Disordered Eating in Musicians: A Mixed-Methods Exploration

Research suggests that eating disorders (EDs) may be a very common problem in musicians, with 32% of the 301 adult musicians in Kapsetaki and Easmon's (2017) study reporting some form of disordered eating over their lifetime. This is considerably higher than the general population's lifetime prevalence rate of EDs of 1.89% in males and 2.58% in females (Qian et al., 2021). Research on EDs in musicians is therefore essential, particularly given the potentially fatal impact of EDs, but the area is under-researched, with only a small handful of studies investigating the topic (Aksoydan & Camci, 2009; DiPasquale, 2012; Kapsetaki & Easmon, 2017).

The determinants that contribute to the development of EDs in other performance disciplines such as dance and sport have been subject to considerable research over the years (Arcelus et al., 2014; Chapa et al., 2022), but music-ED research has fallen far behind in comparison; it is so far unclear as to whether the findings regarding prevalence, determinants and experiences generalise to the musical domain.

As exposed in the All-Party Parliamentary Group on Eating Disorders report compiled by leading ED charity Beat (2021), ED research is severely underfunded in the UK. Though EDs account for 9% of people with a mental health condition in the UK, just 1% of the UK's already limited mental health research funding is dedicated to EDs, despite EDs being associated with a significantly increased risk of mortality (Testa et al., 2020). Treatment outcomes are invariably poor for most EDs, with high rates of relapse for anorexia nervosa, bulimia nervosa and binge-eating disorder (Testa et al., 2020). There is an 'urgent need' (Testa et al., 2020, p.335) for significant improvement in treatment/prevention methods.

The impact of this research project has the potential to reach 1) musicians, 2) other performance disciplines, and 3) extend beyond the music industry and contribute towards our wider understanding of EDs in the general population.

Based on recommendations from the aforementioned research, this project aims to investigate both the prevalence of and the determinants that can contribute to EDs in musicians through qualitative and quantitative methods. I will also consider how this knowledge can be used to improve prevention strategies and treatment outcomes. As there is currently little research on the topic and a clear gap in the literature, I propose a set of open, exploratory questions that will allow me to build a basic foundation before pursuing the more specific lines of enquiry that shall emerge.

RQ1: What is the prevalence rate of EDs among musicians in the context of their professional, psychological, health, and demographic characteristics?
RQ2: What are the determinants of EDs among musicians?
RQ3: What are the individual experiences of musicians who have been diagnosed with an ED?
RQ4: What support might prevent the development of EDs in musicians or benefit musicians who have experienced disordered eating?

The stated population, "musicians", encompasses many different experiences/stages of life/careers; as such, RQ1 shall investigate the impact of the aforementioned characteristics on prevalence rates to determine whether the following RQs ought to focus in on a particularly at-risk subgroup in order to generate more specific/directed knowledge and support.

As this project poses exploratory questions with the aim of understanding both objective prevalence rates and subjective experiences, the project must take a pragmatic approach and utilise both quantitative and qualitative methodologies. Furthermore, as the fourth and arguably most important research question aims to facilitate improvements in prevention/treatment methods, a co-design/co-creation approach will be necessary in order to produce and receive participant feedback on potential resources.