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Understand the complexity of eating disorders in dancers

This is an excerpt from Dance Psychology for Artistic and Performance Excellence With Web Resource by Jim Taylor & Elena Estanol.

Disordered eating is one of the biggest risks faced by dancers, particularly women. Though few dancers develop a clinically defined eating disorder (ED), many engage in some form of dysfunctional eating due to the physical aesthetic woven into the fabric of much of the dance world, especially in ballet. Quite simply, many choreographers, dance masters and mistresses, and dancers themselves expect dancers to look a certain way.

Although this aesthetic is changing in some parts of the dance world—for example, under the influence of noted choreographer Mark Morris—the perceived need to sculpt a certain type of body drives many dancers to eat in unhealthy ways. For a significant number of those dancers, this change in eating behavior results in clinically diagnosable eating disorders with dangerous implications for their physical, psychological, and emotional health. Moreover, in some cases, this harmful eating causes severe health problems and even death.

Our concern for dancers' health has been heightened by public and private accounts of struggles related to eating disorders. Examples include the highly publicized death of 22-year-old ballerina Heidi Guenther, autobiographical accounts such as that of Gelsey Kirkland, and ongoing anecdotal reports from current dancers. We encourage the dancers with whom we work to become informed about their eating habits and, most important, to make good choices about their diet and health.

This chapter first presents the diagnostic criteria for each eating disorder described in the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the "bible" of psychological diagnoses, which is published by the American Psychiatric Association. Often, athletes and dancers have a narrow idea of what constitutes an eating disorder; as a result, they may underestimate the severity of disordered eating behaviors in which they commonly engage. Our hope is that you will be able to recognize any disordered behaviors in which you may engage, as well as the associated risks, and then be willing to seek appropriate help.

The second part of the chapter provides a broader understanding of the complexity of eating disorders, describes the risks factors contributing to their development, notes associated features, and makes recommendations for what to do if you suspect that you or a friend may be struggling with an eating disorder. The chapter also teaches you how to recognize unhealthy eating patterns and validates your efforts to fuel yourself properly. Finally, the chapter offers guidance for seeking help to get yourself back on the path to healthy eating.

Eating disorders are complex medical and psychiatric illnesses that go beyond body or weight dissatisfaction and lead to destructive patterns of eating behavior. To summarize quickly, these problems are disorders of both too much and not enough. They usually involve a high drive to do too much, a need for order and control, as well as a sensitivity to feeling emotionstoo strongly, often causing great distress. The behaviors of the eating disorder are attempts to regulate this sensitivity, but, due to the drive that people with eating disorders often have, they take things to an extreme. As a result, guilt and shame keep them in a state of secrecy, often feeling "not good enough."

These disorders are often accompanied by anxiety, depression, obsessive-compulsive thoughts and behavior, an eerie detachment from reality, and, in extreme cases, dissociative disorders. For example, when one young dancer was confronted with the damage that she was doing to her body and the risk of dying from her illness, her response was this: "At least the pallbearers will be able to lift my coffin without hurting themselves."

Indeed, eating disorders constitute one of the leading contributors to mortality among psychiatric disorders, and their prevalence is on the rise, particularly among adolescent and young adult women living in a culture in which thinness is revered. Studies have found that athletes are about 13 percent more likely than members of the general population to develop eating disorders. More specifically, many studies have indicated that dancers are particularly vulnerable, due to the intense pressure they experience regarding their weight and appearance.

In fact, research has shown that dancers (and participants in other aesthetic sports, such as figure skating) are at the highest risk (20 percent) for developing eating disorders. Studies have reported prevalence rates of eating disorders in dancers that range from 7 percent to 45 percent. For example, a study conducted by Elena in 2008, involving more than 200 dancers in professional schools and companies, found that fewer than 10 percent of the dancers admitted to a current or past diagnosis of an eating disorder. However, 55 percent of female dancers and 27 percent of male dancers admitted to being currently dissatisfied with their weight. These findings indicate that many dancers experience pressure to lose weight and conform to a certain physical aesthetic.

Learn more about Dance Psychology for Artistic and Performance Excellence.

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