Take a moment to picture a young woman engaged in the art of dance. Imagine the fluidity of her lithe body, her graceful and precise motions, the exquisite execution of complex moves. Such an image is easily conjured and a delight to consider. Not so easily conjured and decidedly less delightful is imagining that same woman several years later, after her body has been ravaged by an eating disorder. She may have heart abnormalities, intestinal dysfunction, infertility, advanced osteoporosis, and other medical problems. While still a young woman, she could have the skeletal structure of an 80-year-old.

 

Today, more than 7 million women and girls in the United States suffer from eating disorders. Those with anorexia starve themselves to dangerously thin levels, while those with bulimia binge uncontrollably on large amounts of food, then purge the calories out of their bodies through such methods as vomiting, starving, excessive exercise, and laxative and diuretic abuse. The average age of onset for an eating disorder is 13; up to 20 percent of those with anorexia will die from the disease. Most anorexics, about 90 percent, are female, but males (especially male dancers) also develop the disorder.

 

Though eating disorders are “equal-opportunity” illnesses (meaning they cross all socioeconomic, ethnic, educational, and regional lines), anorexia and bulimia are particularly common in the dance community. Research shows that women who dance have somewhere between 2.5 and 7 times the prevalence of anorexia as women in the general population. Women who dance may also have the highest rates of anorexia among female athletes. Even more alarming, the majority of college dancers—at least 75 percent—are likely to have an eating disorder or significant disordered eating behavior.  Disordered eating includes behaviors (such as fasting or eliminating entire food groups) that do not meet technical criteria for an eating disorder but which often have serious medical and emotional consequences. No data are available for the prevalence of anorexia in non-college-age dancers, but experts suggest that rates are fairly high. Dancers with eating disorders and disordered eating behaviors fatigue more easily and experience muscle weakness, stress fractures, and other injuries more frequently than their healthy peers.

 

Though this information is disturbing, it is not surprising in a world where the body is the focus and the artful instrument. A dancer may get stuck on focusing on her body and an eating disorder may arise, especially in disciplines that accentuate weight, leanness, or thinness, such as ballet. In addition, the personality characteristics found in committed dancers, such as perfectionism and extreme drive and discipline, are the same attributes that make people vulnerable to developing eating disorders.  In contrast, a healthy dancer will regard her body as a medium of expression rather than the focus in and of itself.

 

Unfortunately, for a woman or adolescent who is committed to her art, an eating disorder may appear as an attractive and viable tool to achieve or maintain the “look” she strives for.  Indeed, many young women teach one another how to master the techniques of anorexia and bulimia. They believe the behaviors are harmless, merely an innovative method of weight loss. But they are wrong. Eating disorders kill more people each year than any other psychiatric illness, including depression. Even when the illness is not fatal, it often leaves its victims with devastating and permanent health problems. 

 

 Interestingly, one of a dancer’s most important tools may become her greatest nightmare: mirrors. Dancers stand before floor-to-ceiling mirrors for hours each day. The intent is to analyze the execution of the dance, but simultaneously, even subliminally, they constantly scrutinize their bodies. They grow aware of every tiny flaw, every unwanted change in their shape or size, and they compare themselves to others.  This is particularly detrimental to adolescent girls, for whom it is developmentally normal to compare themselves to others.

 

Although she may desire to change her body, a dancer cannot will herself to have longer legs or a more defined facial structure; she cannot make herself grow taller. Feeling as though she has no control over these features, she may become obsessed with what she believes she can do—control her weight by starving herself, using laxatives and diuretics, binging and purging, or exercising compulsively.

 

Does this mean that all mirrors should be banned and adolescent girls should never dance near one another? Certainly not. However, dance professionals hold a unique position in the lives of dancers. They have consistent and close contact with these women and girls; often, they see more and perhaps even know more about them than do parents or other family members. Although these professionals may not be privy to certain warning signs of an eating disorder, such as the loss of a menstrual cycle, they often are aware of other telling signs, such as:

 

·        Rapid weight loss

·        Intense fear of being overweight

·        Preoccupation with dieting and food

·        Eating little

·        Taking up smoking (especially among those who would normally not smoke)

·        Excessive caffeine use

·        Hyperactivity, including fidgeting or excessive exercise

·        Intolerance of cold

·        Baggy or full-covering clothes (to hide thinness)

·        Skin and hair problems, like sallow, dry skin; thin, dry hair; hair loss; fine hair growth

·        Swollen salivary glands (“chipmunk cheeks”)

·        Mood changes, such as anxiety, depression, irritability, obsessions/compulsions

·        Social withdrawal

·        Perfectionism and low self-esteem

·        Excessive fatigue and poor concentration

 

 What you can do:

Think about the women and girls you see in the studio and in classes. If certain dancers come to mind when you review these warning signs, then consider taking a few simple steps.

 

1.   Get additional information and materials on eating disorders. Two excellent websites are www.nationaleatingdisorders.org and www.remudaranch.com

 

2.   Address the topic with the dancer. Do so when her stress is low, without interruption, and in privacy. Explain why you feel as you do; provide concrete examples of what you have observed and why you are concerned. If the dancer is a child, speak to her parents. If you suspect that a very young girl has an eating disorder or appears to be heading in that direction, you are probably correct. Eating disorders are now being diagnosed commonly in children as young as 9 and occasionally in those as young as 6.

 

3.   Once you have calmly expressed your viewpoint, listen with compassion and patience. Do not judge the dancer or her chosen actions. Encourage her to seek professional help.

 

4.      If the girl does not seek help and her symptoms worsen dramatically—as evidenced by a great deal of vomiting, exercise despite stress fractures, or self-starvation—you need to take action. A call to a friend or family member is justified since the dancer may need urgent medical attention. Certain symptoms, such as fainting or chest pain, can indicate life-threatening conditions and warrant a call to 911 or immediate transport of the dancer to an emergency room.

 

As a final thought, everyone in the dance community should think hard about the focus and language used during dance instruction. An emphasis on achieving strength and health, instead of weight loss in order to be thin, may encourage dancers to develop a healthier relationship with their bodies rather than an obsession with weight and rigid dietary controls. The truth is that everyone was not created with the same petite body type. Today, far too many women, adolescents, and girls are compromising their health and even their lives to achieve what may be unattainable for them.

 

 

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