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Bogár N, Dukay-Szabó S, Simon D, Túry F. Higher orthorexia tendency among female fashion models: an empirical international study. Eat Weight Disord 2024; 29:44. [PMID: 38937320 PMCID: PMC11211108 DOI: 10.1007/s40519-024-01674-4] [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: 11/01/2023] [Accepted: 06/16/2024] [Indexed: 06/29/2024] Open
Abstract
PURPOSE Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on assessing whether female models are more prone to report orthorexia nervosa signs and symptoms than non-models. METHODS Female fashion models (n = 179, mean age: 25.9 SD = 4.40 years) and an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years) were selected by snowball sampling. Participants filled out an online survey containing anthropometric questions and the 18-item Eating Habits Questionnaire. RESULTS According to BMI, fashion models were underweight (mean BMI = 18.1 SD = 1.68) while control participants' BMI was in the normal range (mean = 22.1 SD = 4.23, p < 0.001). On all three of Eating Habits Questionnaire subscales fashion models showed significantly higher average value (Knowledge subscale: M = 2.42 among models versus M = 2.08 in the control group, p < 0.01, Cohen's d = 0.52; Problems subscale: M = 1.93 among models versus M = 2.61 in the control group, p < 0.01, Cohen's d = 0.49; Feelings subscale: M = 3.20 among models versus M = 2.96 in the control group, p < 0.01, Cohen's d = 0.38). Orthorexic tendencies were reported by 35.1% of the models versus 20.2% of controls. CONCLUSION Fashion models are at risk for the development of eating disorders. Even though not yet included in the DSM-5, the assessment of orthorexia nervosa among fashion models seems to be important. It is suggested to take appropriate measures to prevent the spread of disordered eating habits among models as they can lead to the development of anorexia nervosa or bulimia nervosa. LEVEL OF EVIDENCE Level III, well-designed cohort study.
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Affiliation(s)
- Nikolett Bogár
- Faculty of Medicine, Institute of Behavioural Sciences, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | | | - Dávid Simon
- Department of Statistics, Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary
| | - Ferenc Túry
- Faculty of Medicine, Institute of Behavioural Sciences, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.
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Rozmiarek M, Grajek M, Krupa-Kotara K, Malchrowicz-Mośko E. Orthorectic behavior among students and motivation for physical activity, dietary habits, and restrictive eating. Front Nutr 2024; 11:1367767. [PMID: 38887502 PMCID: PMC11180727 DOI: 10.3389/fnut.2024.1367767] [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: 01/09/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
Introduction Orthorexia lacks official recognition as an eating disorder; however, orthorexic behaviors, associated with a stringent selection of food, may serve as a predisposing factor to the development of eating disorders. It is characterized by an obsessive preoccupation with healthy eating and strict dietary standards, often prevalent in high-risk groups such as athletes and individuals concerned with their physical appearance. The objective of this study was to evaluate the incidence of orthorexia among students exhibiting varying lifestyles (including dietary habits and levels of physical activity, along with their respective motivational factors). The research involved 600 participants equally distributed between health-related (HRF) and non-health-related (NRF) academic categories, with the majority of participants in the HRF category being women. Methods Assessments included BMI calculations, dietary evaluation based on Polish standards, categorization of physical activity levels, the EMI-2 questionnaire on motivation to exercise, the DOS test for orthorexia propensity, and the TFEQ-13 questionnaire for eating behavior. Results and discussion Results showed that primary motivators for physical activity included disease prevention, health maintenance, strength/endurance, and physical appearance. Orthorexia tendencies were prevalent, particularly in the HRF group, linked to lower BMI, better diet quality, higher physical activity levels, and a higher prevalence of restrictive eating. In conclusion, students in health-related fields, driven by a strong health consciousness, are at risk of orthorexia. This emphasizes the need for balanced health education and support. Conclusion Orthorexic tendencies are associated with distorted perceptions of food portions and calories, underscoring the importance of awareness and intervention.
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Affiliation(s)
- Mateusz Rozmiarek
- Department of Sports Tourism, Faculty of Physical Culture Sciences, Poznan University of Physical Education, Poznan, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Ewa Malchrowicz-Mośko
- Department of Sports Tourism, Faculty of Physical Culture Sciences, Poznan University of Physical Education, Poznan, Poland
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3
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Bellikci Koyu E, Karaağaç Y, Öner BN. The association between food neophobia, bi-dimensional aspects of orthorexia, and anxiety among vegetarians and omnivores. Appetite 2024; 197:107303. [PMID: 38503030 DOI: 10.1016/j.appet.2024.107303] [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: 12/03/2023] [Revised: 02/08/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
Vegetarianism is a growing trend, and food neophobia and orthorexia nervosa could act as barriers to achieving a healthy vegetarian diet. The aim of this study is to compare the levels of food neophobia, anxiety, and both healthy and pathological aspects of orthorexia among vegetarians and omnivores. Additionally, the study aims to identify the relationships between food neophobia, anxiety, and orthorexia. In this cross-sectional online survey, a total of 324 vegetarian and 455 omnivores adults participated. The questionnaire consisted of four sections: sociodemographic, lifestyle, and health-related characteristics, the Food Neophobia Scale (FNS), the Teruel Orthorexia Scale (TOS), and the Generalized Anxiety Disorders-7 Scale. Vegetarians exhibited lower FNS scores (p < 0.001) and had higher healthy orthorexic scores (p < 0.001) than omnivores. There were no differences between groups for anxiety scores (p > 0.05). Regression analysis indicated that higher food neophobia (OR: 0.953, 95% CI:0.937-0.968) and TOS-OrNe scores (OR: 0.946, 95% CI: 0.901-0.993) were associated with lower odds of following a vegetarian diet. Conversely, higher TOS-HeOr scores (OR: 1.135, 95% CI:1.096-1.176) were linked to an increased likelihood of adopting a vegetarian diet. Furthermore, both FNS and GAD-7 scores showed negative correlations with TOS-HeOR (r = -0.124, p < 0.001 and r = -0.129 p < 0.001, respectively), and positive correlations with TOS-OrNe (r = 0.106, p < 0.001 and r = 0.146, p < 0.001). In conclusion, vegetarians exhibit lower levels of food neophobia and a greater interest in healthy eating than omnivores. Additionally, the distinct correlation between two dimensions of orthorexia and food neophobia and anxiety provides support for the two-dimensional nature of orthorexia.
