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Unal GA, Kocatepe Avcı U. The Mediating Role of Attitudes Towards Eating in the Relationship Between Compulsive Instagram Use and Orthorexia in Adults. Psychol Res Behav Manag 2024; 17:4237-4248. [PMID: 39679318 PMCID: PMC11646376 DOI: 10.2147/prbm.s491268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/07/2024] [Indexed: 12/17/2024] Open
Abstract
Purpose The purpose of this study is to examine the relationship between compulsive use of social media and orthorexia, with a focus on the mediating role of eating attitudes. Patients and Methods The study involved 255 participants between the ages of 18-65 who did not have any psychiatric disorders or developmental disabilities. The participants completed a Sociodemographic Information Form, Orthorexia Nervosa Inventory, Social Media Addiction Scale, and Eating Attitudes Test. Results The results showed a positive correlation between orthorexia and all other scales and sub-scales. Multiple regression analyses revealed that eating attitudes were a significant predictor of all sub-dimensions of orthorexia. Additionally, the sub-dimension of Conflict on the Social Media Addiction Scale was found to predict the Impairments sub-dimension of orthorexia. Further analysis using the PROCESS macro showed that compulsive use of social media not only directly predicted orthorexia, but also indirectly through eating attitudes. Conclusion These findings emphasize the importance of addressing both compulsive use of social media and eating attitudes when working with individuals who exhibit orthorexic symptoms in clinical settings.
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Affiliation(s)
- Gonca Ayse Unal
- Clinic of Psychiatry, Mersin Sehir Egitim ve Arastirma Hastanesi, Toroslar, Mersin, Turkey
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Lakritz C, Tête N, Iceta S, Lafraire J. Orthorexia nervosa tendencies and risk of eating disorders among culinary arts students: A comparative study with dietetics students. J Hum Nutr Diet 2024; 37:1547-1557. [PMID: 39363562 DOI: 10.1111/jhn.13368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Students pursuing food-related academic fields such as dietetics have higher orthorexia nervosa (ON) tendencies and are at a greater risk of developing eating disorders (EDs). However, there is limited research available on ON tendencies and on the risk of EDs in the culinary arts field, which also revolves around food. The present study explored ON tendencies and the risk of EDs among culinary arts students and compared them with those of dietetics students. METHODS A cross-sectional study was conducted in France, using the eating habits questionnaire (EHQ) to measure ON tendencies, and the SCOFF as well as the eating disorders examination questionnaire (EDEQ) to evaluate the risk of EDs and ED symptoms. The study also included questions about sports practice. In total, 267 students participated in the study, including 144 culinary arts students (51 women, 92 men and one other) and 123 dietetics ones (106 women, 15 men and two others). RESULTS Culinary arts students exhibited similar means of EHQ scores as dietetics ones (32.99 vs. 33.34) but higher SCOFF scores (52.8% vs. 39.8%). In addition, a gender difference was evidenced: women in culinary arts showed higher EHQ, SCOFF and EDEQ scores than men in culinary arts. Linear regression models showed no effect of the type of academic field (culinary arts vs. dietetics) on the EDEQ score but revealed effects of gender, body mass index and hours of sports practice. CONCLUSIONS The study emphasises the need to monitor culinary students and implement interventions to prevent EDs. It also suggests a correlation between food-related education and the risk of EDs, which requires further research.
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Affiliation(s)
- Clara Lakritz
- Centre de recherche et d'innovation de l'Institut Lyfe, Ecully, France
- Health, Systemic, Process UR 4129 Research Unit, University Claude Bernard, University of Lyon, Lyon, France
- Département de psychiatrie et de neurosciences, Université Laval, Québec City, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, QC, Canada
| | - Nicolas Tête
- Centre de recherche et d'innovation de l'Institut Lyfe, Ecully, France
| | - Sylvain Iceta
- Département de psychiatrie et de neurosciences, Université Laval, Québec City, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, QC, Canada
| | - Jérémie Lafraire
- Centre de recherche et d'innovation de l'Institut Lyfe, Ecully, France
- Laboratoire CHArt, Cognitions Humaine et ARTificielle, École Pratique des Hautes Études-Paris Sciences Lettres, Campus Condorcet, Aubervilliers, France
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Łucka I, Mazur A, Łucka A, Sarzyńska I, Trojniak J, Kopańska M. Orthorexia as an Eating Disorder Spectrum-A Review of the Literature. Nutrients 2024; 16:3304. [PMID: 39408271 PMCID: PMC11478848 DOI: 10.3390/nu16193304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/24/2024] [Accepted: 09/25/2024] [Indexed: 10/20/2024] Open
Abstract
BACKGROUND The purpose of this study is to compare and analyze research studies focused on orthorexia nervosa (ON) as a spectrum of eating disorders, and to summarize potential risk factors in different age and social groups. ON is characterized by an obsession with healthy eating, which leads to a restrictive diet and health problems. METHODS Due to a lack of comprehensive analyses, this review re-examined studies from 2006 to 2023, initially retrieving 53,134 articles. Upon refining the criteria and risk factors for eating disorders, 34 notable records were identified. These studies employed diagnostic tools such as ORTO and BOT, focusing on risk factors for ON. RESULTS Results indicate that individuals suffering from eating disorders, losing weight, exercising heavily, developing relationship problems, and suffering from body dysmorphic disorder are at high risk of developing ON. A significant correlation was found between ON, BMI, and gender, but not between ON and OCD. Interestingly, ON symptoms appear to overlap with those of other eating disorders, such as anorexia and bulimia, especially in terms of obsessive control over dieting and fear of gaining weight, indicating a close relationship between the two. CONCLUSIONS Interestingly, orthorexia nervosa may serve as a coping mechanism for anorexia, providing a sense of control. However, further research on its long-term effects is required.
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Affiliation(s)
- Izabela Łucka
- Department of Developmental Psychiatry, Psychotic Disorders and Old Age Psychiatry, Medical University of Gdansk, 80-282 Gdansk, Poland;
| | - Artur Mazur
- Institute of Medical Science, College of Medical Sciences, University of Rzeszów, ul. Warzywna 1a, 35-215 Rzeszow, Poland;
| | - Anna Łucka
- Faculty of Law and Administration, University of Gdansk, 80-309 Gdansk, Poland;
| | - Izabela Sarzyńska
- Student Research Club “Reh-Tech”, Medical College of Rzeszow University, 35-959 Rzeszow, Poland; (I.S.); (J.T.)
| | - Julia Trojniak
- Student Research Club “Reh-Tech”, Medical College of Rzeszow University, 35-959 Rzeszow, Poland; (I.S.); (J.T.)
