Getting it right.

THIS ARTICLE, THE FIRST OF TWO ON HOW DANCERS CAN REACH THEIR OPTIMAL WEIGHT WITHOUT COMPROMISING THEIR HEALTH OR CAREERS, IS ADAPTED FROM DR. HAMILTON'S UPCOMING BOOK, ADVICE FOR DANCERS.

In a just world, dancers would be judged solely upon their musicality, talent, and physical grace. Yet what is the first thing the audience spots? The body! That's why even prima ballerinas worry about their weight, and why some dancers may even push themselves to the limit with starvation, compulsive exercise, or unsuccessful trips to the plastic surgeon. Some students send me photos of themselves from dance class, tell me their height and weight, and ask, "Can I be a professional with my body?" Unfortunately, it's difficult, perhaps impossible, to look at a young student and tell who will make it into a dance company. Training and genetic makeup will affect one's future physical development. And dancers with enough talent may still become pros despite less-than-perfect bodies.

One thing is certain: Eating disorders that result from obsessions with thinness can destroy careers and lives. In this, the first of two articles, we consider the reasons for these problems and how to cope with them.

DANCE TRAINING AND WEIGHT LOSS

Students unhappy with their appearance must remember that weekly dance classes will change one's body over a period of years. For example, the repetitive movements of a grand plie slowly mold notches in the front of your ankles, while the bones are growing. Stretching your muscles and tendons improves flexibility and turnout; whereas jumping increases the density in your bones.

Dance training also affects the shape and size of a body by determining how fast the student matures. Research shows that girls who take dance class can have a delay in menarche past the average age (approximately twelve) as a result of physical exercise, particularly if they start their training during early childhood. While there are exceptions to every rule, this delay is associated with a longer, leaner, more linear body. Boys may exhibit a delay in beard growth and voice change and also be significantly thinner.

On average, female dancers begin to menstruate around the age of fourteen, with most breast development occurring about two years later. While this is good for dancing, it may be difficult to fit in with the kids in high school. This happened to one tearful ballet dancer, who told me that she was the only one among her peers without a training bra. The boys made her feel highly self-conscious by calling her "surfboard" because of her flat chest. The good news is that once young dancers mature, they are admired for being physically fit and for having great bodies!

Genetic endowment affects how your body looks. If your parents are chubby, chances are that you will be too. Studies show that family resemblances in weight can run as high as 70 percent across the whole range of body types, from very thin to very fat. Diet and exercise are still important in determining weight and can be extremely effective with the right approach; however, it's clear that genes play a significant role in your eventual body shape and size.

My research on professional ballet dancers shows that heavier dancers eat, on average, 900 fewer calories daily than thinner dancers eat. Yet I continue to hear about dance teachers who tell their students to go on banana-and-yogurt diets or just to go hungry. Instead of advising heavy dancers to go on crash diets, which are dangerous and rarely produce results, it's best to refer them to a nutritionist or weight-loss specialist who can review their histories and make suggestions, based on their unique needs.

One little-appreciated fact about dancing is that it rarely makes anyone thin. I know a 19-year-old dancer who was determined to lose weight. She took four dance classes a day and rehearsed in workshops in her spare time. At the end of each day, she was exhausted. Yet she couldn't make her weight conform to the standards of the school director Like many people, she had confused dancing with aerobic exercise; the most taxing variation lasts only about four minutes, so even a one-hour ballet class burns only 200 to 300 calories. Other dance forms, which are less physically demanding than ballet, also do little toward weight loss.

SETTING REALISTIC GOALS

In my surveys of professional dancers from America, China, Russia, and Western Europe, women's weights in ballet ranged from 10 to 15 percent below their ideal weight for height. Just in case you're wondering how thin this is, it comes uncomfortably close to the weight criterion used by the American Psychiatric Association to diagnose anorexia nervosa (16 percent below ideal)! Fortunately modern and Broadway dancers have more leeway than ballet dancers, hovering around 6 percent below their ideal. This is a much more realistic goal for most women. Men, on the other hand, have less rigid standards to meet: they must be muscular and look physically fit.

