By Melissa Hague
Enrolling your child in a ballet school can offer many benefits that extend far beyond the dance studio. Ballet can provide a well-rounded experience that nurtures various aspects of a child’s growth. It teaches discipline and focus to children at a young age. It encourages creativity and expression. It can often build self-confidence and self-assurance. However, like many other activities, ballet presents warning signs that parents should be aware of to ensure their child is in a positive and healthy learning environment.
Ballet school can pose significant risks when there is an overemphasis on thinness rather than technique and talent. This focus on body image can lead to unhealthy eating habits, disordered eating and poor self-esteem among young dancers. The pressure to maintain a certain physique can overshadow the importance of developing proper technique and artistic expression, causing long-term physical and psychological harm. It’s crucial for ballet schools to prioritize the holistic well-being of their students, emphasizing skill, creativity and personal growth over unrealistic body standards.
Ballet schools and companies that stress unrealistic body standards are breeding grounds for young dancers to develop the Female Athlete Triad, a medical condition observed in physically active girls and women. It involves three interrelated components:
1. Energy deficiency with or without disordered eating occurs when energy intake is insufficient to support the energy expenditure required by both daily living activities and exercise. This may or may not involve eating disorders like anorexia
or bulimia.
2. Menstrual dysfunction can range from irregular menstrual cycles to complete absence of menstruation (amenorrhea). Low energy availability disrupts the normal production of hormones necessary for regular menstrual cycles.
3. Decreased bone mineral density can lead to conditions such as osteopenia or osteoporosis, making bones more fragile and susceptible to fractures.
The Female Athlete Triad is a very serious condition that is well known in the ballet community. A study published in the Clinical Journal of Sport Medicine found that 16.4% of elite ballet dancers met the criteria for all three components of the Female Athlete Triad, while 48.1% had at least two components and 84.5% had at least one component.
Research in the Journal of Dance Medicine & Science indicates that between 20% to 58% of ballet dancers exhibit disordered eating behaviors, which can significantly contribute to energy deficiency. Various studies have reported that 20% to 50% of ballet dancers experience menstrual irregularities or amenorrhea. For instance, a study in the Journal of Clinical Endocrinology & Metabolism found that 36% of adolescent ballet dancers had amenorrhea.
There are several warning signs parents should look for to guard against the Female Athlete Triad in their child.
Regarding eating and nutrition, look for:
• an obsessive focus on weight, body shape or body composition
• restrictive eating or excessive dieting
• unusual eating behaviors, such as cutting out entire food groups
• frequent discussions about calorie counting, weight and dieting
Menstrual health warning signs include:
• delayed menarche (first menstrual period) beyond age 15
• irregular menstrual cycles
• missed periods (amenorrhea)
• complaints of severe menstrual pain
For bone health and physical symptoms, be alert for:
• recurrent stress fractures or bone injuries
• complaints of chronic fatigue or low energy
• decreased performance without an obvious cause
• increased susceptibility to infections and illnesses
Psychological factors are also critical, including increased anxiety; depression; irritability; withdrawal from friends, family, or social activities and a preoccupation with exercise, training and competition. General physical health warning signs encompass noticeable weight loss or fluctuations in weight, frequent complaints of feeling cold or showing signs of cold intolerance and physical signs of nutritional deficiencies like hair loss and dry skin.
Early detection and intervention are crucial for preventing the long-term consequences of the Female Athlete Triad. Parents, teachers and healthcare providers should work together to ensure that female dancers maintain a healthy balance between their physical activity, nutritional intake and overall well-being. Regular medical checkups, including monitoring menstrual cycles and bone health, can help in the early identification and management of the condition.
The high prevalence of the Female Athlete Triad in ballet dancers underscores the need for awareness and preventive measures in the dance community. This includes promoting healthy eating habits, ensuring adequate energy intake, monitoring menstrual health and implementing bone health strategies. Many ballet schools take a proactive approach by providing education and awareness to the dancers and parents; regularly monitoring the dancers; ensuring balanced nutrition through education and access to a nutritionist and offering professional support from experts who specialize in athletes’ health. Before enrolling your child in a ballet school, ask the school what steps it takes to guard against and prevent the Female Athlete Triad.
Melissa Hague is a partner in the office of the Joel Bieber Firm. She has long been an advocate for the rights of those harmed by institutionalized abuse.