| | - Marta Kopańska
- Department of Medical Psychology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
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Białek-Dratwa A, Stoń W, Staśkiewicz-Bartecka W, Grajek M, Krupa-Kotara K, Kowalski O. The Psychosocial Aspects of Vegetarian Diets: A Cross-Sectional Study of the Motivations, Risks, and Limitations in Daily Life. Nutrients 2024; 16:2504. [PMID: 39125383 PMCID: PMC11314235 DOI: 10.3390/nu16152504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION The popularity of vegetarian and vegan diets is linked to various motivations, such as health, ethics, ecology, and social and religious influence. India has the highest proportion of vegetarians and vegans. The practise of these diets is linked to moral and health reasons and environmental concerns. Vegetarianism may also be associated with eating disorders such as orthorexia (ON). AIM The main aim of this study was to determine the psychosocial aspects of vegetarian diets. Understanding these aspects is crucial for identifying potential risks and developing effective interventions. This study investigated the reasons for following vegetarian diets, the duration of dietary adherence, the occurrence of feelings of restriction in selected situations, and the risk of orthorexia and other eating disorders. METHODS A questionnaire survey was conducted among 186 individuals (82 vegetarians and 104 traditional dieters) between October 2023 and April 2024. The survey was administered via a Computer-Assisted Web Interview (CAWI) using Google Forms, distributed through social media, forums, and private messages. The inclusion criteria for the study group included consent, an age over 18, and a vegetarian diet, excluding those with eating disorders or diseases requiring strict diet therapy. The control group criteria were similar, excluding vegetarians and those requiring special diets. Four unreliable questionnaires were excluded from the analysis. The survey consisted of four sections: metric data, the ORTO-15 questionnaire, the EAT-26 questionnaire, and the TFEQ-13 questionnaire. RESULTS The main motivations for following vegetarian diets were ethical and environmental (86.9%) and health (32.1%) reasons. Over half of the vegetarians had been following a plant-based diet for over five years. Vegetarians were more likely to feel restricted in restaurants and when grocery shopping. The ORTO-15 results indicate a higher risk of orthorexia among vegetarians (48.8% vs. 29.4% in the control group; p = 0.00673). The EAT-26 questionnaire showed a higher, but not statistically significant, risk of eating disorders among vegetarians (23.8% vs. 14.7%; p = 0.11391). The TFEQ-13 showed no significant differences between groups (Subscale 1: food restriction, p = 0.77279; Subscale 2: lack of control in overeating, p = 0.91935; Subscale 3: eating under the influence of emotions, p = 0.16612). CONCLUSIONS This study concluded that ethical and environmental considerations and a belief in health benefits mainly drive vegetarians. An analysis of BMI revealed no significant differences between groups. The ORTO-15 results suggest a higher risk of orthorexia among vegetarians. The EAT-26 indicated a higher, but not statistically significant, risk of eating disorders among vegetarians and vegans. The TFEQ-13 showed no significant differences in restrictive eating, lack of control in overeating, and emotional eating. Vegetarians were likelier to encounter dietary difficulties in restaurants and shopping but less likely to feel socially excluded.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
| | - Wiktoria Stoń
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
| | - Wiktoria Staśkiewicz-Bartecka
- Department of Food Technology and Quality Assessment, School of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland;
| | - Mateusz Grajek
- Department of Public Health, School of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Piekarska 18, 41-902 Bytom, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, School of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Piekarska 18, 41-902 Bytom, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
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KORKMAZ YAYIN B, CEYLAN ERGUN C. Mediator Roles of Perfectionism and Self-Critical Rumination in the Relationship Between Perceived Maternal Rejection and Orthorexia: A Model Testing in a Female Sample. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1191242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Orthorexia nervosa (ON) refers to a pathological obsession with healthy eating characterized by a restrictive diet, ritualized eating patterns, and strict avoidance of foods believed to be unhealthy or unclean. On the other hand, healthy orthorexia (HO) is defined as an interest in healthy eating and a tendency to eat healthy foods. This study aimed to investigate the relationships between the ON, HO, maternal rejection, perfectionism, self-critical rumination, and body attitude in the women sample. 445 female students from diverse universities in Turkey was attended to our study. Participants completed questionnaires regarding ON and HO, body attitude, maternal rejection, perfectionism, and self-critical rumination. The results showed that negative body attitudes could not predict both HO (B=-.008, SE=.039, p=.791) and ON (B=.008, SE=.032, p=.835). However, perfectionism and self-critical rumination had mediator roles in the relationship between ON and HO with maternal rejection, despite this relationship was positive for ON (B = .014, Boot SE = .007, 95% Boot CI [.003, .029]), but negative for HO (B = -.023, Boot SE = .010, 95% Boot CI [-.042, -.008]). Not a negative body attitude, but maternal rejection, perfectionism, and self-critical rumination played roles in developing orthorexic tendencies.
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Lakritz C, Iceta S, Duriez P, Makdassi M, Masetti V, Davidenko O, Lafraire J. Measuring implicit associations between food and body stimuli in anorexia nervosa: a Go/No-Go Association Task. Eat Weight Disord 2023; 28:93. [PMID: 37917374 PMCID: PMC10622378 DOI: 10.1007/s40519-023-01621-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE The present study aimed to explore the implicit associations between food and bodily stimuli in patients with anorexia nervosa (AN) and control subjects (HC). METHODS A Go/No-Go Association Task was administrated to 55 participants (28 AN and 27 HC), using food stimuli (low-calorie food vs. high-calorie food) and body stimuli (underweight vs. overweight bodies). RESULTS We evidenced an implicit association between food and body stimuli in the AN group, whereas the HC group only showed a tendency. AN and HC groups also exhibited different categorization strategies: the AN group tended to categorize stimuli as low-calorie foods and underweight bodies less than the HC group, and they tended to categorize stimuli as high-calorie foods and overweight bodies more than the HC group. CONCLUSION The present study revealed for the first time specificities of the AN population's implicit association between food and body stimuli in terms of association strength and categorization strategy. Furthermore, the results suggest that combining implicit methodologies with other methods could contribute to a better characterization of the physiopathology of AN. LEVEL OF EVIDENCE Level I, experimental study.
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Affiliation(s)
- Clara Lakritz
- Centre de Recherche de l'Institut Paul Bocuse, Ecully, France
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Sylvain Iceta
- Département de Psychiatrie et de Neurosciences, Université Laval, Québec, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, QC, Canada
| | - Philibert Duriez
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, 75014, Paris, France
- GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 75014, Paris, France
| | - Maxime Makdassi
- GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, 75014, Paris, France
| | | | - Olga Davidenko
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Jérémie Lafraire
- Centre de Recherche de l'Institut Paul Bocuse, Ecully, France.
- Laboratoire CHArt, Cognitions Humaine et ARTificielle,, EPHE - PSL, École Pratique des Hautes Études - Paris Sciences Lettres, Campus Condorcet, Aubervilliers, France.