After looking at yourself in the mirror for years, it's easy to become your own worst critic. After all, whose body is perfect? In my Dance Magazine survey, published in two parts in the November 1996 and February 1997 issues, only 23 percent of female dancers and 33 percent of male dancers said that they were satisfied with their bodies. In contrast, a British study of the general population in Great Britain found that more than twice as many adolescent girls (47 percent) and boys (72 percent) were "satisfied." Concern over an "unattractive" body image is more pronounced among American dancers.

ARE YOU REALLY OVERWEIGHT?

When I surveyed a large group of dancers who read Dance Magazine, I found that even some whose weight fell within the normal-or-above range for their height said they considered themselves overweight: 37 percent were females and 11 percent were males. Unfortunately, many dancers are confused about where they stand in terms of their ideal weight. One 15-year-old wrote me at the magazine about her distress upon learning that ballerinas like Natalia Makarova, Cynthia Harvey, and Susan Jaffe each weighed at least seven to nine pounds under the lowest weight in their height classification--a goal she thought impossible for herself.

First of all, it's dangerous to judge yourself by others, because people carry their weight differently It's also normal to gain weight as you mature. I know one 14-year-old girl whose weight crept up just before a growth spurt, while another teenager became a little plump as she went through puberty. Neither dancer ended up having a weight problem.

Presently, the Metropolitan Life Insurance Company's weight tables (1983) are being revised to reflect the lower weight tables of the past, because we now know that being thinner is actually healthier. While there's no such thing as a magic number on the scale, you can get a general idea of your weight by checking out Sargent's height-weight table shown below. I prefer using this 1959 table because, unlike other weight tables, its information came from weighing young adults who were wearing neither clothes nor shoes.

To find out where you stand in relation to this table, divide your real weight by the ideal for your height and sex. For example, a female dancer five feet eight inches tall and weighing 124 pounds can tell from the table above that she's 10 percent below her ideal weight for height. While this is within the normal range for most ballet dancers, remember that each dancer carries her weight differently. I know a dancer who's considered thin at five feet eight and one-half inches, weighing in at 128 pounds, because she has big bones!

If you're a modern dancer, the weight requirements of 6 percent below ideal are less stringent. In the previous example, this would amount to 129 pounds for a woman five feet eight inches tall. A male dancer in either style would normally hover a few pounds below his ideal weight of 149 pounds at the same height.

As you can see, weight can affect dancers' future prospects in the profession, as well as their body image and self-esteem. While nutritional counseling on a regular basis by dance schools is a good idea, educational seminars are a more cost-effective way to help dancers achieve their goals. Unfortunately, only 31 percent of dancers in our national survey said that their dance school provides information on nutrition and 18 percent on eating disorders. It's understandable that uninformed dancers may risk their health by going on too stringent diets.

THE RISKS OF DIETING

Over the years, I've heard from many dancers who, unaware of the dangers of dieting, decided to stop eating sugar, fat, meat, or anything at all. One 20-year-old jazz student wrote me that she'd lived on a grapefruit diet, cigarettes, and vitamin supplements until she fainted in class. I know another 19-year-old ballet student who became bulimic and gained twenty pounds after several months of following a menu limited to 800 calories a day. The worst case, however, was a lovely 23-year-old girl who'd been starving herself since a school director told her to lose weight at the age of twelve, injuries, muscle loss, and self-hatred now made dancing an impossible dream.

Every time you take a drastic step to tip the scale, your body revs up to defend its natural weight against "attack." It's like having an internal thermostat that regulates weight instead of temperature. If your "set point" hovers at 130 pounds because of your genes, your body will do its best to keep you there by regulating your activity level, hunger, and metabolic rate, and you ignore this fact at your peril.

The irony is that over time, dieting can actually make you fatter! Besides drastically increasing the urge to overeat, your body will fight you by slowing your resting metabolic rate as much as 45 percent, making it increasingly more difficult to lose weight. If your hunger wins out, which is often the case, you'll gain a greater percentage of fat, because muscle gain is very slow.

