Risk Behaviors for Eating Disorders in Brazilian Dancers

Abstract

This study investigated the frequency of risk behaviors for eating disorders and their association with anthropometric, demographic, and socioeconomic variables in Brazilian professional dancers. Portuguese-language versions of the Eating Attitudes Test and of the Bulimic Investigatory Test, Edinburgh (BITE) were applied to 39 female and 22 male dancers considered to be some of the best classical ballet performers in Brazil. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated. Risk behaviors for eating disorders were observed in 31% of the dancers. Those who had a percentage of body fat above (PR=4.04; 95% CI=1.42–11.47) or below (PR=3.57; 95% CI=1.04–12.24) what is considered normal for the profession, and those who lived alone (PR=3.13; 95% CI=1.16–8.48) presented higher risk for eating disorders. In conclusion, the frequency of risk behaviors for eating disorders among the Brazilian dancers was high, which seems to be associated with the physical requirements of the profession. Those who are outside the BF% expected for dancers and those who live alone are the groups most vulnerable to developing eating disorders, and thus are the ones which are most in need of receiving special attention in regard to the intervention measures.

anorexia - bulimia - ballet - body fat

References

• 1 American Psychiatric Association. .Diagnostic and Statistical Manual of Mental Disorders DSM-IV. Washington (DC) 1994
• 2 Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio.  BMC Med Res Methodol. 2003;  3 21
• 3 Bray GA, Bouchard C, James WPT. Definitions and proposed current classification of obesity.. In: Bray GA, Bouchard C, James WPT Handbook of Obesity. New York: Marcel Dekker; 1998. 25
• 4 Byrne S, McLean N. Eating disorders in athletes: a review of the literature.  J Sci Med Sport. 2001;  4 145-159
• 5 Carlat DJ, Camargo CA, Herzog DB. Eating disorders in males: a report on 135 patients.  Am J Psychiatry. 1997;  154 1127-1132
• 6 Cordás TA, Hochgraf PO. O “BITE”: instrumento para avaliação da bulimia nervosa-versão para o português.  J Bras Psiquiatr. 1993;  42 141-144
• 7 Dotti A, Fioravanti M, Balotta M, Tozzi F, Cannella C, Lazzari R. Eating behavior of ballet dancers.  Eat Weight Disord. 2002;  7 60-67
• 8 Garner DM, Garfinkel PE. The Eating Attitudes Test: An index of the symptoms of anorexia nervosa.  Psychol Med. 1979;  9 273-279
• 9 Granillo BA, Jones-Rodriguez MPH, Carvajal SC. Prevalence of eating disorders in Latina adolescents: associations with substance use and other correlates.  J Adolesc Health. 2005;  36 214-220
• 10 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 11 Hay P. The epidemiology of eating disorder behaviors: an Australian community-based survey.  Int J Eat Disord. 1998;  23 371-382
• 12 Henderson M, Freeman CPL. A self-rating scale for bulimia: the BITE.  Br J Psychiatry. 1987;  150 18-24
• 13 Heyward VH, Stolarczyk LM. Applied Body Composition Assessment. Champaign: Human Kinetics; 1996
• 14 Houtkooper LB, Going SB, Westfall CH, Lohman TG. Prediction of fat-free body corrected for bone mass from impedance and anthropometry in adult females.  Med Sci Sports Exerc. 1989;  21 39
• 15 Janout V, Janoutová G. Eating disorders risk groups in the Czech Republic: cross-sectional epidemiologic pilot study.  Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2004;  148 189-193
• 16 Koutedakis Y, Jamurtas A. The dancer as a performing athlete.  Sports Med. 2004;  34 651-661
• 17 Nunes MA, Bagatini LF, Abuchaim AL, Kunz A, Ramos D, Silva JA, Somenzi L, Pinheiro A. Eating disorders: considerations about the Eating Attitudes Test (EAT).  Revista ABP-APAL. 1994;  6 7-10 [in Portuguese]
• 18 Oppliger RA, Nielsen DH, Hoegh JE, Vance CG. Bioelectrical impedance prediction of fat-free mass for high school wrestlers validated.  Med Sci Sports Exerc. 1991;  23 73
• 19 Ravaldi C, Vannacci A, Bolognesi E, Mancini S, Faravelli C, Ricca V. Gender role, eating disorder symptoms, and body image concern in ballet dancers.  J Psychosom Res. 2006;  61 529-535
• 20 Ravaldi C, Vannaci A, Zucchi T, Mannucci E, Cabras PL, Boldrini M, Murciano L, Rotella CM, Ricca V. Eating disorders and body image disturbances among ballet dancers, gymnasium users and body builders.  Psychopathology. 2003;  36 247-254
• 21 R Development core team. .R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Áustria; 2006
• 22 Ringham R, Klump K, Kaye W, Stone D, Libman S, Stowe S, Marcus M. Eating disorder symptomatology among ballet dancers.  Int J Eat Disord. 2006;  39 503-508
• 23 SPSS (Statistical Package for the Social Sciences) for Windows. .Rel. 11.0.1.2001. Chicago: SPSS Inc; 2001
• 24 Sunday SR, Halmi KA. Energy intake and body composition in anorexia and bulimia nervosa.  Physiol Behav. 2003;  78 11-17
• 25 Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population.  Clin J Sport Med. 2004;  14 25-32
• 26 Thomas JJ, Keel PK, Heatherton TF. Disordered eating attitudes and behaviors in ballet students: Examination of environmental and individual risk factors.  Int J Eat Disord. 2005;  38 263-268
• 27 Van Standen A, Myburgh CPH, Poggenpoel M. A psycho-educational model to enhance the self-development and mental health of classical dancers.  J Dance Med Sci. 2009;  13 20-28
• 28 World Health Organization Expert Committee. .Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report Series. no. 854 Geneva: WHO; 1995: 263-344
• 29 World Health Organization. .In: The ICD-10 Classification of Mental and Behavioral Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva; 1992
• 30 Yager J, Andersen A, Devlin M, Egger H, Herzog D, Mitchell J, Powers P, Yates A, Zerbe K. Practice Guideline for Treatment of Patients with Eating Disorders (2^nd ed). In: American Psychiatric Association Practice Guidelines for Treatment of Psychiatric Disorders: compendium 2000. Washington(DC):: American Psychiatric Association; 2000
• 31 Yannakoulia M, Keramopoulos A, Tsakalakos N, Matalas AL. Body composition in dancers: the bioelectrical impedance method.  Med Sci Sports Exerc. 2000;  32 228-234
• 32 Zoletic E, Durakovic-Belko E. Body image distortion, perfectionism and eating disorder symptoms in risk group of female ballet dancers and models and in control group of female students.  Psychiatr Danub. 2009;  21 302-309

Correspondence