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Cosh SM, Olson J, Tully PJ. Exploration of orthorexia nervosa and diagnostic overlap with eating disorders, anorexia nervosa and obsessive-compulsive disorder. Int J Eat Disord 2023; 56:2155-2161. [PMID: 37615059 DOI: 10.1002/eat.24051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is characterized as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, ON shares theoretical overlap with eating disorders (EDs), especially anorexia nervosa (AN), as well as obsessive-compulsive disorder (OCD). This study aimed to further understand ON and its overlap with related disorders by assessing the ability of ON for detecting the presence/absence of threshold ED, AN, and OCD symptoms. METHOD An observational survey was completed by 197 participants recruited through eating disorder, dieting, and mental health support groups. Receiver operating characteristic (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by Eating Habits Questionnaire [EHQ] orthorexia nervosa [OrNe] and healthy orthorexia [HeOr] subscales, and the Orthorexia Nervosa Inventory [ONI]) for detecting disordered eating symptoms (determined by Eating Disorder Examination Questionnaire [EDE-Q] global cut-scores), probable AN (determined by EDE-Q cut-scores and body mass index [BMI] <18.5), and OCD symptoms and obsessional thinking (assessed by the Revised Obsessive-Compulsive Inventory [OCI-R]). RESULTS Results showed both the ONI and EHQ OrNe measures are able to adequately predict ED symptoms and AN; however, both were poor to moderate at detecting OCD symptoms and obsessional thinking. Healthy orthorexia was poor to moderate at detecting outcomes. DISCUSSION These results suggest that ON, as it is currently operationalized, may be more closely related to EDs than OCD, and that ON may represent a subtype of AN. Results also support healthy orthorexia as a distinct construct to ON. While results are limited by the lack of definitive ON diagnostic criteria, findings suggest that treatments developed for EDs might be most suited to ON. PUBLIC SIGNIFICANCE ON has been proposed as a psychiatric disorder, and it shares theoretical overlap with several existing disorders. This study adopts a novel approach to assessing and exploring the overlap of ON with EDs, AN and OCD. Results suggest that ON shares more overlap with EDs and might best be understood as a subtype of EDs or AN.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Jemma Olson
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
- Freemasons Centre for Male Health and Wellbeing, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Rachubińska K, Cybulska AM, Schneider-Matyka D, Panczyk M, Kupcewicz E, Kamińska M, Grochans E. Personality traits and risk of eating disorders among Polish women: the moderating role of self-esteem. Front Psychiatry 2023; 14:1281898. [PMID: 38025422 PMCID: PMC10644397 DOI: 10.3389/fpsyt.2023.1281898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Personality traits should be taken into account when diagnosing individuals with disordered eating behaviors in the hope of better understanding their etiology and symptom progression and when planning treatment. The objective of this study was to attempt to determine the moderating role of self-esteem in the relationships between personality traits included in the Big Five model among Polish women and estimated risk of eating disorders. Methods The study was conducted among 556 Polish women from Zachodniopomorskie Voivodeship. The average age of the women under study was 34 years. A diagnostic survey was used as the research method, and the empirical data were collected using the following research tools: The NEO Five-Factor Inventory (NEO-FFI), Rosenberg Self-Esteem Scale (SES), ORTO - 15 Questionnaire, The Three-Factor Eating Questionnaire (TFEQ-13), and the authors' original questionnaire. A multivariate linear regression analysis was conducted to examine the influence of selected independent variables. The assumptions for the linear regression model were satisfied, as indicated by the Ramsey Regression Equation Specification Error Test, White's test, and the Jarque-Bera test. Results Only the personality trait of neuroticism exhibits a statistically significant effect on the "Cognitive Restraint of Eating," "Uncontrolled Eating," and "Emotional Eating" scores (p < 0.001). The moderation effect was demonstrated between self-esteem and the personality trait of conscientiousness on the "Cognitive Restraint of Eating" scale score. There is a moderation effect between self-esteem and the personality trait of extraversion on the "Uncontrolled Eating" subscale score. There is a moderation effect between self-esteem and the personality trait of conscientiousness on the "Uncontrolled Eating" scale score. Conclusion Self-esteem was not a predictor of the occurrence of risk of eating disorders while playing a moderating role in the relationship between certain personality traits and estimated risk of eating disorders. A higher level of neuroticism was identified as an important predictor of higher results for orthorexia, Cognitive Restraint of Eating, Uncontrolled Eating, and Emotional Eating. It was also demonstrated that the orthorexia risk index decreased with increased extraversion and openness to experience. The results of this study suggest that eating behaviors and psychological factors should be included in psychological interventions in the treatment of eating disorders. The clinical goal can be considered to be an improvement in non-normative eating behaviors, such as a reduction in overeating episodes or eating less frequently in the absence of a hunger feeling. In order to assist these individuals in their attempts to achieve healthy behaviors, variables related to mental functioning can be then identified as important goals to support individuals in their efforts to change health behaviors by achieving better mental well-being.
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Affiliation(s)
- Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Daria Schneider-Matyka
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Kupcewicz
- Department of Nursing, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Magdalena Kamińska
- Subdepartment of Long-Term Care and Palliative Medicine, Department of Social Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Horovitz O, Argyrides M. Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment. Nutrients 2023; 15:3851. [PMID: 37686883 PMCID: PMC10490497 DOI: 10.3390/nu15173851] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/02/2023] [Accepted: 09/02/2023] [Indexed: 09/10/2023] Open
Abstract
Orthorexia nervosa is an emerging and controversial eating disorder characterized by an obsessive preoccupation with healthy eating and an extreme fixation on food purity. Despite growing public interest in orthorexia, its classification as a distinct eating disorder remains a subject of ongoing debate in the mental health community. This paper comprehensively reviews the current literature on orthorexia nervosa, exploring the prevalence rates, risk factors, diagnosis, and treatment options. The paper offers an overview of orthorexia and its historical context and explores the challenges and considerations in diagnosing orthorexia and orthorexia nervosa. Specifically, the distinction between "orthorexia" and "orthorexia nervosa" is a debated issue in eating disorder research due to a lack of clear diagnostic criteria, making it challenging to accurately differentiate between an obsession with healthy eating and a more severe form with potential distress and impairment. Given the absence of formal diagnostic criteria, developing valid and reliable assessment tools is crucial to accurately identify and treat individuals experiencing these disorders. The paper's final section covers the existing treatment approaches for orthorexia nervosa. Overall, the paper highlights the complex and multifaceted nature of orthorexia nervosa. This review contributes to the ongoing discourse surrounding orthorexia and provides valuable insights for clinicians, researchers, and stakeholders in the mental health and eating disorders fields.
