Dance Recovering from Eating Disorder with Dietician Kia’ikai “Kai” Iguchi
I was so pleased to welcome Kia’ikai “Kai” Iguchi to my podcast for the second installment in my mini-series on Dancing Body Acceptance! They have connected me with a wealth of wonderful resources when it comes to dancing nutrition, eating disorder treatment, equity and access and I’m so grateful for their knowledge.
Kai is a Dietician working in eating disorder recovery, an adult ballet dancer, and nonbinary (they/them pronouns). They were also a ballet student of mine at the University of Hawai’i!
TW: Trigger Warning due to talk of disordered eating behaviors, treatment protocols, & symptoms
“Especially in the mental health field, I feel like people have to be able to feel safe in this treatment environment to be able to make any progress at all. If you’re constantly worrying about being misgendered or whatever in the treatment setting, how would you be able to make any progress or build any trust with the treatment team members?” -Kia’ikai Iguchi
Kia’ikai Iguchi’s Bio
- Eating Disorder Registered Dietitian, Adult Eating Disorder Recovery
- Born in Japan (bilingual with Japanese)
- Passionate about providing high-quality care to trans and gender-nonconforming folks
- MSc: Eating Disorders and Clinical Nutrition (University College London)
- MS: Dietetics (University of Illinois at Chicago)
- Eating Disorders/Mental Health Translator (“Eating in the Light of the Moon”, “Nutrition Counseling in the Treatment of Eating Disorders”, “Sick Enough”
In our recorded conversation, available above as a YouTube Video and below as an audio Podcast, Kai tells about their journey to being a dancing dietician, including dancing and growing up in Japan and studying in Hawai’i, the UK, and on the US Mainland.
Having begun as an undergraduate in marine biology at the University of Hawai’i, Kai realized that they weren’t really cut out for the field while on an oceanic field trip. I can relate to loving dolphins, but not really wanting to be swimming and diving all the time for work! We agree to admire dolphins from afar, and I just love talking with multi-passionate people about their career adventures.
After having personal experience as a dance student with an eating disorder and receiving treatment in Hawai’i, Kai then explored possible professions as a physical therapist, therapist, and dietician before going on to a specialized master’s degree in eating disorder at University College in London.
Kai’s current work is with adults 18-76 in a residential setting. I appreciated their explanation of inpatient, residential, day, and intensive outpatient levels of eating disorder care & recovery as well as discussion of who can access such care (those with really good insurance and/or a lot of money).
Ultimately, Kai would like to continue with work in inpatient or residential setting in a structured program or collaborate with other professionals to create a respite center specific to the trans and LGBT community.
Recovering from Injury with & without an ED
Kai has personal experience of dancing with an eating disorder, as well as attempting to recover from injury while undernourished. Kai tore their ACL while living with eating disorder and didn’t recover well from the injury at that time.
Then once they recovered from eating disorder, they tore ACL again and the second time around saw distinctly better recovery! Usually with such a re-injury, recovery is much worse, but in Kai’s case the improved results point to the nutritional link in our ability to heal.
Current Issues in Dance, Nutrition, & ED Care
Kai identified a number of issues that we are currently facing in the ballet world and in society at large with regard to eating disorder care and nutritional support. Ballet culture has historically included normalization of disordered eating behaviors, fostering negative relationship to food and bodies. We want to facilitate culture change in these areas.
Messages about Food & Bodies
Starting as ballet students, our teachers’ language use can be triggering, especially for younger dancers. Negative narratives towards food (i.e. that specific foods are “bad” or inappropriate) and bodies (that one impossible physical “ideal” is necessary in dance) are harmful and can lead to disordered eating behaviors.
Ballet, Injury, & Disordered Eating
When dancers get hurt, the injury recovery process can trigger eating disorder behaviors, as when they are less active (having to rest and heal before returning to dance), dancers might eat less to compensate for lack of movement. Undereating in turn negatively affects the outcome of physical therapy, as Kai pointed out, you can’t get stronger while malnourished.
Access for Students & Professionals
Kai has had the pleasure of studying at at Ballet Hawai’i, the Joffrey Ballet, and Milwaukee Ballet, none of which have dieticians as part of their medical team (maybe sports or physical therapists if they’re lucky). Further, they can’t name any companies (nor can I) who do have a dietician on staff, though they might invite them to guest speak and educate the dancers. Still, students are prone to picking up eating disorder behaviors.
Professionals get injured frequently and their injuries, for example stress fractures, are often blamed on poor technique and/or “overuse.” Such injuries could also be due to undereating or malnutrition. Professional dancers need nutritional support to prevent injury and in their injury recovery process.
Dancers and athletes in sports that value certain bodies or physiques have difficulty accessing eating disorder treatment due to the need to continue their professional practices/responsibilities (no time off for treatment) and limited income/insurance (no money for treatment). Dancers are statistically shown to be more likely to have eating disorders, but are underrepresented in treatment.