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Affiliation(s)
- Ezgi Bellikci Koyu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, 35620, Türkiye.
| | - Yasemin Karaağaç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, 35620, Türkiye
| | - Beyza Nur Öner
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, 35620, Türkiye
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4
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Plichta M, Kowalkowska J. Orthorexic tendency and its association with weight control methods and dietary variety in Polish adults: a cross-sectional study. Front Nutr 2024; 11:1355871. [PMID: 38711530 PMCID: PMC11073497 DOI: 10.3389/fnut.2024.1355871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
The methods for controlling weight play a central role in formally diagnosed eating disorders (EDs) and appear to be important in the context of other nonformally recognized disorders, such as orthorexia nervosa (ON). These methods also have an impact on eating behaviors, including dietary variety. Our study aimed to: (i) assess the intensity of ON tendency by sex and BMI groups, (ii) evaluate the associations between ON tendency, weight control methods, and dietary variety, and (iii) determine the extent to which weight control methods and dietary variety contribute to the ON tendency among both females and males. Data were gathered from a sample of 936 Polish adults (463 females and 473 males) through a cross-sectional quantitative study conducted in 2019. Participants were requested to complete the ORTO-6, the Weight Control Methods Scale, and the Food Intake Variety Questionnaire (FIVeQ). Multiple linear regression analysis was employed to evaluate associations between ON tendency, weight control methods, and dietary variety. Females exhibited a higher ON tendency than males (14.4 ± 3.4 vs. 13.5 ± 3.7, p < 0.001, d = 0.25). In the regression model, the higher ON tendency was predicted by more frequent use of weight control methods, such as restricting the amount of food consumed, using laxatives, and physical exercise among both females and males as well as following a starvation diet in females, and drinking teas to aid bowel movements among males. Moreover, the higher ON tendency was predicted by higher dietary variety, lower age in both sexes, and higher level of education among males. However, there were no differences in ON tendency across BMI groups. In conclusion, the findings showed that ON tendency was predicted by a higher frequency of weight control methods commonly used by individuals with anorexia nervosa (AN) and bulimia nervosa (BN). The resemblance to these two EDs is also suggested by the higher intensity of ON tendency among females and younger people. However, the prediction of ON tendency by dietary variety indicates that the obsessive preoccupation with healthy eating may not be advanced enough to observe a decrease in the dietary variety among these individuals.
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Affiliation(s)
- Marta Plichta
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Brodock JL, Hopfer H, Masterson TD, Hayes JE. Orthorexia Nervosa and Healthy Orthorexia in a Physically Active North American Population. Nutrients 2024; 16:1107. [PMID: 38674798 PMCID: PMC11053522 DOI: 10.3390/nu16081107] [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: 03/08/2024] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
The Teruel Orthorexia Scale (TOS) defines two related but distinct constructs: Orthorexia Nervosa (OrNe), a pathological fixation on a healthy diet, and Healthy Orthorexia (HeOr), an interest in a healthy diet independent of psychopathology. Here, we (a) assessed both types of Orthorexia in a large North American sample using the TOS and (b) explored if engaging in regular physical activity was associated with a greater risk of Orthorexia. A cohort of physically active adults (n = 927; 41% men) completed the TOS, as well as the Rapid Assessment of Physical Activity (RAPA), to broadly assess aerobic physical activity level and participation in strength and/or flexibility training. As expected, scores for HeOr and OrNe differed between participants, with lower scores for Orthorexia Nervosa in our physically active non-clinical sample. Higher HeOr scores were associated with lower BMI, and this was true for both men and women. We also found that measures of Orthorexia were associated with self-reported physical activity: active adults reporting more aerobic physical activity had higher HeOr scores, with the most active men having the highest scores. Notably, adults who reported regular strength training had higher scores for both HeOr and OrNe, with men who strength trained showing higher OrNe scores than women. Here, those who participate in regular strength training are more likely to exhibit orthorexic behaviors, and this effect was more pronounced for men than women. Prior work has validated the TOS in young, primarily female samples of non-English speakers outside the United States: present data from an age-diverse, physically active, gender balanced sample support the use of TOS for measurement of Orthorexia Nervosa and Healthy Orthorexia in English speakers and suggest that more work is needed to assess potential gender differences in these constructs.
