Maybe Johanna Kandel’s life is just another Dreyfoos alumnus’ success story: she got the body and skill she needed for the career she wanted in professional dance.
But that was not her success.
“To Johanna, success means helping even one person avoid going down the same road she has,” says the website of the organization she founded, The Alliance for Eating Disorder Awareness.
There, at eatingdisorderinfo.org, are resources about eating disorders, including a long list of the statistics Kandal once embodied: 11% of highschool students have been diagnosed with an eating disorder. Over half of females between 18 and 25 would rather be run over by a truck than be fat. 51% of nine and ten year olds feel better about themselves if they are on a diet. The most common behavior that will lead to an eating disorder is dieting.
Yet in a way, Kandal’s story of developing, suffering from, and overcoming Anorexia Nervosa, began years before she ever dieted, at the age of three, the year that she began to dance.
“I knew I was going to become a professional ballet dancer, no matter what the expense and sacrifice,” Kandal writes in her personal story at eatingdisorderinfo.org/Johanna.
For her career in dance, Kandal sacrificed her health:
She first dieted at 13 to fill a position in a production of The Nutcracker. When she didn’t get the part, her dieting intensified.
“Success in ballet depends on the development of a wiry and extremely thin body,” said a March 2002 Reuter’s Health Report on Eating Disorders. Yet ballet is not the only pastime with an “occupational hazard” (Kandal’s term for work-related encouragement of weight loss.) Endurance and performance athletes, like runners and gymnasts, are also at risk. Estimates for episodes of eating disorders among such athletes and performers range from 15 to over 60 percent, Reuters reported. In fact, the term, “female athlete triad” is now used to describe the serious disorder affecting dancers and athletes that has the combined presence of three main components: eating disorders, osteoperosis due to weight loss, and Amenorrhea (absence or irregular menstruation).
Kandal developed all of those traits.
Yet the cause of Female Athlete Triad, namely the pressure to perform, explains why many performers, not just athletes, are in danger of disordered eating. “I would think that [eating disorders are more prevalent] in dance, drama, musical theater and even… the choral department,” said musical theater teacher Craig Ames. “In those areas [where] your body is the instrument of your craft… the pressure is greater to have an instrument that conforms to those of your peers.”
Kandal’s dance department peers supported her dieting and exercising, even as it grew less healthy, and more dangerous. “The anorexic condition may be encouraged by friends who envy thinness or by dance or athletic coaches who encourage low body fat,” explained Reuters Health. When people began noticing Kandal’s weight loss, in her sophomore year at Dreyfoos, “I was getting compliments…particularly in my dance classes, such as, ‘you look so great’, ‘you have lost so much weight’, or ‘I wish I had your discipline,’” wrote Kandal.
Kandal’s discipline drove her weakened body, often collapsed on the mat, to get up, and continue working. Thinner and physically ill, she got a part in that year’s Nutcracker, although she admits her weight may not have been the reason.
“Professional ballet companies want their dancers to be thin. There’s no question of that,” said Dreyfoos dance teacher Jeff Satinoff. “[But] these days, [dance company] directors want their dancers to be athletic and physically fit [too]… It’s less about [being] a rail, and more about strength.” Satinoff believes that with weight standards in the world of professional dance changing for the better, pressure has eased in Dreyfoos dance studios as well. “We have had issues in the past with eating disorders,” admitted Satinoff, “but in the dance department… the weight issue is not a big issue for us… anymore.” At least one anonymous dance student disagrees. [quote from dance student saying something else.] Yet, according to Satinoff, the dance department does not encourage their students to lose weight.
Whether or not Dreyfoos teachers discuss weight in their dance classes, the pressure to be thin certainly transcends their department. When I attended Dreyfoos, the biggest misconception was that dancers were the only ones with eating disorders, said Kandel. Today, persistent stereotypes surround the dance department, while students in all departments suffer with disorders. Eva*, a Dreyfoos junior, developed Anorexia in 8th grade; Kelsey*, Dreyfoos sophomore, had both bulimia and anorexia in middle school.
Neither of them are dancers.
According to Dot Sparks, DSOA school nurse, “Eating disorders are probably more of an issue [at Dreyfoos, in all departments,] because we tend to have overachieving people here, already.”
“I was [always]… a perfectionist… a straight-A student, a type-A personality, and a control freak,” wrote Kandal, “…what you call a textbook anorectic.”
In the February [insert year] issue of the American Journal of Psychiatry, researchers found that perfectionism seems to increase the risk of developing eating disorders, but not other psychiatric problems. “Part of the drive for perfection is…attaining some ideal image of thinness,” reported Reuters Health.
Anorexia is linked, not just with perfectionism, but also with many other mental traits and disorders, including Obsessive Compulsive Disorder (OCD). OCD is defined by the presence of rigid, compulsive behaviors and recurrent ideas or mental images. According to Reuters Health, up to 33% of women with bulimia and up to 69% of women with anorexia suffer with the disorder.