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Affiliation(s)
- Omer Horovitz
- The Physiology and Behavior Laboratory, Tel-Hai Academic College, 9977 North Districts, Qiryat Shemona 1220800, Israel
- Psychology Department, Tel-Hai Academic College, 9977 North Districts, Qiryat Shemona 1220800, Israel
| | - Marios Argyrides
- Psychology Department, Neapolis University Pafos, 2 Danais Avenue, Paphos 8042, Cyprus;
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Yassıbaş E, Ayyıldız F. Turkish Version of the New Instrument for Orthorexia Nervosa-Test of Orthorexia Nervosa (TON-17): A Validity and Reliability Study. Nutrients 2023; 15:3178. [PMID: 37513596 PMCID: PMC10384101 DOI: 10.3390/nu15143178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to adapt the Test of Orthorexia Nervosa- (TON-17) into Turkish and verify its validity and reliability. The study included 539 adults with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed, along with a confirmatory factor analysis to test its construct validity. The time-invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test the relationships between the scale and Eating Attitudes Test-26 and Obsessive Beliefs Questionnaire-9. Analyses were conducted using SPSS Version 28 and the AMOS-24 software. The Cronbach's α internal consistency coefficient of the total scale was found to be 0.82, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.68 for the "control of food quality", 0.64 for the "fixation on health and a healthy diet", and 0.73 for the "disorder symptoms". In addition, the test-retest reliability was found to be 0.87 for the total scale, suggesting excellent reliability. Most of the fit indices (CMIN/df, RMSEA, AGFI, NFI, and TLI) of the scale were acceptable, and the GFI indicated a good model fit. This study shows that the Turkish version of TON-17, which is a new tool with a three-factor structure to evaluate orthorexia, is a valid and reliable scale.
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Affiliation(s)
- Emine Yassıbaş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, 06490 Ankara, Turkey
| | - Feride Ayyıldız
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, 06490 Ankara, Turkey
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Falgares G, Costanzo G, Manna G, Marchetti D, Barrada JR, Roncero M, Verrocchio MC, Ingoglia S. Healthy orthorexia vs. orthorexia nervosa: Italian validation of the Teruel Orthorexia Scale (TOS). Eat Weight Disord 2023; 28:42. [PMID: 37133773 PMCID: PMC10155145 DOI: 10.1007/s40519-023-01568-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
PURPOSE Orthorexia nervosa (OrNe) is a potentially pathological condition characterized by a fixation on healthy diet. An increasing number of studies have been conducted on this mental preoccupation, but the validity and reliability of some of the psychometric instruments employed in its assessment are still under debate. Among these measures, the Teruel Orthorexia Scale (TOS) seems to be promising, given that it allows to differentiate between OrNe and other non-problematic forms of interest with healthy eating, named as healthy orthorexia (HeOr). The aim of this study was to examine the psychometric properties of an Italian version of the TOS, by testing its factorial structure, internal consistency, test-retest reliability, and validity. METHOD Through an online survey, we recruited 782 participants from different regions of Italy, asking them to complete the following self-report instruments: TOS, EHQ, EDI-3, OCI-R, and BSI-18. From the initial sample, 144 participants agreed to complete a second TOS administration 2 weeks later. RESULTS Data confirmed the validity of the 2-correlated factors structure of the TOS. The questionnaire also showed good reliability, both in terms of internal consistency and temporal stability. With regard to the TOS validity, results showed that OrNe was significantly and positively associated with measures of psychopathology and psychological distress, while HeOr showed no correlations or negative associations with the above-mentioned measures. CONCLUSION Based on these results, the TOS can be considered a promising measure for the assessment of both pathological and non-problematic forms of orthorexic eating behavior also in Italian population. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Giorgio Falgares
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Giulia Costanzo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Giovanna Manna
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy.
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Juan Ramón Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Sonia Ingoglia
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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12
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Samaha S, Azzi R, Rizk R, Sarray El Dine A, Malaeb D, Hallit S, Obeid S, Soufia M. Association between the bi-dimensional aspect of orthorexia and healthy behaviors among lebanese adolescents. BMC Psychiatry 2022; 22:725. [PMID: 36411409 PMCID: PMC9676759 DOI: 10.1186/s12888-022-04374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recently, there has been a blooming focus on "eating healthy and clean", with the ideal of being healthy becoming a popular lifestyle trend. Previous research suggested the presence of two forms of orthorexia: Orthorexia Nervosa (OrNe) and Healthy Orthorexia (HeOr). Taking into consideration that orthorexia thoughts are led by the desire to reach an optimal physical health, the dedication to a healthy living may require healthy lifestyle habits: smoking cessation, moderate alcohol intake, and increased physical activity. The main study aim was to determine, among Lebanese adolescents, the association between healthy behaviors and the two likely forms of orthorexia (OrNe and HeOr), given that the adolescent phase is a risky period in the development of eating disorders. METHODS A cross-sectional study, conducted between January and April 2022, enrolled 444 adolescents aged between 14 and 18 years, with an equitable random sample from all the Lebanese governorates (mean age 16.23 ± 1.15 years; 60.1% females). The Teruel Orthorexia Scale (TOS) was used to assess orthorexic eating tendencies. The Lebanese Waterpipe Dependence Scale, the Fagerström Test for Nicotine Dependence and the Alcohol Use Disorder Identification Test scales, all validated in adolescents, were used to evaluate the association between orthorexia and healthy behaviors. RESULTS Higher TOS OrNe scores were significantly and highly correlated with the TOS HeOr scores (r = 0.68; p < 0.001). In the bivariate analysis, waterpipe smoking was weakly but significantly associated with more OrNe, whereas more physical activity was significantly and moderately associated with more HeOr. After adjusting over all sociodemographic characteristics, other behaviors and the other dimension of orthorexia, more alcohol use disorder was significantly but strongly associated with higher OrNe, whereas more physical activity remained significantly associated with higher HeOr. CONCLUSION In light of our results, OrNe and HeOr might be considered as different entities, mainly in their associations with alcohol consumption and physical activity. This supports the hypothesis of OrNe being a new form of eating disorder, whereas HeOr possibly showing protective characteristics. Orthorexia is still a topic of controversy, especially in the probable presence of two facets that are still difficult to differentiate.