WHAT'S WRONG WITH PERFECTION, SELF-DENIAL, FAT, AND CONTROL?

People with clinical eating disorders share several distorted attitudes, fostered by our culture's obsession with thinness. They believe

* Perfection is best; anything less only means failure.

* Self-denial is always superior to self-indulgence.

* The most disgusting thing in the world is being fat.

* Gaining weight means a loss of control.

These rigid beliefs can tap into personal problems, from which being thin provides the illusion of escape. Three out of four people with serious eating disorders are depressed.

What dancers wear on any given day can indicate their mood and how they see themselves. When I was in a bad mood, I used to cover myself in leg warmers, sweatpants, and baggy shirts before I'd face the mirror. Of course, there were also times when I felt confident and I was happy to be seen in only a leotard and pink tights. Being depressed makes you feel as if you're stuck in quicksand. Your eating and sleeping habits, attention span, and hope for the future are all impaired.

HOW DO YOU KNOW IF YOU HAVE A SERIOUS PROBLEM?

Anorexia nervosa is a disorder that involves extreme weight loss, no menses for at least three months (amenorrhea), and the fear of becoming obese. Young women are most likely to show signs of eating problems, from anorexia-like symptoms to serious disorders that require hospitalization. In the general population, the prevalence rate for anorexia nervosa is about one in a hundred, whereas bulimia nervosa, which we will discuss next, occurs in up to 3 percent. It's rare for these problems to affect men, who make up only 5 to 10 percent of the new cases every year. In dance, as many as 46 percent of dancers report eating problems, such as fad diets or going below weight, although only 4 percent in our Dance Magazine survey actually meet all of the diagnostic criteria for a clinical eating disorder.

Take a moment to consider the following official criteria for anorexia nervosa (see above), from the American Psychiatric Association:

Anorexia nervosa is a serious problem that can play tricks with your mind as well as your body. One 16-year-old girl would look at her body one day and consider herself thin. The next day, everything would change, and all she could see was fat. No matter how much weight she lost, she would always think, "I could lose a little bit more."

Here's what one concerned dance teacher had to say: "I've been very worried lately about an adult student who takes my intermediate ballet class. She looks emaciated! I've spoken to her about her weight and even suggested that she get professional help. But nothing happens. I'm afraid that I'm contributing to the problem by letting her exercise."

When in doubt, concerned teachers should ask students for a letter from a physician stating that it's safe for them to take dance class at their present weight. Directors of schools and companies can also set a minimum dancing weight, such as 15 percent below ideal, to prevent severe emaciation. Dancers with eating disorders should always be examined by a physician and be referred for psychotherapy if it seems necessary.

ASKING FOR TROUBLE

In bulimia nervosa (see below), secretive episodes of binge eating alternate with self-induced vomiting, fasting, compulsive exercise, or laxative or diuretic abuse. You should know that laxatives won't make you lose weight; whereas diuretics only affect water weight, which returns as soon as you begin eating and drinking. The dehydration that results from diuretics can also be dangerous. Besides decreasing muscle endurance and work capacity, diuretics cause you to lose electrolytes, such as potassium and sodium, increasing the risk of cardiac arrhythmias.

Now let's check out the symptoms of this condition:

There are two types of bulimia: the purging type uses enemas, laxatives, vomiting, or diuretics to compensate for binge eating. The nonpurging type tries to compensate in other ways, such as with fasting or compulsive exercise.

Nine out of ten bulimics induce vomiting, which produces immediate relief from physical discomfort but at an astronomical cost to your body. I know one 45-year-old dancer whose chronic vomiting removed the enamel from her teeth, disrupted her electrolyte balance, and ruptured her esophagus. Another retired dancer, who is now forty-four, can no longer have a normal bowel movement after taking thirty laxatives a day for the last two decades. The truth is that neither approach is good for weight loss, and once you develop an eating disorder, it's usually very difficult to stop.

