Eating Disorders in the Dance World (2):
Are We Doing Enough?

Copélia Mainardi

Ballet aesthetics impose exacting demands on dancers, particularly women, who are highly vulnerable to eating disorders. Bodies are controlled, weight is monitored. Faced with this reality, described in a first instalment of this 2-parts investigation, are institutional prevention and support measures really able to counteract the pressures that shape the profession?

“The Millepied turning point,” is how many professionals describe the shift in approaches to dancer health that followed the appointment of choreographer Benjamin Millepied as director of dance at the Paris Opera in 2014. The hegemonic position of this prestigious institution gives it considerable influence over other organizations. “If the Paris Opera doesn’t move, no one will,” says Florent Cheymol, who holds a PhD in clinical psychology. 

Yet this need for change is becoming increasingly urgent in the dance world, especially when it comes to mental health, which remains largely taboo. In 2014, a study estimated the prevalence of eating disorders among ballet dancers at 16%, compared to only 1.5% in the general population. How can we understand, treat, and above all prevent these disorders, which are so closely linked to body image, when the body is a dancer’s primary instrument and the object of intense observation and control?

The resources and means available vary according to the institutions, their traditions, and their approach. Originally focused on traumatology and injury management, the Paris Opera’s Health Center—created in 2015 with physical therapists, an osteopath, and a specialized trainer—has gradually expanded to include a gynaecologist, a podiatrist, a psychologist, and others.

“Support must be comprehensive and multidisciplinary,” explains Xavière Barreau, the sports doctor who coordinates the center, which is structured as an independent body separate from the artistic direction. “Preventing physical injuries alone is not enough: it is also essential to monitor dancers psychologically, which remains a delicate task in an environment where they are used to pushing through no matter what.” 

The Conservatoire National Supérieur de Musique et de Danse de Paris (CNSMDP, the Paris Music and Dance Conservatory) has developed a different approach, with fewer internal resources but a stronger external network. Dance therapy is also increasingly used to support patients with eating disorders. “But it has certain limitations for professional dancers, who resist the idea of joining a therapy group with people who don’t know how to use their bodies, when their own mastery is so high—and of course that mastery is part of the problem,” notes Cheymol. 

While new approaches are emerging and notable developments being made, much remains to be done in terms of prevention. “Referring students to a dietitian, a school nurse, or a psychologist allows institutions to absolve themselves of responsibility without questioning their own role,” points out Cheymol, a former dancer and author of a doctoral dissertation on mental health in dance. “Yet eating disorders are often the result of harmful, even abusive teaching methods.” Strong words, but he is not alone in pointing to the toxic impact of certain dance instructors. “We can blame social media for dysfunctional relationships with self-image, but as long as this injunction to conform to beauty standards—bodies that remain eternally untouched by puberty—does not evolve, nothing will change,” he warns.

Eating disorders are hard to overcome and deeply ingrained in dancers’ bodies and minds, especially women’s, who grow accustomed to dealing with control, obsession, and dissatisfaction on a daily basis in order to achieve technical excellence. Marion Borgne, a psychologist at the Paris Opera’s Health Center who regularly leads training sessions for teachers and supervisors to raise awareness of dancers’ psychological needs, points out that these disorders develop at a young age, often in early adolescence.

“In a context where the body is their primary instrument, a single seemingly innocuous remark can permanently alter a young dancer’s still very fragile self-image,” she explains. “This leads to the development of a control mechanism that is difficult to break, which partly explains why patients often wait until a lasting relationship of trust has been established before they feel comfortable enough to talk it.” This is also why Barreau advocates for awareness-raising and nutritional support for young people as young as 12, in order to better address this dysfunctional link between performance and weight loss.

Still, these essential measures remain too limited. “Why aren’t there several prevention sessions throughout the year at the CNSMDP or the Opera?” asks Cheymol. All students go through periods of dissatisfaction, questioning their weight, resorting to substitute behaviors. Discussions about food should be normalized!” Hélène Marquié, a researcher in dance and gender studies at Paris VIII University, is convinced that psychotherapy alone is insufficient. “There is so much competition, so many demands, so many entrenched mechanisms that we need to reinvent everything and give ourselves the means to do things differently so that things really change,” she explains. 

Only when institutions are willing to question their practices will dancers be able to undertake critical reflection and be better equipped to face what these methods have done to their relationship with their bodies. And shaking the foundations on which the prestige of classical dance has been built may go beyond the pedagogy. Marquié thus stresses the need for broader awareness: “All these injunctions about dancers’ physiques are also directed at amateurs and the general public: what is our role when we teach dance, what do we want to see emerge, what vision of dance do we want to bring about?”

Despite some efforts, mental health remains a major taboo in the dance world. “The sports world has changed a lot, with high-profile athletes speaking out about serious issues, which has driven real change, but this is not yet the case in dance,” laments Borgne. “And for people to feel free to speak out about these issues, there needs to be someone ready to listen to them.”

“There is so much competition, so many demands, so many entrenched mechanisms that we need to reinvent everything and give ourselves the means to do things differently so that things really change” Hélène Marquié

Only when institutions are willing to question their practices will dancers be able to undertake critical reflection and be better equipped to face what these methods have done to their relationship with their bodies. And shaking the foundations on which the prestige of classical dance has been built may go beyond the pedagogy. Marquié thus stresses the need for broader awareness: “All these injunctions about dancers’ physiques are also directed at amateurs and the general public: what is our role when we teach dance, what do we want to see emerge, what vision of dance do we want to bring about?”

Despite some efforts, mental health remains a major taboo in the dance world. “The sports world has changed a lot, with high-profile athletes speaking out about serious issues, which has driven real change, but this is not yet the case in dance,” laments Borgne. “And for people to feel free to speak out about these issues, there needs to be someone ready to listen to them.”

Copélia Mainardi is a journalist. She has worked with several big publications such as Télérama, Libération, Le Monde diplomatique and France Culture, reporting, investigating and making documentaries. She studied French literature and then worked in France Culture, the “28 minutes” program on Arte and the culture department of Marianne. She follows closely what is happening on the cultural scene, in the performing arts and literature.