For most, getting back into dieting is the real risk," says Dr. Doug Bunnell, clinical director of the Renfrew Center of Connecticut. "Or any weight-loss situation."
By early 2005 family and friends could see Shortis was in trouble. Says Susan Harty, a teacher's aide who works with her: "She stopped bringing her lunch. I harped on her, but I didn't want her angry at me." One day, recalls her sister Carrie, 33, "I watched her put on a pair of jeans that fit my son—my son is 11—and they were too big for her." Her parents, with whom Jennifer lives, noticed her eating less, but felt at a loss. "Fathers tend to want to fix stuff," says her dad, Tom, 64, a retired engineer. "Your kids are suffering; you want to fix it. With anorexia, I finally realized that I can't fix it."
She began rejecting professional advice too. When Shortis's weight sank to 71 lbs. in February 2006, her nutritionist told her, she says, that "it was time for me to go to an inpatient program. I wasn't ready to listen to her. So I stopped seeing her."
By June, Shortis weighed 68 lbs. Her situation was critical, and even she finally realized it. On July 11 she entered Walden. "When I got weighed in and saw my bones protruding from the hospital gown, I started to cry," she says. "What are people going to say? 'Oh, she's back in the hospital; she's never going to make it.'"
This time she vowed to take treatment more seriously. Last time, she admits, she had lied by claiming to be allergic to peanut butter, her biggest "fear food." This time, she says, "if I was going to recover, I had to face peanut butter." She did. "Quite a few times," she says. "It was really good."
Though determined, Shortis sometimes felt discouraged to be again surrounded by anorexics, not all of whom, she says, were ready to get well. "It's hard to see other people hiding food, exercising and purging. The staff helped me stay focused on my recovery." She counted it all as preparation for reentering "the real world [where] people would be dieting and exercising. I have to deal with that." After 60 days, which was covered by her insurance, she says, "I felt I was ready." She weighed 88 lbs.—acceptable to her doctors—and went home.
That was Sept. 6. Since then her mother, Marlene, 61, a practical nurse, has been weighing her three times a week and reporting progress to Jennifer's nutritionist and doctor. Shortis is also trying to stick to her meal plan—breakfast might be oatmeal, an English muffin, applesauce, chocolate milk and yogurt—with a goal of getting up to 96 lbs. (Her dad is pushing for at least 100: "I want her where if she gets sick, she has a cushion to bounce back.")
Shortis is confident recovery will hold this time, though in 11 weeks she's put on only a pound and a half. "There are times I want to give someone my brain for a day," she says. "It's exhausting constantly fighting."
Shortis can point to several victories. On her birthday in September, she had a piece of cake for the first time since 2000. More recently she accepted a friend's invitation to dinner—her first time eating out with anyone but her parents. "I was happy," says Shortis. "I'd do it again."
Also in her plan: finding a new therapist near her home, a critical component for recovery. So far, she says, "I haven't found anyone who is really an expert in eating disorders." Until then, Shortis, now back at work, finds inspiration in her students. "Some are both deaf and blind," she says. "I try to reach in and get to the person inside. Even though they are trapped and have limitations, there is somebody in there. It is, in a sense, the same for me. I want the Jen person in me to come out. I want to have energy and look forward to things. I want to live."