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Affiliation(s)
- Serena Samaha
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Reine Azzi
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rana Rizk
- grid.411323.60000 0001 2324 5973Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Abir Sarray El Dine
- grid.444421.30000 0004 0417 6142Department of Biomedical Sciences, School of arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon ,grid.411884.00000 0004 1762 9788College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Applied Science Research Center, Applied Science Private University, 11931, Amman, Jordan. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
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13
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Yakın E, Obeid S, Fekih-Romdhane F, Soufia M, Sawma T, Samaha S, Mhanna M, Azzi R, Mina A, Hallit S. "In-between orthorexia" profile: the co-occurrence of pathological and healthy orthorexia among male and female non-clinical adolescents. J Eat Disord 2022; 10:155. [PMID: 36329509 PMCID: PMC9633027 DOI: 10.1186/s40337-022-00673-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The profile of adolescents with orthorexic eating behaviors remains to be explored. This study is the first to explore the typology of Lebanese adolescents from a large non-clinical sample based on orthorexia nervosa (ON) and healthy orthorexia (HO). METHOD A total of 555 adolescents (aged between 15 and 18 years) completed a set of questionnaires assessing orthorexic behaviors, self-esteem, stress, depressive and anxiety symptoms. Cluster analysis based on ON and HO scores was used to identify the typology of the sample. More precisely, this analysis was used to reveal and distinguish between naturally occurring subgroups of individuals with different orthorexic eating profiles, within the studied sample. Further, a series of one-way ANOVA was used to compare observed clusters based on their scores on used questionnaires. This analysis was used to capture the behavioral and psychological differences between previously yielded subgroups of individuals. RESULTS Cluster analysis based on ON and HO scores yielded 3 distinct groups: "Low orthorexia", "Moderate in-between orthorexia" and "High in-between orthorexia". While the first group represented individuals with no particular (healthy or pathological) interest in healthy eating, the two latter groups represented those with respectively moderate and high degrees of an interest in healthy eating that has both pathological and healthy aspects. Significant differences between clusters regarding their levels of stress, depression, anxiety and self-esteem was observed, yet they were found to be negligible due to poor effect sizes. CONCLUSION Findings from this study suggest that ON and HO can indeed co-occur among adolescents, that this co-occurrence can be experienced at different severity levels. Low effect sizes for ANOVA comparisons may suggest the possibility of the co-occurrence of ON and HO reducing the negative effects of ON behavior to some degree. The potential role of confusion around what constitutes "healthy eating" in the emergence of these "in-between orthorexia" profiles is put forward.
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Affiliation(s)
- Ecem Yakın
- Centre d'Études et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Toni Sawma
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Serena Samaha
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Mariam Mhanna
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Reine Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Anthony Mina
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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14
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Aiello P, Toti E, Villaño D, Raguzzini A, Peluso I. Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students. World J Psychiatry 2022; 12:1298-1312. [PMID: 36389086 PMCID: PMC9641377 DOI: 10.5498/wjp.v12.i10.1298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/15/2022] [Accepted: 09/02/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Orthorexia nervosa (ON) is the persistent concern of maintaining the self-imposed diet to improve one's health. Many factors have been associated to ON in univ-ersity students.
AIM To assess the prevalence of ON in Italian and Spanish university students in relation to eating attitude and psychological distress, and the possible overlaps between ON (evaluated with different scored questionnaires from the originally proposed ORTO-15), distress and risk of eating disorders.
METHODS This study was carried out on 160 students recruited at La Sapienza University of Rome and at the Catholic University of Murcia. Questionnaires were administered to evaluate ON (ORTO-15 and sub-scores), body concerns (Multidimensional Body-Self Relations Questionnaire, MBSRQ, and Body Uneasiness test, BUT), psychological distress (Kessler Psychological Distress Scale, K10), physical activity (International Physical Activity Questionnaire, IPAQ), eating attitude (Eating Attitudes Test, EAT-26) and malnutrition (Starvation Symptom Inventory, SSI). Sex differences, within the same country, and differences between Italian and Spanish students, within the same sex, were evaluated.
RESULTS The ORTO-15 positive subjects, assessed with the originally proposed cut-off, were above 70% in both Italian and Spanish students, with a higher prevalence in the Spanish sample (Italian females 76.3%, Italian males 70.7%; Spanish females 97.0%, Spanish males 96.3%). According to ORTO-7, about 30% of Italian and 48% of Spanish students were positive to ON with no significant sex differences. When excluding students underweight (UW), overweight (OW) or obese (OB), as well as those potentially at risk of eating disorders or presenting mild, moderate and severe distress, in the resultant normal weight (NW)-K10neg-EAT-26neg subgroup, we did not find many correlations observed in the whole sample, including those between ORTO scores and BUT, SSI, Total MBSRQ and some of its components. Moreover, ORTO-7 resulted in the only ON score unrelated with Body Mass Index, MBSRQ components and IPAQ-assessed intense activity, in the NW-K10neg-EAT-26neg subgroup. After this sort of “exclusion diagnosis”, the prevalence of ON of these students on the overall sample resulted in 16.9%, 12.2%, 15.2% and 25.9% for Italian females, Italian males, Spanish females and Spanish males, respectively.
CONCLUSION In some university students ON could be a symptom of other conditions related to body image concerns and distress, as well as to high physical activity and appearance, fitness, health or illness orientation (from MBSRQ). However, ORTO-7 became independent from these confounding variables, after the exclusion of UW, OW, OB and students positive to EAT-26 and K10, suggesting the possibility of identifying orthorexic subjects with this specific questionnaire.
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Affiliation(s)
- Paola Aiello
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University, Rome 00185, Italy
| | - Elisabetta Toti
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome 00178, Italy
| | - Débora Villaño
- Food Science and Technology Department, UCAM, Murcia 30107, Spain
| | - Anna Raguzzini
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome 00178, Italy
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome 00178, Italy
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15
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Traditional, Vegetarian, or Low FODMAP Diets and Their Relation to Symptoms of Eating Disorders: A Cross-Sectional Study among Young Women in Poland. Nutrients 2022; 14:nu14194125. [PMID: 36235777 PMCID: PMC9570588 DOI: 10.3390/nu14194125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Eating disorders (EDs) are an ever-growing problem, seen most commonly among young women. People with EDs are particularly predisposed to restrictive eating patterns. Diet therapy for many diseases involves the elimination of certain food groups, and the use of restrictive diets in people with EDs may indirectly influence the recurrence of the disorder. The aim of this study was to assess the prevalence of the possible presence of EDs and orthorexia symptoms among young women following a traditional, alternative (vegetarian), or therapeutic (low FODMAP) diet. Methods: The analysis was based on 420 responses from female respondents aged 19 to 30 years. The research tool consisted of questionnaires to assess the possible presence of EDs (SCOFF), cognitive-behavioral aspects of eating (TFEQ-13), and the presence of orthorexia symptoms (ORTO-15). Results: Uncontrolled and emotional eating was least common in women on a vegetarian diet (5.6 ± 3.7; 3.5 ± 2.7; p < 0.05). Women on a low FODMAP diet were most prevalent with symptoms of orthorexia (n = 37, 47.4%; p < 0.05). Conclusions: It seems important to perform screening tests for eating disorders before recommending diet therapy in order to individually adjust the dietary regimen and refer patients to appropriate specialists.
