"As a dancer, I know that nutrition is important. That's why I only eat healthy, clean, organic food and avoid sugar, saturated fat, most carbohydrates, and processed foods. At first, I felt great, but now I have intense sugar cravings, I'm tired all the time, and have an injury that isn't healing. Do you think it's something I'm eating or not eating? I feel bad about myself when I eat something that's "not healthy" for me but I'm not sure what to eat anymore."

It's no secret that individuals in aesthetic sports are at an elevated risk for eating disorders, but in a society and environment that values thinness, disordered eating gets undetected and overlooked as being a problem. Dancers often possess the will power and desire for perfectionism that propels them to do whatever it takes to be competitive. As demonstrated in the previous quote, when this drive and desire to "eat perfect" or mange body weight gets taken to an extreme, physical and psychological consequences may undermine a dancer's performance and overall health. 

How do you know when eating is healthy and appropriate versus disordered and dangerous? Adequate fueling and eating well is a key factor for any athlete -- including dancers -- who wants to achieve their best performance. Disordered eating may start as a "diet" or simple plan to achieve a certain aesthetic appearance or better performance. When eating and dietary advice includes the elimination of too many foods or food groups, or if the dancer becomes "fixated" on eating a certain way, it is likely that healthy eating has become an unhealthy obsession. Consequently, the dancer may struggle due to a deficiency of calories and other important nutrients.

Too much rigidity (and perfectionism) around food and eating may also lead to a form of dysfunctional eating called orthorexia nervosa. Orthorexia nervosa is not officially defined as an eating disorder, but is like other eating disorders in that the obsession with eating "clean, pure, right" is often used to manage underlying emotional issues. 

Clinically defined eating disorders include Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. These illnesses are complex medical and psychiatric illnesses that go well beyond negative body image and eating too little or too much. Unfortunately, many people underestimate the severity of eating disorders, as well as the disordered eating behaviors that often precede these illnesses. Consequently, the prevalence of orthorexia nervosa and other eating disorders has increased, with a greater risk among dancers and athletes in aesthetic sports.

The effect of disordered eating on a dancer's health can be quite significant. In addition to an increased risk of soft tissue and bone injuries, inadequate fueling can have a negative effect on a variety of body functions. Signs to look for include fatigue or lack of energy, sleep problems, frequent sickness, colds or infections, constipation, bloating or diarrhea, and increased injuries (sprains, tendonitis or even stress fractures) that don't some to heal well. The dancer may also suffer psychological effects, such as irritability, low self-esteem, depression, anxiety, or other mood problems. Individuals may become isolated to avoid eating at restaurants or other social events and may notice they spend more time thinking about food and planning the "right" thing to eat. 

What Can You Do?

For those who may be concerned whether their healthy eating has gone too far -- or for coaches and parents - The National Eating Disorders Association or NEDA (www.nationaleatingdisorders.org) provides some excellent resources for learning more. NEDA recommends that an individual consider the following questions if there is a concern. Answering yes to several of these may be an indication of a problem, or a risk for developing some problems with their eating.  

Do you avoid eating with family or friends, or in social situations?

Do you wish that occasionally you could just eat and not worry about the food or food quality?

Do you reject foods you once loved to eat?

Do you ever wish you could spend less time thinking about food?

Does it seem beyond your ability to eat a meal prepared by someone else -- one single meal -- and not try to control what is served?

Are you constantly looking for ways foods are unhealthy for you?

Do loving relationships and other things in life take a back seat to following the perfect diet?

Do you feel guilty when you stray from your diet?

Do you feel in control when you stick to the "correct" diet?

Do you judge people based on the way they eat? 

Do you take pride in eating healthier than other people?

Do you refuse to eat certain foods because they are not "pure" or "clean"?

It is certainly possible for a dancer to eat well, follow a healthy diet and maintain a reasonable weight without developing an eating disorder or disordered eating. There is nothing wrong with the dancer who is trying to do their best with fueling and eating a well-balanced diet! Eating problems develop when an individual is using food to manage underlying emotional issues, such as a compulsion for control, low self-esteem, desire to be thin or other identity concerns. The focus on food and eating becomes a distraction from dealing with these more distressing issues and often help the individual feel "safe" or in control -- when life feels out of control.  

For anyone who may be struggling with food, eating and weight, it's important to learn how to become more flexible with their food and eating and develop a new understanding of what healthy eating is. Working with a Registered Dietitian (more notably a sports dietitian) and/or Licensed Psychologist who are specifically qualified in treating eating disorders and sports medicine, may be necessary to help the dancer work through misunderstandings about food and nutrition, while dealing with any underlying emotional issues. 

Val Schonberg MS, RD, CSSD, LD, NCMP

Val is a Registered Dietitian and Board Certified as a Specialist in Sports Dietetics specializing in nutrition for performance, wellness, weight management and disordered eating.  She is the founder of EnlightenU Nutrition Consulting (www.enlightenUnutrition.com) and enjoys enlightening recreational and competitive athletes about food, eating and overall wellness.