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Affiliation(s)
- Jennifer L. Brodock
- Sensory Evaluation Center, The Pennsylvania State University, University Park, Centre County, PA 16802, USA (H.H.)
- Department of Food Science, The Pennsylvania State University, University Park, Centre County, PA 16802, USA
| | - Helene Hopfer
- Sensory Evaluation Center, The Pennsylvania State University, University Park, Centre County, PA 16802, USA (H.H.)
- Department of Food Science, The Pennsylvania State University, University Park, Centre County, PA 16802, USA
| | - Travis D. Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Centre County, PA 16802, USA;
| | - John E. Hayes
- Sensory Evaluation Center, The Pennsylvania State University, University Park, Centre County, PA 16802, USA (H.H.)
- Department of Food Science, The Pennsylvania State University, University Park, Centre County, PA 16802, USA
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Mohammad Johari MH, Tan ST. Internet addiction and its relationship with food choice motives and the risk of eating disorders among young adults in Malaysia. Sci Rep 2024; 14:5643. [PMID: 38454136 PMCID: PMC10920804 DOI: 10.1038/s41598-024-56050-0] [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: 10/03/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
The COVID-19 lockdown measures have dramatically altered the daily routines of young adults. Therefore, this study aims to elucidate the relationships between internet addiction, food choice motives and the risk of eating disorders in young adults during the transition to the endemic phase of COVID-19. The Internet Addiction Test was utilised to evaluate the presence and severity of internet addiction among young adults. The Food Choice Questionnaire was employed to assess the food choice motives of young adults, while the risk of eating disorders was determined using the Eating Attitude Test-26. The relationships between internet addiction, food choice motives, and the risk of eating disorders were assessed using model 4 of the PROCESS macro for SPSS. The findings indicated that 29.0% of young adults experienced moderate-to-severe internet addiction, whereas 32.6% were at risk of eating disorders. Young adults were highly valued for the price, sensory appeal, and mood when deciding food choices. The relationship between internet addiction and the risk of eating disorders was partially mediated by convenience (b = - 0.211, SE = 0.140, - 0.548 to - 0.016) and familiarity (b = 0.219, SE = 0.122, 0.019 to 0.494). A significant direct effect was also observed between internet addiction and the risk of eating disorders (B = 0.793, p = 0.017). There is an urgent need to implement intervention strategies aimed at reducing problematic internet use, promoting healthier food choices, and fostering healthy eating habits among young adults.
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Affiliation(s)
- Muhammad Haziq Mohammad Johari
- School of Graduate Studies, Management and Science University, University Drive, Off Persiaran Olahraga, Seksyen 13, 40100, Shah Alam, Selangor, Malaysia
| | - Seok Tyug Tan
- Department of Healthcare Professional, Faculty of Health and Life Sciences, Management and Science University, University Drive, Off Persiaran Olahraga, Seksyen 13, 40100, Shah Alam, Selangor, Malaysia.
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
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7
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Boutin C, Maïano C, Aimé A. Relation between orthorexia nervosa and healthy orthorexia: A latent profile analysis. Appetite 2024; 194:107165. [PMID: 38103792 DOI: 10.1016/j.appet.2023.107165] [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: 06/09/2023] [Revised: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Orthorexic eating behaviors can be conceptualized as a bidimensional construct encompassing an orthorexia nervosa dimension (ON) and a healthy orthorexia dimension (HO). Although variable-centered studies showed that ON and HO are distinguishable orthorexic eating behaviors, the evidence of whether they can co-occur or be distinct in subgroups of individuals is still limited. The present study aimed to address previous person-centered studies' limitations by examining profiles of ON and HO among a convenience sample of 251 French-speaking Canadian adults (85.7% women; Mage = 33.56). Profile membership was examined as function of participants characteristics such as age, gender, body mass index, frequency of physical activity and sports and vegetarianism. The relation between profile membership, intuitive eating and disordered eating attitudes and behaviors was also assessed. Latent profile analysis (LPA) were used to estimate profiles of ON and HO. Results from LPA did not provide support for the distinguishability of ON and HO. Indeed, they revealed the presence of two profiles showing co-occurring levels of ON and HO that only differed quantitatively: low (68.9% of the sample; low levels of ON and HO) or moderate orthorexic eating behaviors (31.1%; moderate levels of ON and HO). Participants who declared being vegetarian and being more frequently involved in physical activities and sports were more likely to belong to the moderate orthorexic eating behaviors' profile. Finally, participants from the moderate orthorexic eating behaviors' profile showed higher levels of disordered eating attitudes and behaviors, whereas those from the low orthorexic eating behaviors' profile showed higher levels of intuitive eating. Findings from the present study question the distinguishability of ON and HO dimensions. They also suggest that, similarly to ON, HO is also related to higher eating and lifestyle preoccupations.
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Affiliation(s)
- Camille Boutin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | - Christophe Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada; Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérôme, Canada.
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
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Argyrides M, Anastasiades E, Maïano C, Swami V. Greek adaptation of the Teruel Orthorexia Scale (TOS) in adults from the Republic of Cyprus: A bidimensional model may not be universal. Appetite 2024; 194:107180. [PMID: 38145878 DOI: 10.1016/j.appet.2023.107180] [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: 09/29/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.
