Disordered eating and injuries among adolescent ballet dancers.

BACKGROUND: 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.
METHOD: 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.
RESULTS: 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).
CONCLUSION: 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.