These figures once characterized both Kandal and Natalie.
“When people think of OCD, they think of hand-washing and jumping over the cracks in sidewalks,” explained Kandel, “but it’s also [about] thoughts…[and] most people with eating disorders have obsessive thoughts.”
“There [was] a time when all I would think about was my weight, and if I was skinnier than the girl sitting next to me,” said Eva. “It was so consuming. It completely takes over your life.”
Reuters reports that “Some experts believe that eating disorders are just variants of OCD.”
“[Buhlimia] made me feel like I was in control,” explained Kelsey.
“The [control of] food is just a sublimation,” said local psychologist Dr. Suzanne Kaplin. “You [must] numb the feelings of inadequacy with something, and food is the easiest [substance] to get.”
The perceived inadequacies that lead to an eating disorder often stem from troubled pasts. Studies have reported sexual abuse rates as high as 35% in women with bulimia, according to Reuters Health.
Yet soon the eating disorder is something else in the sufferer’s life rapidly becoming out-of-control. In that way, “an eating disorder is like any other addiction,” explained Kaplan. Kandal, too, sees a link between addictive behaviors and eating disorders, and is currently working, as a dual diagnostic therapist at a treatment center, with people who suffer from both addiction and disordered eating.
Like addictions, there may be a genetic cause for eating disorders. A National Institute of Mental Health (NIMH) study is taking place right now to investigate the possibility that Kandal’s anorexia formed in her genetic code, long before she began dancing, and before she was even born. According to Reuters Health, anorexia is eight times more common in people who have relatives with the disorder. Yet the cause of that trend may not be genetics, but psychology. One study found that 40% of 9 to ten year olds lose weight at the urging of their mothers.
“I have a mother who is very fit, and I was envious of her,” said Eva. “Knowing that she was anorexic as a teenager, I thought in order to be thin, it was something I had to do.”
Kandal believes a gene gives someone a predisposition to an eating disorder, but that an environmental factor triggers the disease, itself.
Many people believe the Western media is such a factor, that it encourages eating disorders in its display of often unnatural and unattainable thinness. The National Eating Disorders Association reports that the average fashion model is 5’11” and weighs 117 pounds, while the average American woman is 5’4” and weighs in at 140.
Yet, according to Reuters Health, the societal causes of disordered eating go deeper than the pictures on the pages of magazines: not only does the media market the emaciated ideal, but also the ‘junk food’ that makes rampant obesity a national reality. “In a country where obesity is an epidemic, young women who achieve thinness believe they have accomplished a major cultural and personal victory; they have overcome the temptations of junk food and, at the same time, created body images idealized by the media,” said Reuters Health. “Few people living in this overfed and sedentary culture eat a meal guiltlessly” the report continues, “one can nearly make the sweeping generalization that everyone who lives in a developed nation is at risk for either obesity or some eating disorder.”
Yet within developed nations, females are at greater risk of developing eating disorders than males: 90% of eating disorder cases are in females, reports Reuters. Kaplan believes this gender discrepancy is due to imbalanced societal pressure. “Girls are taught they’re supposed to be beautiful, and thin….and lately, they’re also supposed to be smart,” she said. “That’s a lot to handle.” Kaplan believes the rising rates of eating disorders among men can also be traced back to gender-based pressure. “As women have had to change their roles in society, men have had to acclimate to that change,” she said.
Sexual orientation also seems to affect the occurrence of eating disorders among men. According to Reuters, in one study, 42% of men with bulimia said were they homosexual or bisexual.
Yet all sufferers of eating disorders, regardless of gender or sexual preference, develop certain symptoms.
“[When] I was fifteen years old…although I was literally at the point of [being] nothing but skin and bones, when I looked in the mirror, the … person [I saw] was extremely heavy (maybe even obese),” Kandal wrote. She was experiencing distorted body image, or body dysmorphia, a symptom of both eating disorders.
Bulimia is also characterized by a promiscuous attitude, broken blood vessels in the eyes from the strain of vomiting, tooth decay from stomach acid, dramatic weight fluctuations, poor self esteem, poor control of other impulses like drinking alchohol or spending money, and wearing tight clothing.
As an anorexic, Kandal developed different symptoms: she noticed her hair was falling out in clumps, her skin was yellow, and her body was growing a layer of fine hair, called Lanugo, which served to warm her, and compensate for a lack of insulating fat. Other symptoms of Anorexia are dizziness, fainting spells, exhaustion, mood swings, excessive excercising, and very poor self-esteem.
Kandal developed all of those symptoms. Her dance teachers, friends and family members began approaching her with concerns, but her parents still didn’t notice her disorder, due in part to another one of its symptoms: secrecy.
“When an individual has an eating disorder, he or she becomes very good at hiding it,” Kandal wrote.
