Bulimia Nervosa: The Disorder Behind The Dancing

Part 1

The feature film, Center Stage, was directed by Nicholas Hytner and released in theaters on May 12, 2000. The screenplay for the movie was developed by Carol Heikkinen and it was produced by Laurence Mark. The plot of the movie takes place primarily in the present and is contained within the prestigious American Ballet Academy in New York City and follows twelve teenagers who audition and attend the ballet school. The film centers on these twelve dancers through the hardships accompanied with attending one of the toughest ballet schools in the country, such as the perfect body type, being proficient in their technique, and the obstacles standing in the way in the pursuit of their dreams. Although the movie is about the twelve dancers, it focuses on six major cast members and their minor stories and relationships outside the school. Another focus of the movie is three characters who have problems with weight. Two of the characters are healthy, but are penalized for not striving to attain the "perfect body," and one has an unhealthy obsession with weight.

The movie begins with the ballet audition of Judy Saywer, performed by Amanda Schull, and shows that she does not have the ideal body right from the start. Then the movie shifts to Maureen, played by Susan May Pratt. She is a major character who has studied at the American Ballet Academy since the age of nine and is considered to be the Prime Dona by her fellow classmates. Throughout the movie, Maureen develops a relationship with Jim, a medical student played by Eion Bailey, and she begins to focus more on her new boyfriend rather than on her dancing. Their relationship is shaken when Maureen's eating disorder is discovered by Jim, but she refuses to admit her problem and accept his help. After a personal struggle with denial, Maureen admits to having the disorder and seeks help. In the end of the movie, Maureen decides to give up the stressful, self-conscious life of a dancer and pursue things that will make her happy and not have the regret she would have if she followed her mom's dreams of a dance career. The resolution of the movie takes place with the announcement of who made the company, something each of the twelve students aspired to, but only three would achieve.

Part 2

Bulimia nervosa is a psychological disorder that plagues approximately 1%-3% of adolescent and young adult females (American Psychiatric Association, 1994, 548). This illness most commonly develops during adolescence, with the peak onset at the age of 18 (Mehler, 2003). Along with bulimia nervosa comes many psychological and medical complications that may lead to osteoporosis, growth or developmental delay, or an end result of death (Pritts & Susman, 2003).

There are two chief types of bulimia nervosa: purging and nonpurging. Purging is characterized by the patient inducing vomiting or using laxatives, diuretics, or enemas improperly. Nonpurging bulimia nervosa is closely related to anorexia nervosa in that the patient undergoes fasting or extreme exercise, but has rare episodes of inducing vomiting or using laxatives, diuretics, or enemas improperly. For a person to be classified into either on of their categories, the behaviors must occur, on average, at least twice a week for 3 months (American Psychiatric Association, 1994, 545).

Activities that promote thinness, such as ballet dancing, modeling, and athletics, expose adolescents to situations that may cause the development of an eating disorder. These activities lend to the personality traits carried by individuals with bulimia nervosa. Adolescents may portray behaviors such as being a perfectionist, low self-esteem issues, social isolation, and difficulty in verbally expressing emotions (Pritts & Susman, 2003).

There are multiple symptoms attributed to bulimia nervosa. Some physical symptoms may include sore throat, acid reflux disease, abdominal pain, cold intolerance, and constipation (Pritts & Susman, 2003). A major trait is the use of extreme methods so as to prevent weight gain. "The method of purging is employed by 80-90% of individuals with Bulimia Nervosa" so as to feel the immediate "relief from physical discomfort and reduction of fear of gaining weight" (American Psychiatric Association, 1994). The method of purging is not only limited to self-induced vomiting, but may also include laxatives, diuretics, enemas, or other medications (Pritts & Susman). Individuals may also feel a lack of control. This symptom is often felt during binge eating and causes the person to be unable to stop eating. These uncontrollable binge eating periods are reoccurring and usually last only a short time. Another characteristic is that during the binge eating, individuals will consume "an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances" (American Psychiatric Association, 1994). Patients may often experience embarrassment of their illness and will most likely try to hide their symptoms, in that their fasting or purging will occur in secret. Individuals will also have self-esteem issue associated with poor self-evaluation caused by their views of body shape and weight (Pritts & Susman, 2003).

Some health risks associated with bulimia nervosa are hypokalemia, hyonatremia, and hypochloremia (American Psychiatric Association, 1994). Hypokalemia, which is a low level of potassium in the blood stream, affects the ability of nerve and muscle cells, but most importantly the heart. This condition is primarily caused by the increased consumption of a diuretic that promotes an increase in urination. Hyponatremia is another illness associated with the disorder in which the patient consumes large amounts of water causing the salt content in the blood to be diluted leading to a hindrance in brain, heart, and muscle function. The vomiting of the patient causes hypochloremia whereas there is an abnormally low level of chloride, an anion regulated by the body, and if untreated, will result in death (Electrolyte, 1998).

There are multiple psychological risks attributed to eating disorders such as depression. According to Pritts and Susman (2003), severe depression is considered the most common comorbid condition with a lifetime risk as high as 80%. Another common condition is anxiety, which causes the patient to experience social phobia. Personality and obsessive compulsive disorders are prevalent in patients with eating disorders, whereas 21 to 97 percent experience a personality disorder and 30 percent suffer from obsessive compulsive disorder (Pritts & Susman, 2003). In a study concerning the effects of anxiety, depressive, or personality, or substance use disorders, researchers looked for a correlation between these