"It's hard work, and it's not easy. I wouldn't wish this on my worst enemy," Shanholtz says.
She also participates in a weekly therapy group at Meadowbrook. The program helps patients try to understand why they use food as they do, and why it is a coping mechanism, says Jackie Ewing, a therapist at Brook Lane who treats eating disorders and serves as co-leader of the group.
"Once we learn what dynamics in their life contributed, we try to identify ways they can begin to break the pattern," Ewing says.
Persons with eating disorders often have an underlying problem such as family troubles, emotional distress or social pressures, says Chris Zoller, leader of a Hagerstown support group that is part of National Association of Anorexia Nervosa and Associated Disorders.
"They turn to food, because it's the one thing they can control," Zoller says.
Shanholtz says her struggle with her weight began when she was a child. She weighed 185 pounds, and her doctor suggested that her parents have her join Weight Watchers.
When she lost weight, people started to notice her, she says.
She developed anorexia in her early teens, and at one point she was down to 69 pounds. She was hospitalized numerous times, and she weighed 70 pounds for 10 years.
"I had to wear kids' clothes, and I didn't want to go outside the house," says Shanholtz, who has been married twice and has a 15-year-old daughter.
She cooked and baked constantly, watched cooking shows on television and went to the grocery store to look at food, she says.
"When your main concern is food, it's all you think about," she says.
Persons with eating disorders also become obsessed with body image, she says.
"You look in the mirror and see a fat person, and you're not fat," she says.
She'd go for treatment, then she'd slip back into her old pattern.
"I had my own little world I lived in, and I had no life. I purged every time I ate or drank, from the time I got up until the time I went to bed," she says.
She knew she needed help. Her doctor suggested she talk to a counselor at Brook Lane.
"I knew I could either die or go get some help," she says.
Shanholtz says she was trying to please everyone and make them love her.
She's learning that she needs to do things to make herself happy, and she can't live her life for someone else.
To remind herself of her importance, she posts messages on the refrigerator and walls of her Hagerstown apartment. The notebook pages, bearing phrases such as "I am worth it," "I am not a failure" and "I am worthy because God says I am worthy," help strengthen her resolve.
People without an eating disorder don't understand the hold it takes on a person, she says.
"They say `Just go ahead and eat.' "
Shanholtz - who is 5 feet, 6 inches tall - now weighs 102 pounds and has a goal of 125. She has osteoporosis and is taking medication to build her bones.
She knows there will be ups and downs.
"It's no straight path up - you don't just get over it," she says.
She wants to encourage others who have eating disorders, or who might be developing symptoms, to seek help.
"I still wonder why I'm still living. God does have some purpose for me," she says.