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Affiliation(s)
- Marios Argyrides
- Eating and Appearance Research Laboratory, Department of Psychology, Neapolis University Pafos, Paphos, Cyprus.
| | - Elly Anastasiades
- Eating and Appearance Research Laboratory, Department of Psychology, Neapolis University Pafos, Paphos, Cyprus
| | - Christophe Maïano
- Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université Du Québec en Outaouais, Saint-Jérôme, Canada; Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults. Nutrients 2024; 16:638. [PMID: 38474767 DOI: 10.3390/nu16050638] [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: 01/20/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Measuring orthorexia nervosa is challenging due to the use of various existing tools and problems with sample representativeness. Another challenge for the Polish population is the adaptation of existing research tools and the evaluation of their relevance and research reliability. Our research aimed to adapt the TOS to the Polish language and measure pathological and nonpathological orthorexic behavior among the Polish population. The adaptation of the PL-TOS has high psychometric value and allows us to assess healthy and nervous orthorexia levels. This scale can be used not only for further research but also for diagnostic purposes in the daily work of clinicians and psychologists. Our results obtained in the present study indicate a correlation between TOS and both the use of supplements and diet. Higher TOS, ORTO_R and KZZJ_Diet Restrictions scores were obtained for individuals using dietary supplements than for those not using dietary supplements. In the future, it is worth conducting research aimed at various risk groups of individuals with orthorexia to confirm the psychometric properties of this adaptation of the TOS.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-093 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
| | - Emilia Samardakiewicz-Kirol
- Simulation Laboratory for Patient Safety, Department of Medical Education, Medical University of Lublin, 20-093 Lublin, Poland
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Barakat M, Salim NA, Malaeb D, Dabbous M, Sakr F, Hallit S, Fekih-Romdhame F, Obeid S. Mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. BMC Public Health 2024; 24:352. [PMID: 38308268 PMCID: PMC10836016 DOI: 10.1186/s12889-024-17812-7] [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: 09/13/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. METHODS A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale. RESULTS The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (β= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (β= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (β=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (β = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models. CONCLUSION This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success.
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Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- Middle East University Research Unit, Middle East University, Amman, Jordan
| | - Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman, Jordan
- Prosthodontic Department, Jordan University Hospital, Amman, Jordan
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, P.O. Box 446, Lebanon.
| | - Feten Fekih-Romdhame
- 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
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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11
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Huynh PA, Miles S, Nedeljkovic M. Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive-compulsive symptoms. Eat Weight Disord 2024; 29:6. [PMID: 38198059 PMCID: PMC10781834 DOI: 10.1007/s40519-023-01629-1] [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: 08/19/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE Orthorexia nervosa (ON), a proposed disorder describing an obsessive focus on "healthy" eating, is characterised as having overlapping symptoms with obsessive-compulsive disorder. However, ON/obsessive-compulsive (OC) symptom relationships are inconsistently reported. The current study aimed to investigate if the contribution of OC symptoms and beliefs explain variability in ON symptoms and determine if perfectionism, a transdiagnostic factor, moderates the ON/OC symptom relationship. METHODS The study comprised 190 participants (Mage = 28.63, SDage = 9.88; 80% female) recruited via an undergraduate research programme, social media, advocacy organisations, and a participant registry. Participants completed an online questionnaire assessing ON, OC, and perfectionism symptoms. RESULTS A linear regression analysis found OC symptoms and beliefs explained 22.9% variability in ON symptoms (p < 0.001, f2 = 0.38) and perfectionism moderated the ON/OC symptom relationship, where higher levels of perfectionism with higher levels of OC symptoms was associated with higher levels of ON symptoms, explaining 2.2% variability (p = .01, f2 = 0.03). CONCLUSION OC symptoms appear more common in ON than previous studies indicate. However, the interaction between perfectionism and OC symptoms may drive obsessions in ON. Findings help refine our current understanding of ON phenomenology with implications for ON treatment development. Future research should further explore perfectionism in ON phenomenology. 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)
- Phillipa Ann Huynh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn Campus, PO Box 218, Hawthorn, VIC, 3122, Australia.
| | - Stephanie Miles
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, VIC, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn Campus, PO Box 218, Hawthorn, VIC, 3122, Australia
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12
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Sezer Katar K, Şahin B, Kurtoğlu MB. Healthy orthorexia, orthorexia nervosa, and personality traits in a community sample in Turkey. Int J Psychiatry Med 2024; 59:83-100. [PMID: 37542522 DOI: 10.1177/00912174231194745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Orthorexia nervosa is an eating disorder characterized by a rigid preoccupation with a perceived healthy diet. However, little is known about healthy orthorexia compared to orthorexia nervosa. The current study examined the relationship between healthy orthorexia and orthorexia nervosa and personality traits in a Turkish sample. METHODS Three hundred fifty participants from a community sample aged 18-65 were included in the study. Participants completed a sociodemographic data collection form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Teruel Orthorexia Scale (TOS), and the 10-Item Personality Inventory (TIPI). RESULTS The frequency of healthy orthorexia was 32.3% and orthorexia nervosa was 10.2%. There were no differences between genders regarding healthy orthorexia and orthorexia nervosa scores. Healthy orthorexia symptoms were negatively correlated with depression and anxiety (r = -0.11 and r = -0.20, respectively, P < .05), while they were positively correlated with agreeableness (r = 0.17), conscientiousness (r = 0.14), and extraversion (r = 0.15). Orthorexia nervosa symptoms were positively associated with anxiety (r = 0.12), depression (r = 0.10), and healthy orthorexia (r = 0.55). Hierarchical regression analyses demonstrated that depression was negatively associated with healthy orthorexia symptoms, explaining 4% of the variance. The agreeableness trait was positively associated with healthy orthorexia symptoms, explaining 4% of the variance. However, no specific personality trait was associated with orthorexia nervosa symptoms. CONCLUSION To our knowledge, the present study is the first to examine the relationships between personality traits, healthy orthorexia, and orthorexia nervosa symptoms in a Turkish sample. Sociocultural factors may be important for understanding orthorexia nervosa and healthy eating behaviors in this population.