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16
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Hallit S, Azzi V, Malaeb D, Obeid S. Any overlap between orthorexia nervosa and obsessive-compulsive disorder in Lebanese adults? Results of a cross-sectional study and validation of the 12-item and 4-item obsessive-compulsive inventory (OCI-12 and OCI-4). BMC Psychiatry 2022; 22:470. [PMID: 35836242 PMCID: PMC9282139 DOI: 10.1186/s12888-022-04119-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON), a compulsive obsession with vigorous eating, has increasingly caught researchers' attention. Although Orthorexia Nervosa has not been labeled an eating disorder, research about ON highlighted a strong link with anorexia nervosa or obsessive-compulsive disorder (OCD). Therefore, this study aimed to (1) validate the Arabic version of the Obsession-Compulsion Inventory (OCI-12 and OCI-4) and (2) check if there is an overlap between ON and OCD among a sample of Lebanese adults. METHODS This cross-sectional study involved 487 Lebanese participants between July and August 2021. The Dusseldorf Orthorexia Scale (DOS) was used to assess ON; scores between 25 and 29 indicate probable ON, whereas scores ≥ 30 indicate ON tendencies. A confirmatory factor analysis (CFA) was carried out using SPSS AMOS v.24 on the OCI-12 and OCI-4 scales' items. The root mean square error of approximation (RMSEA) statistic, the Tucker Lewis Index (TLI) and the comparative fit index (CFI) were used to evaluate the goodness-of-fit of the model. RESULTS The CFA results indicated an excellent fit of the model: the Maximum Likelihood Chi-Square = 147.73 and Degrees of Freedom = 48, which gave a χ2/df = 3.08, TLI = 0.934, CFI = 0.952, and RMSEA = 0.065 [95% CI 0.054-0.078]. The fit indices of the one-factor structure of the OCI-4 were excellent as well: χ2/df = 6.15/2 = 3.08, TLI = 0.95, CFI = 0.98 and RMSEA = 0.065 [95% CI 0.007-0.127]. The Area Under the Curve was 0.600 [95% CI 0.524-0.674]. There was no cutoff value that showed good sensitivity or specificity at the same time. At the DOS cutoff of 25, sensitivity was 19.1%, whereas the specificity was 90.6%. The positive and negative predictive values (PPV and NPV) at this cutoff value were 24.4% and 88.7% respectively. At the DOS cutoff of 30, sensitivity was 8.8%, whereas the specificity was 94.3%. The PPV and NPV at this cutoff value were 10.6% and 92.5% respectively. The results showed that higher total OCD scores (Beta = 0.15) were significantly associated with more ON tendencies. Moreover, higher OCD washing scores (Beta = 0.52), physical activity index (Beta = 0.06), and Body Mass Index (Beta = 0.17) were significantly associated with more ON tendencies. CONCLUSION The present results suggest that ON, as measured by the DOS, shares more common features with disordered eating and cannot adequately predict the presence of OCD symptoms.
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Affiliation(s)
- Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Vanessa Azzi
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- grid.411884.00000 0004 1762 9788School of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates ,grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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17
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Skella P, Chelmi ME, Panagouli E, Garoufi A, Psaltopoulou T, Mastorakos G, Sergentanis TN, Tsitsika A. Orthorexia and Eating Disorders in Adolescents and Young Adults: A Systematic Review. CHILDREN 2022; 9:children9040514. [PMID: 35455559 PMCID: PMC9030415 DOI: 10.3390/children9040514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 12/17/2022]
Abstract
Background: In recent years a new term in the field of eating behaviors has emerged, namely “orthorexia”. This behavior is associated with significant dietary restrictions and omission of food groups. The aim of the present study is to estimate the possible correlations between orthorexia and eating disorders in young adults and adolescents. Methods: A systematic review of related articles in PubMed, Google Scholar, and PsycInfo was conducted up to 30 June 2021. Results: A total of 37 studies (16,402 subjects) were considered eligible for this systematic review. Significant correlations were observed in most of the studies between orthorexia and eating disorders. However, the majority of studies adopted a cross-sectional design. Conclusions: An association between and eating disorders emerged. Prospective studies seem necessary to investigate associations and succession of orthorexia and eating disorders over time.
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Affiliation(s)
- Panagiota Skella
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Maria Eleni Chelmi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Clinical Psychopathology, University of Macedonia, 546 36 Thessaloniki, Greece
| | - Eleni Panagouli
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Anastasia Garoufi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Theodora Psaltopoulou
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodoros N. Sergentanis
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Public Health Policy, University of West Attica, 122 43 Athens, Greece
| | - Artemis Tsitsika
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Correspondence: ; Tel.: +30-216-0033788
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18
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Brytek-Matera A, Pardini S, Modrzejewska J, Modrzejewska A, Szymańska P, Czepczor-Bernat K, Novara C. Orthorexia Nervosa and its association with obsessive-compulsive disorder symptoms: initial cross-cultural comparison between Polish and Italian university students. Eat Weight Disord 2022; 27:913-927. [PMID: 34076878 PMCID: PMC8964579 DOI: 10.1007/s40519-021-01228-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
There is limited evidence of a link between Orthorexia Nervosa (ON) and Obsessive-Compulsive Disorder (OCD), and no definitive conclusions can be drawn. The interplay between socio-cultural context and ON has been poorly investigated as well. Therefore, the objectives of the present study were: (1) to investigate the differences in ON and OCD symptoms and (2) to assess the relationship between ON and OCD symptoms among university students. Six hundred and sixty-six university students participated in the present study: 286 from Poland and 320 from Italy. No age, gender and marital status differences were identified between two samples of university students. However, on average, Polish university students had a higher Body Mass Index than Italian ones. Our findings showed that Polish students present more problems related to obsessive symptomatology, core beliefs of OCD, perfectionism traits, and a major ON symptomatology than Italian ones. Also, Polish students with a higher level of ON exhibited higher levels of OCD symptoms and parental expectations/parental criticism. While Italian students with a higher level of ON showed higher levels of perfectionism features (organization and concern over mistakes). In general, correlations were low as confirmation of partial independence ON from OCD symptoms and core beliefs of OCD in both Polish and Italian university students. The present results highlight a need for further investigation of the correlates of ON across different cultural groups. Future research may screen individuals with ON to determine the comorbidity between ON and OCD symptomology to facilitate appropriate treatment choices. LEVEL OF EVIDENCE: Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527, Wroclaw, Poland.
