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Dancers and Eating Disorders

Hillary Roberts

27 April 2011

 

What is Dance?

            Dance is a form of art movement that focuses on the movement of the body, typically relative to some form of music. Some people choose to study this movement, and the type of movement varies depending on what type of dance they choose. Unlike tap and folk dance, ballet, modern, and jazz are three common dance forms that require the use of the whole body. All of these focus on the flexibility of the body and are mainly cardio and aerobic exercises. In relation to eating disorders, dancers are not required to be thin, but in order to achieve the perfect silhouette or have the flexibility to perform certain movements, they will engage in unhealthy behaviors. This strive to have a perfect silhouette can lead to a dislike of the current state of one’s body, or a negative body image.

What is Body Image?

            The body is a constantly changing entity. Everything about it is altered and shifted, expanded or contracted at some point in one’s life. These changes in appearance are embraced by some but shunned by others. Those who embrace these changes have a positive body image, they are proud of what they see when they look in the mirror. In contrast, those who shun the changes in their bodies have a negative body image, or body dissatisfaction. To people with a large amount of body dissatisfaction, body shape, weight and appearance are incredibly important to their everyday lives. This feeling can lead to the belief that they must change the way they look in order to feel better about themselves. One of the ways to change is to alter one’s eating behaviors, and by doing this one can control their weight and possibly the size of their body.

What is Anorexia Nervosa?

            Eating disorders have become more and more common in the past few decades, anorexia nervosa being one of them. Anorexia is “characterized by a refusal to maintain body weight at or above what is considered a minimal normal weight for age and height” (Dancyger et al., 2008, p. 1). The DSM-IV defines specifically what qualifies for specific disorders such as anorexia nervosa and bulimia nervosa, among others. According to the DSM-IV, in order for a person to be diagnosed with anorexia nervosa, there must be a refusal to maintain body weight at or above what is considered a minimally normal weight for age and height, a fear of becoming fat or gaining weight, despite being underweight, amenorrhea in women, lack of at least three consecutive menstrual cycles, and a denial of the seriousness of low body weight. Many of the people who have been diagnosed with anorexia nervosa first had low self-esteem or body dissatisfaction.

Eating Disorders and Dancers

            In an experiment performed by Toro et al. (2008), 76 adolescent dancers, who combined dancing and school studies, answered questionnaires to assess “attitudes to eating, cultural influences on the body shape model, eating disorders, and risk factors for eating disorders” (Toro et al., 2008). From these questionnaires it was discovered that these dancers demonstrate prevalence toward eating disorders and risk eating behaviors that were similar to like adolescents in the general population. The dancers in the study also had a higher prevalence of amenorrhea that coincided with a considerably low BMI, body mass index. It was also discovered that those that participated in dance classes had a dedication to physical exercise that exceeds the dedication of those in the general population. Also these dancers had a greater desire than the general population to reduce the size of their breasts and buttocks. Many of the dancers questioned felt pressure from the authority figures on their choice of food, physical appearance, and weight.

Thinness-Related Learning

            In research performed by Annus et al. (2009), it was hypothesized that a major risk factor in future eating disturbance is specifically learning about thinness in a dance class. To perform this experiment, Annus et al., implemented the expectancy theory, which suggests “social learning experiences lead to the formation of expectances for the consequences of behavior, which affect the future likelihood of that behavior” (Annus et al. 2009). 500 college-aged women were questioned about their previous experiences in dance, what they learned about thinness in dance classes, as well as their eating behaviors and attitudes toward thinness. In the results it was found that simply taking dance class had no relation to the symptoms of eating disorders, however, those women who participated in higher-level dance classes were more likely to learn thinness attitudes and behaviors. Therefore, those women are at greater risk for exposing themselves to environmental risks to eating disorders. Particularly women who participate in competitive dance training, including but not limited to college conservatories and professional ballet schools, experience increasing symptomatology in relation to eating disorders, particularly anorexia nervosa. This study was, of course, subject to the honesty of the participants and their personal opinions of their learning.

            Annus et al. (2009) also reported on other studies that researched the amount of dancers that experience some or all of the risks of eating disorders. The different risks evaluated included levels of body dissatisfactions, pathological weight control behaviors, amenorrhea, and the prevalence of eating disorders. In all of these areas, dancers exhibit higher levels than non-dancers. It was thought that these levels are considerably higher in dancers because both characteristics appear in most dancers as well as being in an environment that promotes dieting and thinness.