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Affiliation(s)
- Kübra Sezer Katar
- Department of Psychiatry, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Başak Şahin
- Department of Psychiatry, Ankara Etlik City Hospital, Ankara, Turkey
| | - Mustafa Batuhan Kurtoğlu
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
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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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Basaran AG, Ozbek YD. A Study of the Relationship between University Students' Food Neophobia and Their Tendencies towards Orthorexia Nervosa. Behav Sci (Basel) 2023; 13:958. [PMID: 38131814 PMCID: PMC10741013 DOI: 10.3390/bs13120958] [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: 10/05/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Food neophobia, known as an avoidance of the consumption of unknown foods, can negatively impact nutritional quality. In orthorexia nervosa, there is an excessive mental effort to consume healthy food. Individuals exhibiting symptoms of food neophobia and orthorexia nervosa may experience food restrictions. This study aimed to assess food neophobia levels and orthorexia nervosa tendencies among university students, investigate the potential association between the two constructs, and explore the effect of the demographic characteristics of the participants on the variables. This is a descriptive cross-sectional study. The study sample consisted of 609 students enrolled at Recep Tayyip Erdoğan University. The data were collected through Google Forms using a sociodemographic information form, the Food Neophobia Scale, and the ORTO-11 scale. Ethics committee approval and institutional permission were obtained for the study. Of the students participating in the survey, 71.9% were female, 14.6% were classified as neophobic, and 47.1% had orthorexia nervosa symptoms. The mean scores from the Food Neophobia Scale (39.41 ± 9.23) and the ORTO-11 scale (27.43 ± 5.35) were in the normal range. Food neophobia was significantly higher among those who did not consume alcohol. Orthorexia nervosa symptoms were significantly more common among married people. In the correlation analysis, no significant relationship was found between age, food neophobia, and orthorexia nervosa. It can be said that food neophobia in this study is similar to in other studies conducted on university students. In addition, about half of the participants had symptoms of orthorexia nervosa. This result is higher compared to other studies conducted with university students. The findings of this study indicate that the participants care about the healthfulness of food.
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Affiliation(s)
| | - Yagmur Demirel Ozbek
- Faculty of Health Sciences, Recep Tayyip Erdoğan University, Rize 53350, Turkey;
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15
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Reynolds R, McGowan A, Smith S, Rawstorne P. Vegan and vegetarian males and females have higher orthorexic traits than omnivores, and are motivated in their food choice by factors including ethics and weight control. Nutr Health 2023:2601060231187924. [PMID: 37464872 DOI: 10.1177/02601060231187924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Evidence associating plant-based diets with the proposed 'obsessively healthy eating' eating disorder, orthorexia nervosa, has mostly focused on females. Diet motivations have seldom been assessed. AIM To compare orthorexic tendencies between vegans/vegetarians and omnivores of both sexes, and reasons behind food choice with an English-validated Food Choice Questionnaire. METHODS A cross-sectional survey of 444 males and females were recruited via social media, email, and Amazon MTurk; to investigate eating patterns, orthorexic tendencies using the ORTO-15 questionnaire, and eating motivations using the Food Choice Questionnaire. RESULTS Over half of the participants were male (53.4%), younger adults (mean ± SD 37.2 ± 11.2 years), and mostly from the United States (89%). Vegan and vegetarian eating habits were reported by 15.8% of people. Vegans/vegetarians had significantly higher orthorexic tendencies than omnivores, and chose food significantly more often for Weight Control, Ethical Concern, Natural Content, and Mood reasons. People with greater orthorexic tendencies (ORTO-15 score<35) chose food significantly more often for Weight Control and Ethical Concern reasons than those with less orthorexic tendencies (ORTO-15 score 35+). CONCLUSION This study's results are in line with the majority of the evidence that shows an association between vegan/vegetarian diets and orthorexic tendencies, but strengthens the evidence base by including more male participants. Additionally, this is the first study to use an English-validated motivation-based questionnaire that explored diet motivators in vegans/vegetarians compared to omnivories, and in those with orthorexic tendencies vs. those without orthorexic tendencies.