Marginalized Identities & Finding an LGBT-Friendly Dietician
Sadly, Kai finds it very difficult to recommend an eating disorder treatment center for trans folks, since such clinical settings are often an unsafe environment (due to misgendering, pronoun misuse, etc.). In particular, medical clinics need more consideration of language and better policies.
Kai also spoke about the prevalence of eating disorders among people with marginalized identities. While the disordered eating behavior is sometimes blamed on individuals identifying with marginalized groups, Kai argues that the eating disorder can actually have to do with the treatment such individuals experience, in society as well as in a clinical environment.
Additionally, what medical practitioners sometimes claim to be “noncompliance” on the part of patients from marginalized communities can actually be dismissal of patient’s need to feel safe. Administrations have room to grow in the area of affirming policies for LGBT and other marginalized identities. In making such policies it is important to listen to the concerns of the community, avoid virtue signaling and involve affected people.
Ballet Difficult for Nonbinary Dancers
Due to a lack of body and gender diversity in the field of ballet, it can be very hard for trans dancers to fit in. Traditionally, ballet features very gendered roles and steps, as well as a lot of “girls” and “boys” language. Kai pointed out if there’s one boy in the class, teachers will say “dancers” or something neutral, but if the students all appear to be feminine, the tendency will be to call them all “girls” or “ladies,” leaving no room for people who do not identify in those ways. There is pressure to choose a narrowly-defined and clear gender expression that may not align with the dancer’s own identity.
“Why can’t they be just ‘dancers?'” – Kia’ikai Iguchi
Gendered, racist, transphobic dance uniforms were also a topic of conversation, along with assumptions on the part of teachers and administrators about how students identify, gendered pointework, changing/locker rooms and bathrooms. All with “tradition” as an excuse.
Adult/recreational ballet classes are more inclusive of diverse bodies than in a children’s, pre-professional or professional setting, more focused on strength, balance, enjoyment and technique
Kai finds that to this day, ballet variations work is difficult to navigate as a trans or nonbinary dancer, as such choreographies tend to be very gendered and often skew to the “feminine” in classes with apparently mostly females. We are navigating a space where a few companies are trying to question traditionally gendered assumptions about ballet, but they are more fringe projects than mainstream, large, or prestigious companies.
A few nonbinary-friendly and diverse ballet companies:
Black Sheep Ballet (virtual)
Contretemps Ballet (Chicago)
Ballet 22 (Oakland)
The Work Ahead
So what can we do to make it better? We need to keep asking ourselves how we can make things better for all bodies, listening to stories from people with lived experiences, not tokenizing marginalized voices, making real changes, working to make things better continuously.
Kai spoke to the difficulty of creating change in big institutions (like large clinics or hospitals), ensuring that standards and policies are met in multiple locations, and sees these as challenges that the medical field needs to actively address
As teachers or role models, we can avoid negative narratives towards food (i.e. that specific foods are “bad” or inappropriate) and bodies, instead supporting a neutral relationship to body and encouraging nourishment and thriving.
It’s helpful to focus on the whole picture of dancers’ technique rather than fixating on body size or build. Since taking ballet classes in the states, Kai reports that things have been pretty smooth and non-triggering due to the overall holistic approach of the teachers they has been lucky to have. (Japan was another story). Even so, they had a recent triggering experience of having a substitute ballet teacher who displayed alarming signs of malnutrition/disordered eating.
We also recommend that you follow and support diverse dancers and companies, in terms of racial, gender, and body-size representation, to get a fuller picture of what is possible, beautiful, and healthy.
Kai, Fumi Somehara, and dancer and therapist Colleen Werner will also participate in a panel in January for the Royal Academy of Dance, Australia conference (virtual):
Finding a Dance-Specific Anti-Diet Dietician
Kai currently only knows a couple dieticians that specialize in ballet/dance that they would be willing to refer to (i.e. no “get in shape for the audition/performance” weight loss language), and feels it is still a hard-to-find specialty. Here are a few, and hopefully we can find more in the future!
Dance-friendly anti-diet (HAES, Intuitive Eating, etc.) nutritionists:
DDD Center for Recovery
Thanks again to Kai for their time in speaking with me and referring myself and my students to excellent resources for further learning (including Dietician Fumi Somehara in last week’s Dancing Body Acceptance Blog!)!
Questions for Reflection
- Have you ever worked with a Dietician? Taken nutritional advice from other sources?
- What is your experience with body image in dance or other areas of your life?
- What is your current relationship to weight loss and diet culture?
- What do you want to know about body acceptance, diverse representation, and intersectionality in ballet or in dance?
- What would you like to reinvent about your relationship to your body and eating?
I am committed to continuing to learn more about body neutrality, positive relationships to food and body, eating disorder prevention and treatment, and supporting marginalized communities including LGBTQIA+ and BIPOC.
More about cultivating healthy body image, intuitive eating, and the joy of movement to come!
Blythe Stephens, MFA & Bliss Catalyst
she/her or they/them
A Blythe Coach: move through life with balance, grace, & power
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