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Greville-Harris M, Vuillier L, Goodall S, Talbot CV, Walker C, Appleton KM. Striving for the perfect diet? The mediating role of perfectionism in the relationship between obsessive compulsive symptoms and traits of Orthorexia Nervosa. J Eat Disord 2024; 12:91. [PMID: 38951924 PMCID: PMC11218215 DOI: 10.1186/s40337-024-01032-w] [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: 01/12/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) is a disordered eating style involving an unhealthy obsession with 'healthy' or 'clean' eating. Its aetiology is still poorly understood and is not yet recognised in diagnostic manuals. While ON has been associated with Obsessive Compulsive (OC) symptoms and perfectionism, no study to date has looked at the relationship between OC symptoms and ON tendencies via perfectionism, or the influence of two facets of perfectionism in this relationship, namely evaluative concern and achievement striving. Examining the potential role of perfectionism helps to understand the aetiology of ON as well as inform potential treatments tailored specifically for ON and comorbid OC symptoms. METHODS In this cross sectional study, we tested 507 participants (n = 70 males, n = 69 at risk of ON) on questionnaires measuring OC symptoms, perfectionism and ON symptoms. We ran two mediation analyses to look at the overall relationship between perfectionism and OC and ON symptoms (Model 1) as well as the specific contribution of evaluative concern and achievement striving in the relationship between OC and ON symptoms (Model 2). RESULTS We found that perfectionism partially mediated the relationship between OC and ON symptoms. Specifically, we found that while achievement striving and evaluative concern were associated with OC symptoms, only achievement striving was significantly associated with ON symptoms, mediating the relationship between OC and ON symptoms. CONCLUSIONS This study highlighted the role of one key facet of perfectionism (achievement striving) in the aetiology of ON. The role of achievement striving was indicated as a transdiagnostic construct explaining the link between ON and OC symptoms. These findings are discussed in terms of their implications for treatment models, specifically in terms of the potential role of targeting perfectionism in ON treatment.
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Affiliation(s)
- Maddy Greville-Harris
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK.
| | - Laura Vuillier
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Summer Goodall
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Catherine V Talbot
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Cliona Walker
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Katherine M Appleton
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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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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Foyster M, Sultan N, Tonkovic M, Govus A, Burton-Murray H, Tuck CJ, Biesiekierski JR. Assessing the presence and motivations of orthorexia nervosa among athletes and adults with eating disorders: a cross-sectional study. Eat Weight Disord 2023; 28:101. [PMID: 38070009 PMCID: PMC10710386 DOI: 10.1007/s40519-023-01631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Orthorexia nervosa involves restricting diet based on quality rather than quantity. Although orthorexia is well reported in many at-risk populations, limited data addresses its presence in individuals with eating disorder history (EDs) or athletes. We aimed to identify the presence and potential drivers of orthorexia in adults with EDs and endurance athletes, compared to control subjects. METHODS Participants ≥ 18y included: people with a diagnosed eating disorder (ED as per DSM-5); endurance athletes (training/competing ≥ 5 h/week); or control subjects. Participants (n = 197) completed an online survey assessing orthorexia (eating habits questionnaire, EHQ), eating motivations (TEMS-B) and compulsive exercise (CET). RESULTS ED had the highest orthorexia symptom severity (92.0 ± 3.02, n = 32), followed by athletes (76.2 ± 2.74, n = 54) and controls (71.0 ± 1.80, n = 111) (F (2) = 18.2, p < 0.001). A strong positive correlation existed between weight control motives and higher orthorexia symptom severity (r = 0.54, 95% CI [1.35, 2.36], p < 0.001), while a weak negative association existed between Hunger and Pleasure motives and higher orthorexia symptom severity (r = 0.23, 95% CI [- 2.24, - 0.34], p = 0.008; r = 0.26, 95% CI [- 2.11, - 0.47], p = 0.002, respectively). A moderate positive relationship was found between CET and orthorexia symptom severity (95% CI [1.52, 3.12], p < 0.001). CONCLUSION Adults with ED history and endurance athletes have greater orthorexia symptom severity compared to control. Clinicians working with at-risk populations should screen patients and be aware of red-flags of orthorexic traits, desire to control weight, and compulsive exercise behavior. LEVEL OF EVIDENCE III: Evidence obtained from cohort studies.
