For a quarter of a century performing arts medicine personnel have been aware of the elevated risk of eating disorders in preprofessional high school dance students. This article reviews the etiological considerations related to this trend and how they affect the prevention and management of eating disorders. Are the students in question making a considered response to society's demand for a lean appearance, or do they represent a sub-population that is suffering from clinical disorders (the pathologic results of dieting behaviors, self-image problems, social difficulties, physical injuries, and so forth)? Recent school-based programs have shown encouraging results in reducing incidence. On the basis of what those programs have taught us, practical recommendations for the management of existing disorders are presented, from a psychiatric perspective.
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