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Justyna Modrzejewska
- Faculty of Humanities and Social Sciences, University of Bielsko-Biała, Bielsko-Biała, Poland
| | | | - Paulina Szymańska
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527, Wroclaw, Poland
| | | | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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19
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Zagaria A, Vacca M, Cerolini S, Ballesio A, Lombardo C. Associations between orthorexia, disordered eating, and obsessive-compulsive symptoms: A systematic review and meta-analysis. Int J Eat Disord 2022; 55:295-312. [PMID: 34921564 DOI: 10.1002/eat.23654] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is defined as an unhealthy obsession with healthy eating, focusing on concerns regarding food quality and composition. Currently, there is still a lack of consensus about a clear definition of the construct. Specifically, it has yet to be clarified whether ON pertains to eating disorders (EDs) or obsessive-compulsive disorder (OCD) spectrum. Hence, we conducted a systematic review and meta-analysis addressing the magnitude of the association between these groups of symptoms. METHOD PubMed, Medline, SCOPUS, PsychINFO, CINAHL, and Web of Science were searched from inception up to February 2021. Data from individual studies were pooled using a random-effects model. Pearson's r was used as the effect size metric. Subgroup analyses were conducted exploring the role of ON-related instruments, body mass index, study quality, and cultural context. RESULTS Thirty-six studies met the eligibility criteria and were included in the meta-analysis. Random-effects model yielded a moderate association between ON and EDs symptoms with an overall effect size of r = .36 (p < .001; 95% confidence interval [CI] = 0.30-0.43). On the other hand, the results showed a small association between ON and OCD symptoms with a mean effect size of r = .21 (p < .001; 95% CI = 0.15-0.27). DISCUSSION Meta-analytic findings showed that ON symptoms are more associated to EDs compared to OCD. Despite the similarities, the nonhigh magnitude of the pooled correlations suggests that ON might be different from pre-existing EDs and OCD. Hence, ON might be treated as a stand-alone ED and included as an emerging syndrome in the DSM classification.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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20
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Demir HP, Bayram HM. Orthorexia nervosa: The relationship with obsessive-compulsive symptoms and eating attitudes among individuals with and without healthcare professionals. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-210015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Today, individuals with eating disorders or orthorexia nervosa (ON) are increasing. OBJECTIVE: This study aimed to determine the association between ON, eating attitudes, and obsessive-compulsive symptoms among healthcare and non-healthcare professionals. METHODS: The present study was cross-sectional, and conducted by 310 healthcare, and non-healthcare professionals. Data on demographic characteristics, the Orthorexia Nervosa Evaluation Scale (ORTO-15), the Eating Attitudes Test-40 (EAT-40), and the Maudsley Obsessive-Compulsive Inventory (MOCI) were obtained by a questionnaire form. Additionally, the body weight and height of participants were taken to calculate the body mass index (BMI). Data were analyzed with SPSS statistical package 24.0. RESULTS: The ORTO-15 score of 30.3% of healthcare professionals and 27.1% of non-healthcare professionals were ≤40 (p: 0.616). The EAT-40 scores were found to be ≥30 in 7.7% of healthcare professionals and 4.5% of non-healthcare professionals (p: 0.081). According to the MOCI scores, the possibility of obsessive-compulsive symptoms was high in 29.7% of healthcare professionals (p < 0.001). There was a weak negative correlation between ORTO-15 and EAT-40 (r: –0.176, p: 0.002) and MOCI (r: –0.170, p: 0.003); and EAT-40 and MOCI (r:0.166, p: 0.03). CONCLUSION: Further studies are required to understand the relationship between ON and eating disorders that are included in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria.
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Affiliation(s)
- Halime Pulat Demir
- Department of Nutrition and Dietetics, Istanbul Gelisim University, Istanbul, Turkey
| | - Hatice Merve Bayram
- Department of Nutrition and Dietetics, Istanbul Gelisim University, Istanbul, Turkey
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21
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Bhattacharya A, Cooper M, McAdams C, Peebles R, Timko CA. Cultural shifts in the symptoms of Anorexia Nervosa: The case of Orthorexia Nervosa. Appetite 2021; 170:105869. [PMID: 34910984 DOI: 10.1016/j.appet.2021.105869] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/29/2021] [Accepted: 12/11/2021] [Indexed: 12/26/2022]
Abstract
Orthorexia Nervosa (ON) is a term describing a fixation on food purity, involving ritualized eating patterns and a rigid avoidance of "unhealthy foods." Those self-identified as having ON tend to focus on food composition and feel immense guilt after eating food deemed "unhealthy." Although not formally recognized as a psychiatric disorder by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ON has received increasing attention since its identification in 1997. There is ongoing work to establish diagnostic and empirical tools for measuring ON; embedded in this is the question as to whether or not ON is a new eating disorder. In this paper, we argue ON is not a new psychiatric disorder but rather a new cultural manifestation of anorexia nervosa (AN). We begin by providing an overview of historical representations and classification of eating disorders, with a specific focus on AN. This is followed by discussion of the rise in diet culture and healthism since the 19th century. We conclude by examining the diagnostic validity and utility of ON through a discussion of empirical evidence. Classifying ON under the diagnostic umbrella of AN may improve our understanding of factors underlying restrictive eating behaviors.
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Affiliation(s)
- Anushua Bhattacharya
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19104, USA.
| | - Marita Cooper
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19104, USA.
| | - Carrie McAdams
- Department of Psychiatry, University of Texas Southwestern Medical School, 6363 Forest Park Road, Dallas, TX, 75390, USA.
| | - Rebecka Peebles
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, 800 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19104, USA; Department of Psychology in Psychiatry, Perelman School of Medicine at University of Pennsylvania, 800 Civic Center Blvd, Philadelphia, PA, 19104, USA.
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22
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Is orthorexia nervosa a feature of obsessive-compulsive disorder? A multicentric, controlled study. Eat Weight Disord 2021; 26:2531-2544. [PMID: 33544361 DOI: 10.1007/s40519-021-01114-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/13/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive-Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population). METHODS We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R. RESULTS In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p = .0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study. CONCLUSIONS ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.
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Niedzielski A, Kaźmierczak-Wojtaś N. Prevalence of Orthorexia Nervosa and Its Diagnostic Tools-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105488. [PMID: 34065506 PMCID: PMC8160773 DOI: 10.3390/ijerph18105488] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 12/12/2022]
Abstract
The aim of this article is to present the up-to-date diagnostic tools of orthorexia and markers of its prevalence on the basis of the available literature. The authors searched PubMedCentral (PMC) and Google Scholar with the search entry of “orthorexia”, “orthorexia nervosa”, and “orthorexicbehaviours”. We describe the tools of evaluation of orthorexicbehaviour (i.e., orthorexia self-test—BOT, the ORTO-15 questionnaire, Eating Habits Questionnaire—EHQ, Düsseldorf Orthorexia Scale—DOS, Teruel Orthorexia Scale—TOS, Barcelona Orthorexia Scale—BOS, and Orthorexia Nervosa Inventory—ONI), and offer a review of the studies on orthorexia nervosa. We conclude that there are no reliable data regarding the prevalence of orthorexia nervosa. The available studies point to significant differences in the prevalence depending on the value of cut-off points and tools used. The prevalence varies across countries and across populations, ranging from 6.9% in the Italian population to 88.7% in the group of Brazilian students of dieting. Thus, it indicates that some groups seem to be susceptible to the risk of ON more than others. It is a challenge to determine the prevalence of orthorexia, and any obtained results should be treated with caution. Consequently, we claim that the use of the ORTO-15 questionnaire to diagnose orthorexia is questionable due to a high percentage of falsely positive results.