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Affiliation(s)
- Rebecca Reynolds
- School of Population Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Andrea McGowan
- School of Population Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sophie Smith
- School of Population Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Patrick Rawstorne
- School of Population Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
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16
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Mazzolani BC, Smaira FI, Esteves GP, Santini MH, Leitão AE, Santo André HC, Gualano B, Roschel H. Disordered Eating Attitudes and Food Choice Motives Among Individuals Who Follow a Vegan Diet in Brazil. JAMA Netw Open 2023; 6:e2321065. [PMID: 37382953 PMCID: PMC10311387 DOI: 10.1001/jamanetworkopen.2023.21065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 06/30/2023] Open
Abstract
Importance It remains controversial whether adhering to a vegan diet may be associated with a higher prevalence of disordered eating. Also, main food choice motives and their association with disordered eating in this population are still unknown. Objective To determine the association between disordered eating attitudes and food choice motives of individuals who follow a vegan diet. Design, Setting, and Participants This is a cross-sectional online survey conducted between September 2021 and January 2023. Individuals of both sexes, aged 18 years or older, following a vegan diet for at least 6 months, currently living in Brazil were recruited through advertisements on social media. Exposure Adherence to a vegan diet and food choice motives. Main Outcomes and Measures Disordered eating attitudes and food choice motives. Results Nine hundred seventy-one participants completed the online survey. Median (IQR) age and BMI of participants was 29 (24-36) years and 22.6 (20.3-24.9), respectively, and 800 participants (82.4%) were female. Most participants (908 respondents [94%]) were categorized with the lowest level of disturbed eating attitudes. "Need and hunger," "liking," "health," "habits," and "natural concerns" were the most important food choice motives in this population, while "affect regulation," "social norms," and "social image" were the less important ones. Adjusted models showed that "liking," "need and hunger," and "health" were associated with lower levels of disordered eating attitudes, while "price," "pleasure," "sociability," "traditional eating," "visual appeal," "social norms," "social image," "weight control," and "affect regulation" were associated with higher levels of disordered eating attitudes. Conclusions and Relevance In this cross-sectional study, as opposed to previous suggestions, levels of disordered eating were very low among vegans, although certain food choice motives were associated with disordered eating attitudes. Understanding the motivations of adhering to diets that may impose restrictions, which include vegan diets, may help tailor interventions focused on promoting healthy eating and preventing or treating disordered eating.
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Affiliation(s)
- Bruna Caruso Mazzolani
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Fabiana Infante Smaira
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Gabriel P. Esteves
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Martin Hindermann Santini
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Alice Erwig Leitão
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | | | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, University of São Paulo, Sao Paulo, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, Brazil
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Messer M, Liu C, Linardon J. Orthorexia nervosa symptoms prospectively predict symptoms of eating disorders and depression. Eat Behav 2023; 49:101734. [PMID: 37146411 DOI: 10.1016/j.eatbeh.2023.101734] [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: 09/14/2022] [Revised: 03/29/2023] [Accepted: 04/23/2023] [Indexed: 05/07/2023]
Abstract
The possible mental health impacts of orthorexia nervosa (ON) symptoms are poorly understood, as existing research in this field has mostly employed cross-sectional designs. This study investigated whether ON symptoms prospectively predict changes in eating disorder psychopathology and general mental health. A convenience, non-clinical sample of adults (n = 313; 83 % women) completed study measures at baseline (T1) and three-month follow-up (T2). Negative binomial regressions were computed to test whether T1 ON symptoms predict changes in binge eating and driven exercise episodes. Linear regressions were computed to test whether T1 ON symptoms predict changes in eating concerns, depressive symptoms, and life satisfaction. Higher ON symptoms prospectively predicted greater number of binge eating and driven exercise episodes at T2. Higher ON symptoms predicted increased eating concerns and depressive symptoms at T2. ON symptoms did not predict changes in life satisfaction. Findings highlight possible risks associated with ON symptomatology. Efforts to better inform the public about the risks of these pathological eating patterns are needed.
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Affiliation(s)
- Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Claudia Liu
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia; Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria 3125, Australia.
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18
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Lasson C, Rousseau A, Vicente S, Goutaudier N, Romo L, Roncero M, Barrada JR. Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS). J Eat Disord 2023; 11:65. [PMID: 37106441 PMCID: PMC10139919 DOI: 10.1186/s40337-023-00764-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/26/2023] [Indexed: 04/29/2023] Open
Abstract
As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive-Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI = .963, TLI = .949, RMSEA = .068). The mean loading was .65 for HeOr and .70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr = .83 and αOrNe = .81). Partial correlations showed that eating disorders and obsessive-compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research.
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Affiliation(s)
- Clotilde Lasson
- Laboratoire CERPPS (Centre d'Etudes Et de Recherches en Psychopathologie Et Psychologie de La Santé), Université Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France.