There is also a new category of disorder, binge eating. People with this disorder will overeat without resorting to maladaptive ways to lose weight. As you can see, its symptoms (at left) are very similar to those of bulimia.

Binge eating is a common problem in women who attend weight-loss clinics for obesity, suggesting that this problem occurs from fighting one's genetic set point for weight. "Jenny," a 35-year-old recreational tap dancer, had been determined to lose weight and had tried a liquid diet. Twelve months later, she came to see me because she now spent most of her day driving through every fast-food restaurant in her neighborhood, wolfing down burgers, milkshakes, and apple pies. She had lost twenty pounds but had gained back thirty more.

THINGS YOU CAN DO RIGHT NOW

If you are suffering from a clinical eating disorder, you can get help by phoning the Renfrew Center at (800) RENFREW or by asking your regional psychological association for a therapist who specializes in eating disorders. Dance schools and companies can also make changes to help prevent these problems. Dance teachers can help students (few of whom become professionals) by allowing different sizes and shapes in class. Teachers and artistic directors can also refuse to give preferential treatment (such as leading roles) to dancers who are obviously emaciated. Finally, dancers should be offered educational seminars on eating disorders and healthy weight-loss practices.

Next month we'll discuss how you can achieve your optimal weight by balancing exercise with your food intake while dealing with the biggest bugaboo of them all--temptation.

RELATED ARTICLE: CRITERIA FOR ANOREXIA NERVOSA

1. You lose more than 15 percent below your ideal weight for height by dieting and sometimes purging, or you fail to make expected weight gains while growing (use the table on page 82).

2. You are underweight, but you have an intense fear of gaining weight or of becoming fat.

3. You see yourself as fatter than you are, your appearance has too big an effect on your self-esteem, or you deny the seriousness of your current low weight.

4. You have missed at least three consecutive menstrual cycles, thus exhibiting amenorrhea.

RELATED ARTICLE: THE CRITERIA FOR BULIMIA NERVOSA

1. You hinge within a two-hour period, eating a larger amount of food than others and feeling out of control.

2. You try to prevent weight gain by repeatedly vomiting or using other inappropriate means, including going overboard on exercise.

3. The bulimia is on ongoing problem: you binge or purge, on average, at least two times a week and have done so for three months straight.

4. Your body shape and weight ploy major roles in your self-evaluation.

5. The bulimia doesn't occur only during an anorexic episode.

RELATED ARTICLE: THE SYMPTOMS OF BINGE EATING

1. You have repeated binges within a two. hour period, In which you eat a much larger amount of food than others and feel out of control.

2. Your binge has at least three of those characteristics:

* You eat much more rapidly than usual.

* You eat until you're uncomfortably full.

* You overeat even when you aren't physically hungry.

* You eat along, embarrassed at the amount.

* You fool disgusted, depressed, or guilty afterward.

3. Your problem with binge eating makes you very unhappy.

4. This behavior Is an ongoing problem; you binge two days a week and have done so for six months.

6. You don't try to compensate for your binge eating In order to love weight, and this problem Isn't occurring only during an anorexic episode.

REALISTIC HEIGHT-WEIGHT RELATIONSHIPS

      Females             Males

Height    Weight     Height    Weight

5'        108 lbs    5'5"      138 lbs
5'1"      112 lbs    5'6"      142 lbs
5'2"      116 lbs    5'7"      146 lbs
5'3"      119 lbs    5'8"      149 lbs
5'4"      123 lbs    5'9"      153 lbs
5'5"      126 lbs    5'1"      157 lbs
5'6"      129 lbs    5'1"      161 lbs
5'7"      133 lbs    6'        165 lbs
5'8"      137 lbs    6'1"      169 lbs
5'9"      141 lbs    6'2"      173 lbs
5'1"      144 lbs    6'3"      177 lbs
5'1"      147 lbs    6'4"      182 lbs

Linda Hamilton, Ph.D., who danced with New York City Ballet from 1969 to 1988, is now a clinical psychologist. Her Advice for Dancers, from which this article was adapted with permission of the publisher, Jossey-Bass, Inc., will be published in spring 1998.