enlarge Gregory Rec/Staff Photographer

Jill Johnson, a former McAuley High athlete, received help from a Portland hospital’s program, but the recovery hasn’t been easy.

enlarge 2009 Telegram File

Ashley Marble, right, a former UMaine and Southern Maine athlete, says eating disorders are overlooked in athletes.

enlarge 2006 Telegram File

Patrice Lockhart is a doctor who heads the eating disorder program at Mercy Hospital in Portland, which treats 400 patients per year.

may be particularly vulnerable to eating disorders.

Lockhart, the medical director, said there's even a new term describing an eating disorder born not from a desire for thinness, but from a desire for health and proper nutrition. It's called orthorexia and, translated from Greek, means "correct appetite."

The line between a practicing vegetarian and a disordered eater can be a fine one, particularly if the athlete is in denial or dealing with other issues such as depression or anxiety.

"Oh, it can be a very, very complicated topic to deal with because there's so much going on," said Audrey McKenzie, head athletic trainer at Portland High. "There are psychological aspects and emotional components to it. Sometimes it goes real deep."

"It's a red flag when I see a kid starting to count calories," said Arlene Verre, now in her 16th year as head trainer at Kennebunk High. "Most of the kids who have had it here have been extremely intelligent individuals, usually in the top 5 percent of their class, with a very hard work ethic. They want to get better at their sport. They start training, lifting weights, and they become obsessive because they see good results and people tell them they look great. Then they start losing control of it and get bogged down and start controlling their food more."

Both Verre and McKenzie try to educate their athletes, coaches and parents about the importance of rest and recovery, and of providing enough fuel for growing bodies. At Kennebunk, Verre encourages all female athletes to safeguard their knees by building up muscles in their hips, thighs and buttocks, often with resistance that has nothing to do with barbells.

"I have females who don't want to have big butts," she said. "But we want them to do squats. It's not good to be skinny. You need to have power to prevent knee injuries."

Not until she felt powerless did Johnson, the runner from McAuley, finally admit her eating disorder. A friend helped her make an appointment with her doctor, who encouraged her to enroll in the Mercy program.

"I got to the point where I couldn't function," Johnson said. "I was so tired. My body was sore. I couldn't do anything. I was really, really miserable. At the same time I was scared to gain weight. Obviously I was really out of shape, but in my eating-disorder mind I was in shape."

Johnson spent three weeks at Mercy, arriving at 7 in the morning and departing 12 hours later. She ate three meals a day under supervision, plus snacks in the morning and afternoon.

"There are people of all ages there," she said. "Teenagers, people in their 40s and 50s. People who have been struggling for 25 or 30 years. And that was huge motivation. I thought, 'Wow, I do not want to be them in 30 years. I want to put this in my past. I want to have a life.'"

Family members and close friends became trained observers, monitoring Johnson when she used the bathroom or showered (she was required to sing or at least talk while behind the curtain). On weekends they prepared her food.

"They had to be compassionate and supportive but tough," Johnson said, "because if you're struggling with an eating disorder, you're going to try to manipulate the situation. It was a huge responsibility for them."

Johnson spent one more week in a transition mode, taking only one meal at the hospital, before testing the waters on her own for a week before leaving for college. She made it through the fall and winter before suffering a relapse brought on, she said, by starting to run again when she was deemed physically safe, according to her weight and body mass.

"But," she said, "I wasn't emotionally able to run."

She returned to Mercy for three weeks, gained weight and returned to school. She remained there throughout her sophomore year, spending a month on crutches after developing stress fractures near her right knee and ankle after joining Clark's track team.

This summer she's been running sporadically, when she feels like it rather than when she feels she ought to, and working in Kennebunk Beach tending gardens.

Her major is philosophy with a minor in elementary education. Her long-term plan is to teach. Short term, she plans to run cross country, more for the social aspects than competition.

And if she can educate others about the dangers of eating disorders, that would be worthwhile, too.

"It took me a while to come to terms with it, that this is something I'm struggling with," she said. "People may think that it's a fault of their own, that it's not a disease, which it is. It's similar to alcoholism. You don't see it happening to yourself. It just happens and you have no control over it."

Johnson counts herself fortunate she has no lasting heart or lung problems, and shows no signs of osteoporosis or calcium deficiencies. She still battles her caloric demons, still fears cheese and white bread and waffles, but she knows the alternative is worse.

"Going back to the eating disorder just isn't worth it," she said. "I'd have to sacrifice so much. I wouldn't be able to run. I wouldn't be able to be at school. And I don't want to go through that again. It's hell."

Staff Writer Glenn Jordan can be contacted at 791-6425 or at:

gjordan@pressherald.com