| | - Amélie Rousseau
- Laboratoire CERPPS (Centre d'Etudes Et de Recherches en Psychopathologie Et Psychologie de La Santé), Université Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Siobhan Vicente
- Centre de Recherches Sur La Cognition Et L'Apprentissage-CeRCA-(CNRS, UMR 7295) MSHS, Université de Poitiers, 5 Rue Théodore Lefebvre, 86073, Poitiers Cedex 9, France
| | - Nelly Goutaudier
- Centre de Recherches Sur La Cognition Et L'Apprentissage-CeRCA-(CNRS, UMR 7295) MSHS, Université de Poitiers, 5 Rue Théodore Lefebvre, 86073, Poitiers Cedex 9, France
| | - Lucia Romo
- UR4430 CLIPSYD, Université Paris Nanterre; HU Raymond-Poincaré, Inserm CESP 1018 UPS, Nanterre, France
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Juan Ramón Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain
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The effect of social media use on orthorexia nervosa: a sample from Turkey. NUTR HOSP 2023; 40:384-390. [PMID: 36880720 DOI: 10.20960/nh.04217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES the current study evaluated the orthorexic tendencies of social media users and the factors affecting these tendencies. METHODS a total of 2526 adult participants (696 male and 1830 female, 28.4 ± 10.3 years) completed a questionnaire that includes personal information, the Orthorexia Nervosa Scale (ORTO-11), the Social Media and Eating Behavior Scale (SMEB), and the International Physical Activity Questionnaire Short Form (IPAQ). Body mass index (BMI) was calculated from the reported weight and height of the participants. Independent-sample t-tests or chi-square tests were computed to evaluate various information of the participants according to the ON tendency. A binary logistic regression analysis was used to identify risk factors. RESULTS according to ORTO-11, 56.1 % of the participants had a tendency to ON, and the trend to ON increased with age and BMI (p < 0.05). People without ON tendency spent more time (172.2 ± 119.9 min/day) on social media. Participants who followed webpages with healthy nutrition and sport-exercise recommendations had an increased ON risk when compared to those who did not follow those pages (p < 0.05). In addition, although there was a significant difference between participants in physical activity level according to the ON tendency, this relationship was not significant in the regression model (p > 0.05). CONCLUSION this study indicates that increasing social media usage, especially web pages that include health and nutrition recommendations, may boost the tendency to ON. Thus, raising awareness of social media may be beneficial to people who have a tendency to ON.
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20
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Anastasiades E, Argyrides M. Exploring the role of positive body image in healthy orthorexia and orthorexia nervosa: A gender comparison. Appetite 2023; 185:106523. [PMID: 36871603 DOI: 10.1016/j.appet.2023.106523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
Current scholarship on orthorexia nervosa remains undecided about the role of body image in this novel eating disorder. This study aimed to explore the role of positive body image in differentiating between healthy orthorexia and orthorexia nervosa and assess how this might differ for men and women. A total of 814 participants (67.1% women; age M = 40.30, SD = 14.50) completed the Teruel Orthorexia scale, as well as measures of embodiment, intuitive eating, body appreciation and functionality appreciation. A cluster analysis revealed four distinct profiles characterized by high healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and low orthorexia nervosa; low healthy orthorexia and high orthorexia nervosa; and high healthy orthorexia and high orthorexia nervosa. A MANOVA identified significant differences for positive body image between these four clusters, as well as that there were no significant differences between men and women for healthy orthorexia and orthorexia nervosa, despite men scoring significantly higher than women on all measures of positive body image. Cluster × gender interaction effects were found for intuitive eating, functionality appreciation, body appreciation and experience of embodiment. These findings indicate that the role of positive body image in healthy orthorexia and orthorexia nervosa may differ for men and women, making these relationships worthy of further exploration.
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Kamarli Altun H, Özyildirim C, Koç Ş, Aksoy HN, Sağir B, Bozkurt MS, Karasu H. The factors associated with orthorexia nervosa in type 2 diabetes and their effect on diabetes self-management scores. Eat Weight Disord 2023; 28:22. [PMID: 36809582 PMCID: PMC9944002 DOI: 10.1007/s40519-023-01552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/10/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE This study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management. METHODS The study included 373 individuals with type 2 diabetes between the ages of 18-65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R. RESULTS The linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management. CONCLUSION It should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
- Hülya Kamarli Altun
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Caner Özyildirim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye.
| | - Şeyma Koç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hatice Nur Aksoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Beyza Sağir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Merve Sefa Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hakan Karasu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
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22
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Levin RL, Mills JS, McComb SE, Rawana JS. Examining orthorexia nervosa: Using latent profile analysis to explore potential diagnostic classification and subtypes in a non-clinical sample. Appetite 2023; 181:106398. [PMID: 36455786 DOI: 10.1016/j.appet.2022.106398] [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: 05/25/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 11/29/2022]
Abstract
Orthorexia nervosa (ON) is a proposed psychological disorder characterized by a pathological preoccupation with healthy eating. The purpose of the current study was to clarify the relationships between ON and related forms of psychopathology. In addition, we sought to explore whether there may be subtypes of ON and if ON is associated with BMI, gender, or social media use. The sample included 333 undergraduate students (72% female, Mage = 20.91) who completed measures of ON, eating disorder (ED) symptoms, obsessive compulsive disorder (OCD), obsessive compulsive personality disorder (OCPD), and health anxiety. Latent profile analysis detected three distinct groups with high ON scores. The ON/ED combined group (n = 16) was characterized by high levels of psychopathology, particularly in the areas of ON and eating disorder symptoms. In comparison, the ON/ED combined, without weight/shape concerns group (n = 35) had fewer body-related concerns. The ON only group (n = 23) reported minimal ED pathology. Regression analyses revealed those in the ON only group were more likely to be male, while the ON/ED group was associated with higher BMI. Being in the ON/ED combined, without weight/shape concerns was associated with viewing and sharing healthy eating content on social media. Our findings suggest that ON has the most overlap with ED pathology as compared to OCD, OCPD, and health anxiety, and that there may be three subtypes of ON. The first two share significant overlap with ED symptomatology while the third appears relatively distinct, characterized by less disordered eating and fewer positive emotions related to healthy eating. Future research should examine these subtypes more closely to determine whether they are clinically meaningful, potentially requiring different interventions.
