Dear directors and ballet staff still weighing your dance students,

Stop telling me I should first conduct a study proving that weigh-ins are harmful before telling you not to. Stop, because as healthcare professionals and scientists, we are not allowed to do harm to our patients and study participants. This is regulated by professional ethical standards and  the ethics committees for science; and that is the reason why we cannot conduct a study where we expose dance students to weigh-ins, tell them to lose weight, restrict their food intake and then wait and see what happens to their physical and mental health. The reason why such an approach would never pass the ethics committee (they need to agree to our study proposals), is that retrospective studies about the damaging effects of methods like weigh-ins and other weight and body-image related issues in dance are already available, and have been for  a long time. I did one of them myself. 

Yes, these studies may mostly rely on the reports of dancers, and hence not have the highest scientific evidence, but you know, at least they have evidence. And this cannot be said about your approach. What you’re doing by using body weight as a measure for future success and a goal weight as a predictor for who will be able to dance on stage, or participate in Pas de Deux class, or even graduate, has actually been shown to be evidence-free and irrelevant. There should be no excuses for doing this, as this isn’t information from yesterday, but rather something we have known since the 1960s. Some of you will not even be as old as 60 years of age. So, what is your excuse?!

The world has known for decades, that weight is only a tiny, and rather irrelevant fraction of body composition, particularly when used as a single (and only) measure. And that focusing on weight alone – without proper nutritional guidance – is a common trigger for disordered eating and eating disorders. The dance world has a much higher prevalence of eating disorders than the general population, so, once again, what is your excuse for adding insult to injury? And whilst we’re at it, can I assume that since you prefer age-old, outdated methods for your students, you would not care about receiving outdated medical care should you need it? Oh, no, you want the up-to-date approach? Then, what was your excuse again for asking exactly that from your students, putting up with outdated and harmful ‘healthcare’ methods? 

Furthermore, where is it written down that you’re allowed to not only act as a teacher but also as a dietitian? Giving out advice to students such as ‘eat as little as you can, or even better, eat nothing.’ Oh, wait, no dietitian would ever do that because we have professional standards, so why do you think you’re allowed to? You are not qualified for that. You have been able to act like that due to the culture of fear that you create. And I am suitably qualified to call you out and say in public that you’ve been adding to the ever increasing number of dancers with long-term, if not life-long physical and mental consequences due to your unqualified procedures and behaviour. 

The UK has a debate going on whether being an artist should be considered an essential job, or whether they should better re-train. As much as this debate may seem superfluous, it makes me contemplate if we really can consider dance to be essential, if you keep doing what you’re doing. For the sake of hundreds and thousands of young people’s health, I’d suggest you do the re-training. There are so many more appropriately qualified teachers in the world, most of them with an actual teaching qualification that so many of you are lacking, and with their open minds and pro-active approach to the arts, they’d be much better ambassadors for the arts as an essential part of life. It’s hard to argue that something should be considered essential when it is moulded by abuse.

It may well be that you have been through all this yourself. But does that justify the fact that you do not make an effort to stay on top of the current evidence regarding the health and wellbeing of your dancers? No, it does not. Nor does it justify the fact that you put yourself above dance medicine, dance science and dance nutrition. Your feeling of superiority is entirely misplaced. A higher number of healthy and resilient dancers should be your goal, as this will spare your colleagues in the companies a lot of hassle, as they will have fewer dancers with (recurrent) injuries, which in turn means less time off, less time away from class and rehearsal, fewer costs for the company, and most importantly for the dancers to give their very best to the company. At the same time, enabling the dancers to fully focus on their studies as students, and on their artistry as professional dancers, without the consuming thoughts about their bodies and the food they eat (or rather not eat). It is only possible for a dancer to be fully present in the studio with a sufficiently fuelled brain, in order to provide full motor control and memorisation of corrections in exercises and choreography; two aspects needed urgently for dance. Not to mention enabling them to tap into their emotions – that’s what we want to see on stage! A starved dancer cannot access their emotions fully. I thought that’s what art is about?  You’re making your own lives harder – or so, one should think. The reason why you’re doing the things that you do, are likely to be connected to your very own issues, and yes, these may come from your time as dance student and dancer. This is sad, however, there is no room for personal issues in your workplace. Professional code of conduct is the word. We are all responsible for the future and the wellbeing of humans.

Change is on its way, and instead of holding on to harmful traditions, become a cutting-edge educator, being respected for what you do for your dancers, not what you do to make their lives miserable. The time is now. 




References (selection)

Mountjoy M, Sundgot-Bergen JK, Burke LM et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine 2018; 52:687-697

Mountjoy M, Sundgot-Bergen J, Burke LM et al. The IOC consensus statement: beyond the Female Athlete Triad – Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine 2014; 48:491-497

Keay N, AusDancersOverseas, Francis G. Indicators and correlates of low energy availability on male and female dancers. Nov 26;6(1):e000906; doi: 10.1136/bmjsem-2020-000906

Wells KR, Jeacocke NA, Appaneal R et al. The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. British Journal of Sports Medicine, ’online first’ publication 2020, dod:10.1136/bjsports-2019-101813

Ackerman K, Hultman B, Cooper K et al. Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport. British Journal of Sports Medicine 2019; 53(10):628-633

Hincapie C, Cassidy J. Disordered eating, Menstrual Disturbances, and Low Bone Mineral Density in Dancers: A Systematic Review. Archives of Physical medicine and Rehabilitation 2010; 91(11):1777-1789

De Souza MJ, Hontscharuk R, Olmsted M. Drive for Thinness score is a proxy indicator of energy deficiency in exercising women. Appetite 2007; 48:359-367

Penniment K, Egan S. Perfectionism and learning experiences in dance class as risk factors for eating disorders in dancers. Eur Eat Disorders Rev 2012; 20:13-22