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Affiliation(s)
- Antoni Niedzielski
- Independent General Psychology Unit, Medical University in Lublin, 20-093 Lublin, Poland
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
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24
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Prevalence and Characteristics of Orthorectic Disorders in Adolescence and Young People: Polish Preliminary Studies. Nutrients 2021; 13:nu13051568. [PMID: 34066985 PMCID: PMC8150448 DOI: 10.3390/nu13051568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of this work was to assess orthorectic behaviors among young people and to evaluate their attitudes towards caring for their health. The study was conducted in 2019 on a group of 538 respondents aged 16–35. After analysis, 65 questionnaires were eliminated from further research, and the assessment of orthorectic disorders was performed using a method based on the modified ORTO-15 questionnaire on a group of 473 respondents. A large percentage of them exhibited an increased risk of orthorectic behaviors (32.8), which was higher among women than men (34.7% and 28.2%, respectively). People with higher risks of orthorectic disorders significantly more often reduced their consumption of foods high in fats and sugars. Attitudes of people with orthorectic disorders towards health care proved neutral, with a tendency to be positive. Nutritional behaviors observed in the studied group show some irregularities, which indicates the need for preventive and educational measures aimed at increasing awareness of the role of proper nutrition among young people. The obtained results may be the basis for further research on ON symptoms. One of the major areas of future research would be to create a reliable diagnostic tool which would allow for distinguishing between orthorexia and overdiagnosis.
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Dajon M, Sudres JL. Orthorexie et troubles des conduites alimentaires : spécificité d’un profil ? ANNALES MEDICO-PSYCHOLOGIQUES 2021. [DOI: 10.1016/j.amp.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Structural validation of the ORTO-12-FR questionnaire among a French sample as a first attempt to assess orthorexia nervosa in France. Eat Weight Disord 2020; 25:1771-1778. [PMID: 31863296 DOI: 10.1007/s40519-019-00835-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To the best of our knowledge, no scientific publications on orthorexia nervosa have been based on a French population. The goal of our study was to confirm the factor structure of the French version of the ORTO-15 questionnaire. METHODS An online survey (N = 768) was conducted asking participants (84.77% were women) to answer several questions about their dietary habits and to assess orthorexia nervosa using the ORTO-15 scale. Confirmatory factor analysis (CFA) was used for the validation. RESULTS Given our results, we deemed it necessary to adapt the French version of the ORTO-15 questionnaire by omitting three items. The CFA supported the ORTO-12-FR (composed of 12 items and addressing three domains: rational, emotional, and behavioral) as the better-fitting model, with an internal consistency of 0.73. The Comparative Fit Index value was 0.93, the Tucker-Lewis Index was 0.90, and the Root Mean-Square Error of Approximation was 0.05. CONCLUSIONS Our results provide evidence for the reliability of ORTO-12-FR with a French population. LEVEL OF EVIDENCE V, descriptive cross-sectional study.
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27
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Strahler J, Stark R. Perspective: Classifying Orthorexia Nervosa as a New Mental Illness-Much Discussion, Little Evidence. Adv Nutr 2020; 11:784-789. [PMID: 32059052 PMCID: PMC7360443 DOI: 10.1093/advances/nmaa012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/15/2020] [Accepted: 01/31/2020] [Indexed: 12/20/2022] Open
Abstract
Significant prevalence rates of pathological healthful eating and its extreme form, orthorexia nervosa (ON), the pathological obsession with healthy eating, have led to increased efforts to understand this phenomenon's clinical relevance. This narrative review qualitatively summarizes existing evidence on the (psycho-)pathology and consequences of ON and offers an interpretation within the frame of existing theories and models of psychiatric disease. Adding to the controversy in the field of ON, this review offers important critiques and identifies gaps in our current understanding of ON as a (distinct) mental illness.
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Affiliation(s)
- Jana Strahler
- Psychotherapy and Systems Neuroscience, Justus-Liebig-University, Giessen, Germany
| | - Rudolf Stark
- Psychotherapy and Systems Neuroscience, Justus-Liebig-University, Giessen, Germany
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Yılmaz H, Karakuş G, Tamam L, Demirkol ME, Namlı Z, Yeşiloğlu C. Association of Orthorexic Tendencies with Obsessive-Compulsive Symptoms, Eating Attitudes and Exercise. Neuropsychiatr Dis Treat 2020; 16:3035-3044. [PMID: 33364760 PMCID: PMC7751779 DOI: 10.2147/ndt.s280047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder (OCD), and other mental disorders. Individuals with orthorexic tendencies may have high physical activity as well as a healthy diet. This study aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features. PATIENTS AND METHODS We included 63 patients diagnosed with OCD, 63 healthy volunteers who perform physical exercises at least three days a week, at least 30 minutes a day, and 63 healthy volunteers who do not perform physical exercises regularly. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale, ORTO-11 Scale, Eating Attitude Test, Hamilton Anxiety Scale, and Structured Clinical Interview for DSM-5 Disorders (SCID-5 CV) were administered to all participants. OCD data form was also applied to patients with OCD diagnosis. RESULTS We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with OCD (p<0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with OCD (p>0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who regularly performed physical exercises and patients with OCD (p<0.05). The orthorexic tendencies of participants who regularly performed physical exercises were higher than those diagnosed with OCD and healthy individuals who did not perform physical exercises. CONCLUSION The absence of a significant relationship between disorder severity and orthorexia nervosa in patients diagnosed with OCD and the increase in orthorexic tendencies as the deterioration in eating attitudes increases in both patients with OCD and the participants who regularly perform physical exercises suggest that orthorexia nervosa may be closer to the eating disorders group than obsessive-compulsive spectrum. Studies with large samples and different diagnoses are needed to determine the place of orthorexia nervosa in diagnosis and classification systems.
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Affiliation(s)
- Hamdi Yılmaz
- Department of Psychiatry, Çukurova University School of Medicine, Adana, Turkey
| | - Gonca Karakuş
- Department of Psychiatry, Çukurova University School of Medicine, Adana, Turkey
| | - Lut Tamam
- Department of Psychiatry, Çukurova University School of Medicine, Adana, Turkey
| | | | - Zeynep Namlı
- Department of Psychiatry, Çukurova University School of Medicine, Adana, Turkey
| | - Caner Yeşiloğlu
- Department of Psychiatry, Çukurova University School of Medicine, Adana, Turkey
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#Orthorexia on Instagram: a descriptive study exploring the online conversation and community using the Netlytic software. Eat Weight Disord 2019; 24:283-290. [PMID: 30317422 DOI: 10.1007/s40519-018-0594-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/04/2018] [Indexed: 02/06/2023] Open
Abstract
Orthorexia nervosa (ON) is a relatively new phenomenon. The purpose of this study was to investigate (1) the #orthorexia conversation on Instagram (using the Netlytic software), and (2) among a random subsample of images (N = 245), analyse the types of images (N = 145) and author biographies (N = 68). Among the 4,533 downloaded records, there were 48,780 unique words associated with the posts, with the most commonly used being love (n = 535) and #edrecovery (n = 425). Among the images, the majority contained food (68%) and people (13%). Among the unique authors, the majority were female (84%) and mentioned ED (eating disorder) recovery and being food/fitness focused. The ON community on Instagram is relatively small and the positive conversation may suggest a supportive community that focuses on recovery and adopting healthier eating behaviours.Level of evidence Level V, descriptive study.
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