Despite this evidence that indicates an association between ballet training in adolescence to deteriorated health, there are studies that seem to find the opposite information. Many trials and case studies report that dance, in fact, has a positive impact on young girls’ lives and their mental health. A review of controlled trials published in the British Journal of Sports Medicine found that exercise can help to improve self esteem (Eekland, 792). The overall purpose of this review was to analyze 23 trials that all studied the effects of exercise or physical activity and their effects on self-esteem, behavioral problems, depression, and anxiety (Eekland, 792). A more specific case study focused on Whitney Thore, a tv personality who had gained almost 100 pounds due to health complications (Jimison). According to Thore, she expressed that she had noticed a definite difference in her confidence and mental health almost immediately after taking up dance (Jimison). While these cases have confirmed a connection between dance class and positive mental health, they do not give any insight on more specific programs such as pre-professional ballet training. The structure of these classes and their purposes are very different from recreational classes. Children that dance recreationally typically take one class a week for each style that they practice and their ultimate goal is to perform for their parents at a year-end recital. Pre-professional training is very different. Adolescents that are on a pre-professional track train intensively for the majority of their weeks for the hopes of one day accepting a role in a company. The same article about Thore specifically mentioned a study that concluded that girls that participate in dance that is focused on enjoying movement, rather than perfection and performance-based classes, are more positively impacted (Jimison). Ballet is a performance-based art that inspires individuals to strive for perfection, therefore this study does not apply to ballerinas-in-training. In actuality, this concept of dance and exercise improving mental health is what ballet should strive for, but it is a matter of changing the cultural mentality surrounding ballet.