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The complicated truth

Posted on March 5, 2012


Birmingham Royal Ballet’s Matthew Lawrence investigates eating disorders in ballet


Ballet is suffering a Black Swan hangover. Darren Aronofsky’s movie has unwittingly re-fuelled debate over the prevalence of eating disorders amongst dancers. With contradictory accounts creating a maelstrom of controversy, it once again raises the question: What is the truth?

Google “Ballet and eating disorders”, and you will be inundated with links. Most are connected to the film’s portrayal of bulimic ballerina Nina (played by Natalie Portman), with articles either advocating or berating the movie’s interpretation of eating disorders (EDs) within the ballet world. Take Italian ballerina, Mariafrancesca Garritano’s story. Last December, she revealed she suffered from anorexia and controversially maintained she was not alone. She claimed as many as one in five dancers in La Scala’s ballet company were anorexic. In breaking what she calls the ballet world’s “code of silence”, she asserted: “I saw the film Black Swan and it was not very far from the truth at all.”

Paradoxically, in reaction to the film, former Royal Ballet principal Deborah Bull, made a passionate rebuttal against Aronofsky’s representation of a disturbed ballerina who suffers from bulimia, affirming: “Well, it’s not like that at The Royal Ballet.” She declared the movie had set the public’s perception of ballet back 50 years. Uniting these opposing views is the release of their respective books – Garritano’s The Truth, Please, about Ballet, and Bull’s The Everyday Dancer.

Nick Allen, clinical director of Birmingham Royal Ballet’s (BRB) Jerwood Centre has dealt with dancers injuries, injury prevention and their general wellbeing for seven years. EDs come under his umbrella of care. When I mention to Allen I’m looking for “truths” on EDs with dancers, he obliges with numerous articles and research data, yet acknowledges, “Nobody has ever done a proper incidence or prevalence study with dancers and eating disorders.”

He concedes that existing data is marked by low compliancy rates, relying chiefly on self-reporting. Denial being a major factor with EDs makes currently available research incomplete. This is the case with Helen Laws’ book, Fit to Dance 2, which is arguably the most comprehensive report into the health of UK dance companies. Her research in 2005 found that, nine per cent of professional ballet dancers, and 19 per cent of vocational dance students had some form of ED.

Being on the front-line, so to speak, Allen admits that nobody really knows how widespread EDs are in ballet. He demonstrates the difficulty with diagnoses: “With anorexia there’s a visual appearance, yet bulimics can look very, very much like everybody else.” However, he goes on to say, “Sadly, and this is based on nothing other than my day-to-day experiences, I do believe there is a problem within ballet. Because for me, one person having an eating disorder is a problem.”

Mental health issues – which EDs are considered – are not covered by standard insurance policies for dance companies. Yet BRB self-funds a sizable amount of money to support and rehabilitate its dancers. Its Jerwood team – made up of three physiotherapists, two Masseurs, a Pilates instructor, a seasonal doctor, psychologist and sports psychologist – work alongside nutritionist, Wendy Martinson OBE from the National Centre for Eating Disorders in Sport. (Interestingly, there is a high prevalence of EDs within the aesthetic sports; gymnastics, figure skating, synchronized swimming and diving, but, curiously, this rarely makes the news.)

Rachel Peppin, 42, is a retired principal dancer with BRB. She is one of the inspirational success stories of The Jerwood Centre, but remembers her “trigger” moment occurred whilst dancing with US-based Atlanta Ballet over 20 years ago. It was the reaction, “Oh gosh, you look amazing”, from dancers and staff, after a stomach virus had left her “seriously thin”, that started her disordered-eating spiral. She noticed castings changed with more opportunities, and a review that complimented, “The incredible, waif-like Peppin.” She confesses, “I started to associate this extreme thinness with success.”

Anorexia and bulimia are readily associated as the most common forms of EDs within dance. However, research suspects a grey, hard to detect area of disordered-eating habits are more frequent. Peppin admits, “This must paint the worst picture”, as she recalls over-exercising, restricting her caloric intake and taking the occasional laxative – symptoms associated with the ambiguously titled “Eating Disorder Not Otherwise Specified”.

Peppin thinks that company doctor Victor Cross’ research in 1993 was her turning point. Part of his research was correlating the bone health of female dancers with EDs. Bone scans revealed, “My spine was comparable to a 70-year-old’s,” she says. Only 23 at the time, she admits to naivety: “I always thought osteoporosis was something that happened to elderly women.” Seeing her grandmother in severe pain from osteoporosis, it was the realisation, “Is this going to be me?” that kick-started her rehabilitation.

Now married, with a child – and healthy bones – Peppin acknowledges to being one of the lucky ones. She goes on to say that, “I always knew I was obsessed with my image, with exercise, and that the things I was doing were destructive,” yet all the while thought, “I’ll get over it one day; but then it becomes a habit.” She warns that osteoporosis starts as a silent disease, citing, “If it hadn’t been for support and intervention of the Jerwood team, God knows where I’d be today.”

When did this problem of EDs begin within ballet? Celebrated choreographer George Balanchine is blamed by many for being the main skinny-enforcing catalyst. Perhaps due to well-documented accounts, such as Gelsey Kirkland’s autobiography Dancing on my Grave, where she recollects when she weighed less than 100 pounds, Balanchine struck her chest saying, “Must see the bones. Eat nothing.” Balanchine is probably vilified unfairly. Most likely, a new physical ideal had already been permeating within the ballet world as a reflection of greater society. Art, after all, is an imitator of life, and since the 1930s, with its sleek Art Deco aesthetic, women have aspired to the thinner “model look”.

The media has played a significant part in patrolling this lithe ideal. Take a recent review by Alastair Macaulay of The New York Times, where he wrote that a ballerina performing the Sugar Plum Fairy (who had suffered from anorexia and compulsive eating disorder) looked as if she had eaten, “one sugar plum too many.” Macaulay, in defence of his review, stated, “If you want to make your appearance irrelevant to criticism, do not choose ballet as a career.”

I mention this review to Allen, who recalls a similar review criticising BRB. He goes on to acknowledge that, “It’s everyone’s worst nightmare of getting up on stage, day-in, day-out, having every aspect of their bodies picked on and scrutinised; if you’re ever looking for triggers, it’s there.”

Considering this pressure, it’s surprising more dancers don’t suffer from EDs. Maybe its because most dancers are naturally lean. This point is affirmed by Allen, who recognises that ballet dancers, on a whole, show “ectomorph” – or slight – body types. “If dance students have grown too big or too tall, they are just moved away from ballet.”

Last month, debate heated up again with the firing of Mariafrancesca Garritano from La Scala, for her aforementioned comments. In reaction to this, La Repubblica reported that Paris Opéra étoile, Eleonora Abbagnato, stated of Garritano: “Nothing of what she says is true.” Conversely, The Observer reported that retired La Scala dancer Michele Villanova declared: “One in five of the ballerinas of that generation from that school [La Scala] had eating disorders, and continue to experience serious consequences.”

So what is the truth about EDs in ballet? It’s complicated. I think it safe to say that nobody really knows how widespread it is. Yet it’s an issue ballet shares with aesthetic sports, and in sport’s well-funded world ballet has a powerful ally – if it chooses to use it. BRB acknowledges there is a problem with EDs in ballet. Without this honesty and support, who is going to save the Rachel Peppins of the future?


Photograph of Matthew Lawrence by Roy Smiljanic.

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