Yet, in one moment in the middle of her junior year of highschool, Kandal’s lies stopped working. She was changing out of her dance clothes, and had left the door cracked open, when her mother walked by, glimpsed her ematiated body, and became horrified. “She began shaking me,” Kandal wrote. “She was crying and yelling at the top of her lungs, ‘You look like you just walked out of a concentration camp…You can see all of your bones and muscles.”
Kandal’s mother then took her to a doctor, who found that even with the layers of heavy clothing she had worn for the occasion, her weight was extremely low.
Kandal believes the first step to eating disorder recovery is seeing an MD, and getting a blood test to determine eloktrolyte and nutrient levels, and an Electrocardiogram (EKG) to measure heart damage.
At the age of sixteen, Kandal, who had never gotten her period, found she would also never be able to have children; she also had osteoporosis from lack of protein, and massive kidney and heart problems.
“[In anorexia-induced starvation,] the body will start to use its own tissue, including muscle and organs, for energy, since [it] has no food to use” reported the Eating Problems Service (EPS), at eatingproblems.org/epsefffect. “The heart muscle…can become thin and flabby,” according to the EPS, “and heart failure [may] occur.”
According to the South Carolina Department of Mental Health, (DMH), about 20% of people suffering with anorexia will prematurely die from complications related to their eating disorder.
Bulimia also has serious long-term consequences. “I have esophogitis, and a hiatal hernia,” said Natasha*, a woman in her early 20’s who still suffers with bulimia. “If I eat too much, [food] automatically comes up without force,” she continued, “It is [an] embarrassing… and constant reminder of the harm I have done to my body.”
Bulimia, too, can be fatal in some cases, notably when the esophagus ruptures, esophageal cancer develops, or long-term dehydration leads to kidney failure.
Eating disorders have a higher death rate than any other psychiatric disorder.
“One day my mom literally broke down because she thought I was going to die,” said Eva. “I didnt want to die.”
The next day, after previous relapses, Ava began to truly battle her disorder.
To recover, an eating disorder sufferer must first break the barrier of denial they have built. But even after overcoming denial, many eating disorder patients relapse, often because of stress.
Kandal relapsed once she was accepted into a dance company. Yet she went on to prove that relapse doesn’t mean there is no chance of recovery.
Kandal found that, for her, recovery meant “doing the unthinkable”; it meant quitting ballet.
For Eva and Kelsey, recovery is a day-to-day struggle with their weights and their minds; and for Natasha, it is still elusive.
Although many eating disorder patients never achieve a normal weight, or lose all weight-related mental criticism, “[they] can develop positive tools that help them…supplement negative behaviors,” said Kandal.
She recommends never keeping negative thoughts inside, and for help, seeing an eating disorder specialist.
She, herself, was in out-patient therapy, and seeing a nutritionist, when she realized she “wanted to help others deal with eating disorders.” She enrolled at UCF, and worked at recovering, volunteering with the International Association of Eating Disorder Profesionals, and earning a degree in Women’s Studies and Psychology.
After graduating, Kandal realized, “I wanted to create my own association…and help make eating disorders understood by the teenage population and every other age, gender, class, and race group.” With this goal in mind, Kendal founded the Alliance for Eating Disorder Awareness, at age 21.
Today, Kandal runs the non-profit Alliance from a small office in West Palm Beach, with private donations, one full-time employee, and five part-time volunteers. She answers about a hundred e-mails a day, mostly from people suffering with eating disorders, their loved ones and their caregivers. She does interviews with teen magazines, and radio stations to raise awareness. She visits local middle schools and high schools, workshopping and lecturing.
And everywhere she goes, she tells her stor- knowing it will never be a typical Dreyfoos success story, but hoping it will change typical standards of success.

Labels: By Ana

I’ve begun to think there are strings that connect people,
So that from the moon, the earth looks like it’s laced with spider’s silk.

For us,
On Earth
strings are invisible.
But once they pulled
at me
till
I could see dust motes breathing
a frequency of light
i tried to write
softer than words could hear
and I could hear
the dust motes eating strings’ vibrations.

I hear dust is creation’s beautiful parasite.
I hear it’s the color of strings.

I’ve begun to think strings are everything.
binding the wings
we would grow from our backs
if our backs
weren’t breaking.
tying our lungs too small to
swallow
the stars
till
in shadows
i see
we are
puppets in gallows:
dancing till dancing is snapping our necks.

I cry
sometimes
till I choke on strings
I sob knots into my stomach
I sew lines into my hands
And if I stand for too long in one place
I replace
my veins with threads
and my limbs with ropes,
dead
and thirsty for blood.

But I’ve heard the strings are our’s
and I’ve heard they go on forever.

And I’ve heard they’re a single strand of DNA
Weaving, as we walk between them and across them, our fates.

And I’ve heard they’re an endless line of music:
The refrain that plays at the beginning and ending of everything.

But they pull at me
like they can't be
anything
but
Love.

Labels: By Ana