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Affiliation(s)
- Mandy Foyster
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Nessmah Sultan
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Matilda Tonkovic
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Andrew Govus
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Helen Burton-Murray
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline J Tuck
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nursing and Allied Health, Swinburne University, Hawthorn, VIC, Australia
| | - Jessica R Biesiekierski
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.
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Pratt VB, Hill AP, Madigan DJ. A longitudinal study of perfectionism and orthorexia in exercisers. Appetite 2023; 183:106455. [PMID: 36623773 DOI: 10.1016/j.appet.2023.106455] [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: 09/21/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
Research suggests that trait perfectionism and perfectionistic self-presentation are related to orthorexia - a pathological obsession with correct nutrition. However, no studies have examined these relationships over time or compared the influence of the two aspects of perfectionism on orthorexia. In the present study we sought to address these two issues. Gym members who engaged in high degrees of exercise were recruited via social media platforms. They completed an online questionnaire that included the Multidimensional Perfectionism Scale-Short Form, Perfectionistic Self-Presentation Scale, and the Eating Habits Questionnaire on two occasions: 177 participants (Mean age = 31.6 years) initially completed the questionnaire and 82 completed the questionnaire six weeks later. A series of multiple regression analyses revealed that (i) trait perfectionism predicted an increase in orthorexia symptomatology over time with socially prescribed perfectionism and other-oriented perfectionism unique predictors of orthorexia, (ii) perfectionistic self-presentation predicted orthorexia over time with nondisplay of imperfection a unique predictor of orthorexia, and (iii) when considered alongside each other, only trait dimensions of perfectionism were unique predictors of orthorexia. The present study provides further evidence that perfectionism is related to orthorexia. In addition, the study also provides preliminary evidence that more engrained trait aspects of perfectionism are more predictive of orthorexia over time than the self-presentational aspects of perfectionism.
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Affiliation(s)
- Verity B Pratt
- School of Science, Technology, and Health, York St John University, Lord Mayor's Walk, York, YO31 7EX, United Kingdom.
| | - Andrew P Hill
- School of Science, Technology, and Health, York St John University, Lord Mayor's Walk, York, YO31 7EX, United Kingdom.
| | - Daniel J Madigan
- School of Science, Technology, and Health, York St John University, Lord Mayor's Walk, York, YO31 7EX, United Kingdom.
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Paludo AC, Magatão M, Martins HRF, Martins MVS, Kumstát M. Prevalence of Risk for Orthorexia in Athletes Using the ORTO-15 Questionnaire: A Systematic Mini-Review. Front Psychol 2022; 13:856185. [PMID: 35645852 PMCID: PMC9133840 DOI: 10.3389/fpsyg.2022.856185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The article aims to summarize the literature about the profile of risk of orthorexia in athletes using the ORTO-15 questionnaire. The search was performed at PubMed, Embase, Web of Science, and Sport Discus databases, using the terms “orthorexia” AND “athletes” with the respective entry terms. A multistage process of selection followed the PRISMA 2020 recommendation. A total of 688 articles were identified, and six studies were available for the final process. The prevalence of risk for orthorexia was assessed by the articles by the ORTO-15 questionnaire and ranged between 38 and 35 points. The comparison between male and female athletes and, athletes and non-athletes was not significant in the six articles. In conclusion, the review highlights that athletes from different sports, included in the review, do not present a risk of orthorexia nervosa considering the cutoff of 40 points, but not 35 points. Also, athletes present the same orthorexic behavior compared to non-athletes, demonstrating that orthorexia is an issue that needs to be considered in the general population. Moreover, a special focus should be given on the ORTO-15 questionnaire, about the sensitivity to diagnose the prevalence of orthorexia, especially in athletes.
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Affiliation(s)
- Ana Carolina Paludo
- Incubator of Kinanthropology Research, Faculty of Sport Studies, Masaryk University, Brno, Czechia
- *Correspondence: Ana Carolina Paludo,
| | - Marina Magatão
- Department of Physical Education, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
| | - Hilana Rickli Fiuza Martins
- Department of Physical Therapy, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Department of Physical Therapy, UniGuairacá, Guarapuava, Brazil
| | | | - Michal Kumstát
- Department of Health Promotion, Faculty of Sport Studies, Masaryk University, Brno, Czechia
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