Disordered eating and injuries among adolescent ballet dancers

Ballet dancers are at elevated risk for eating disorders, but the extent to which disordered eating attitudes and behaviors represent a relatively benign adaptation to an environment that values extreme thinness, or a functionally impairing form of psychopathology, has sparked considerable debate.

To determine whether disordered eating is associated with role impairment in dancers, we evaluated its association with musculoskeletal injuries among 239 adolescent female ballet students.

Dance students reported a variety of lifetime disordered eating behaviors to control weight including fasting (29.3%), vomiting (9.6%), and laxative use (4.2%). More than half (52.3%) reported a lifetime history of injury (stress fracture, broken bone, and/or medically treated tendonitis). A greater number of lifetime disordered eating behaviors was associated with a greater number of lifetime injuries (p=0.01). Moreover, vomiting history was associated with greater likelihood of injury (p=0.004) and increased time to recover from injury (median difference=22.8 days, p=0.006).

Although the direction of causality cannot be determined from this retrospective design, these results suggest that disordered eating is associated with role-relevant functional impairment, even among members of a subculture that values extreme thinness.