Amenorrhea

            One of the main symptoms of anorexia nervosa, the eating disorder that afflicts most of those dancers with eating disorders, is amenorrhea. This can be associated with high levels of activity and inconsistent eating behaviors. Amenorrhea can also be associated with late menarche, or the time when a girl begins her menstrual cycle. In the results of an experiment comparing the rates of amenorrhea and late menarche in dancers and non-dancers Frisch et al. (1980) reported the results from 89 young ballet dancers. The results collected were consistent with excessive thinness, a consequence of anorexia nervosa. For thirteen dancers, a late mean age of menarche of 15.4 years was reported and associated with thinness and hard training. Compared to both a group of women runners and college athletes, all had a consistently late age of menarche. With the runners, there was a positive correlation with the number of miles run per week. Occasionally menarche occurs after a person sustains an injury that prevents dance, this situation supports the thought that a change in the ratio of fat to lean body tissue and the changing metabolic and hormone levels that go along with physical exercise could be factors in late menarche and amenorrhea in dancers. Although the occurrence of amenorrhea and late menarche in dancers does not suggest the presence of anorexia nervosa in dancers, it shows a significant presence of one of the major symptoms of anorexia nervosa.

Athletes

            Ravaldi et al. (2003) studied dancers, gymnasts, and body builders and their relationship with eating disorders. Roughly 113 female dancers, 54 female gym users, and 44 noncompetitive male body builders were compared to a number of male and female controls using several tests to compare the prevalence of eating disorders. In terms of the dance students, dancers who participated in the study were selected randomly from several non-professional schools. In order to be included they had to participate in at least three hours of ballet lessons per week and have participated in the last two ballet exhibitions put on by the school. The results showed that the BMI, body mass index, of the dancers was significantly lower than the BMI observed in both the gym users and the control groups, and about thirty percent of the dancers were underweight. Overall, the dancers and gym users had a higher prevalence of eating disorders than their control groups.

One common characteristic Ravaldi et al. (2003) among dancers and body builders, regardless of weight, was body image disturbance. Typically, body image disturbance is seen in overweight subjects, which suggests that this disturbance could potentially lead to a distorted perception of one’s body, thus increasing this person’s risk of developing an eating disorder. It was determined in this study that the dissatisfaction that results from body image disturbance, the competitive environment that goes along with any sport, including dancing and body building, that hinders on appearance. Dancers strive to achieve what has been deemed the perfect silhouette for performing professionally and in order to achieve this they risk developing an eating disorder by engaging in inappropriate eating habits and having an uneasiness about the shape of their bodies. The likely eating disorder for dancers to develop is anorexia nervosa, because those with anorexia strive for thinness as many dancers do.

Discussion

            The studies used in this paper, show that there is a positive correlation between dancers and eating disorders, particularly anorexia nervosa. This result may stem from the characteristic of many dancers being perfectionists, pressure from teachers, or personal pressure to achieve certain goals, among others. Many of the studies indicated that when a dancer started at a young age there was more of a risk of developing an eating disorder. In the case of most dancers, at least those wanting to pursue a professional career, beginning to train at an early age is crucial, which may also be a reason for the increasing number of eating disorders among dancers. Remedying this would be difficult because one of the main contributing factors is pressure from teachers. It would be difficult for teachers to be convinced that a dancer’s physical appearance will not alter an audience’s reaction to a dance.

 

 

 

 

 

 

References

            Annus, A., Smith, G.T. (2009). Learning experiences in dance class predict adult eating disturbance. European Eating Disorders Review, 17(1). Retrieved April 20, 2011, from http://onlinelibrary.wiley.com.proxy.library.vanderbilt.edu/doi/10.1002/erv.899/pdf

            Dancyger, I.F., Fornari, V.M. (2009). Evidence Based Treatments for Eating Disorders. New York: Nova Science Publishers, Inc.

Frisch, R.E., Wyshak, G., Vincent, L. (1980). Delayed menarche and amenorrhea in ballet dancers. The New England Journal of Medicine, 303(1). Retrieved April 23, 2011, from http://www.nejm.org.proxy.library.vanderbilt.edu/doi/pdf/10.1056/NEJM198007033030105

            Ravaldi, C., Vannacci, A., Zucchi, T., Mannucci, E., Cabras, P.L., Boldrini, M., Murciano, L., Rotella, C.M., Ricca, V. (2003). Eating disorders and body image disturbances among ballet dancers, gymnasium users, and body builders. Psychopathology, 36(5). Retrieved April 23, 2011, from http://content.karger.com.proxy.library.vanderbilt.edu/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000073450&Ausgabe=229601&ProduktNr=224276&filename=000073450.pdf

Toro, J., Guerrero, M., Sentis, J., Castro, J., Puertolas, C. (2008). Eating disorders in ballet dancing student: Problems and risk factors. European Eating Disorders Review, 17(1). Retrieved April 19, 2011, from http://onlinelibrary.wiley.com.proxy.library.vanderbilt.edu/doi/10.1002/erv.888/pdf

 

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