The Mirror Has Two Faces: Dancers Have a Special Vulnerability to Eating Disorders, Particularly Anorexia. Schools and Companies Now Take a More Proactive Role in Helping Them Fight These Inner Demons, but Some Still Fall Prey to Self-Destructive Behavior. Here Is a Special Report on What the Dance World Is Doing to Help Them, How to Spot Early Warning Signs, and What It Takes to Overcome the Illness

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Anorexia. The word is charged with electricity in our culture and in the world of ballet. It is a feared and potentially life-threatening condition. Any dancer who slides down the slippery slope of anorexia is at risk of losing the physical mastery she has gained--not to mention her good health. However, major ballet companies across America are becoming more aware about eating disorders. Teachers and artistic directors are putting nutritionists on staff, organizing educational workshops, and watching closely for signs of the disorder. As a result, while the incidence of anorexia may be rising in the general population, it seems to be dropping in large ballet companies.

More prevalent in ballet, and almost entirely a female disease, anorexia is rarely seen in modern dance. Modern is more forgiving of, and even sometimes champions, diverse body types. Too, people often come to modern dance later, into their teens or even in college, when their bodies--and their perceptions of themselves--are more settled.

What exactly is anorexia? According to Dr. Charles L. Bardes, professor of clinical medicine at New York's Weill Cornell Medical College, it has less to do with one's degree of thinness and more to do with "the role that thinness plays in a person's life." Medical clues include compulsive behaviors like intentional vomiting and using of laxatives to lose weight. These actions stem from what Dr. Bardes calls "severe body image disturbance."

Often we see a thin dancer onstage and immediately declare her "anorexic." But no matter how thin she is, you would not necessarily be accurate. "I would urge spectators not to observe a thin dancer and speculate that she is anorexic," says Dr. Bardes. "That badge would require knowing a lot more about her personal psychological constitution than can be known by an audience watching figures on a stage."

Northwest Ballet, says, "Anorexia goes along with an obsessive-compulsive personality. It coexists with perfectionism." Sound familiar? Perhaps ballet attracts people who have a bent toward perfectionism. Sometimes that intense energy gets poured into a systematic plan to lose weight. Peggy Swistak, PNB's nutritionist, describes obsessive behavior typical of eating disorders. "She will have certain eating rituals that may include rearranging the food on her plate or excessive chewing."

Kay Mazzo, co-chair of faculty of the School of American Ballet, acknowledges the pressure to be thin. "There's definitely an aesthetic you have to have in ballet." But, she maintains, "it doesn't mean you have to be [just] bones." She describes the school's approach to anorexia. When they spot a problem, they contact the parents first, then initiate talks with the student. They arrange for the dancer to see a nutritionist, then a doctor. If the doctor feels it's necessary, he sends the student to a psychiatrist.

SAB maintains a health committee that meets monthly and includes a nutritionist (who Mazzo says is particularly good at getting the students to consider their future), a physical therapist, doctor, psychiatrist, and directors of resident and student life for students who board. "We don't want anybody to slip through the cracks," says Mazzo. "We always stress we want them to be healthy. We want them to deal with it in the correct way, because it [affects] the rest of their lives."

When Mazzo and other faculty members give auditions around the country, they are on the lookout for potential cases of the disorder. "When there's a girl who seems to be talented but is too thin, we won't take her," she says. "It's a warning to us. Let her stay another year at home and see what happens."

Eleanor D'Antuono, a former principal with American Ballet Theatre who teaches at the Joffrey Ballet School in Manhattan, the Nutmeg Conservatory in Connecticut, and New Jersey Ballet, has a practiced eye at spotting anorexia. She says she becomes aware of "behavior that's different, a glassiness in the eye, a different concentration level. …