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Affiliation(s)
- Rivka L Levin
- York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jennifer S Mills
- York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Sarah E McComb
- York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jennine S Rawana
- York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Şentürk E, Güler Şentürk B, Erus S, Geniş B, Coşar B. Dietary patterns and eating behaviors on the border between healthy and pathological orthorexia. Eat Weight Disord 2022; 27:3279-3288. [PMID: 35917092 DOI: 10.1007/s40519-022-01457-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 07/22/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The obsession with healthy eating associated with restrictive behaviors is called Orthorexia Nervosa (OrNe). Nevertheless, some studies suggest that orthorexia can also be a non-pathological interest in healthy eating which is called Healthy Orthorexia (HeOr). First, one of the main objectives of this study is to compare HeOr, OrNe and eating behaviors in different dietary patterns (vegan, vegetarian and omnivore). Second is to reveal the relationship between HeOr, OrNe and eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating). Lastly, to determine the potential predictors of HeOr and OrNe. METHODS Participants (N = 426 with an omnivorous diet; N = 415 with a vegan diet, N = 324 with a vegetarian diet) completed a web-based descriptive survey, the Teruel Orthorexia Scale and the Three-Factor Eating Questionnaire-R 21. RESULTS HeOr and OrNe were more common in individuals following both vegan and vegetarian diets. Individuals following a vegan or a vegetarian diet had lower body mass index and higher body image satisfaction than individuals following an omnivorous diet. Cognitive restraint and following a vegan or a vegetarian diet were the two main predictors of both HeOr and OrNe. Cognitive restraint was positively associated with both HeOr and OrNe (more strongly correlated with OrNe), whereas uncontrolled eating and emotional eating behaviors were positively related to OrNe and negatively related to HeOr. CONCLUSION The present study contributes to a better understanding of the some similarities and differences between HeOr and OrNe. It also points to higher rates of orthorexia in individuals following a vegan or vegetarian diet and represents a further step towards developing prevention and intervention programs by identifying risk factors for OrNe. Level V Cross-sectional descriptive study.
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Affiliation(s)
- Erman Şentürk
- Department of Psychiatry, Üsküdar University NP Feneryolu Medical Center, Istanbul, Turkey.
| | - Begüm Güler Şentürk
- Department of Internal Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Suat Erus
- Department of Thoracic Surgery, School of Medicine, Koç University, Istanbul, Turkey
| | - Bahadır Geniş
- Department of Psychiatry, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Behcet Coşar
- Department of Psychiatry, School of Medicine, Gazi University, Ankara, Turkey
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Healthy orthorexia vs orthorexia nervosa: associations with body appreciation, functionality appreciation, intuitive eating and embodiment. Eat Weight Disord 2022; 27:3197-3206. [PMID: 35864300 DOI: 10.1007/s40519-022-01449-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/10/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Current conceptualizations and measures of orthorexia nervosa may not be accurately distinguishing between the healthy vs pathological pursuit of a healthy diet, leading to very high prevalence rates and risking the pathologizing and stigmatizing of healthy eating more generally. Recent research has identified healthy orthorexia as a novel construct conceptually distinct from orthorexia nervosa, which represents the non-pathological pursuit of a healthy diet. In light of the strong body of evidence supporting the role of positive body image in eating behavior, the current study aimed to examine the associations between healthy orthorexia, orthorexia nervosa, intuitive eating and indices of positive body image. METHODS The current study employed a cross-sectional design. An online community sample (N = 835; 62% women; Mage = 40.24, SD = 14.45) completed self-report questionnaires including the Teruel Orthorexia Scale, Body Appreciation Scale-2, Functionality Appreciation Scale, Intuitive Eating Scale-2, and Experience of Embodiment Scale. RESULTS Intuitive eating and indices of positive body image were significantly positively associated with healthy orthorexia and inversely associated with orthorexia nervosa. A hierarchical multiple regression analysis found that intuitive eating and indices of body image were uniquely associated with 13.3% of the variance of healthy orthorexia above and beyond that accounted for by orthorexia nervosa. Intuitive eating moderated the relationship between healthy orthorexia and orthorexia nervosa. CONCLUSION The findings of this study provide support for intuitive eating and indices of positive body image as worthy of further exploration as important factors which distinguish between healthy orthorexia and orthorexia nervosa. LEVEL OF EVIDENCE V, descriptive study.
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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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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: 1.5] [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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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: 0] [Impact Index Per Article: 0] [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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Hanras E, Dorard G, Boujut E. Une ou plusieurs orthorexies ? Conceptualisation, évaluation et enjeux sociétaux : une revue critique de la littérature. PSYCHOLOGIE FRANCAISE 2022. [DOI: 10.1016/j.psfr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Miley M, Egan H, Wallis D, Mantzios M. Orthorexia nervosa, mindful eating, and perfectionism: an exploratory investigation. Eat Weight Disord 2022; 27:2869-2878. [PMID: 35829900 PMCID: PMC9556414 DOI: 10.1007/s40519-022-01440-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Research has drawn associations between Mindful Eating (ME) and perfectionism in the aetiology and treatment of eating disorders (ED), but understanding into the relationship between these factors and Orthorexia nervosa (ON) is limited. The purpose of this research is to explore the relationship between perfectionism, ME, and ON. METHOD Participants (n = 670) completed the Düsseldorf Orthorexia scale, the Mindful Eating Behavior scale, and the Big-Three Perfectionism scale Short-form, to reveal the relationship between ON, ME, and perfectionism. The relationship was assessed using correlational and regression analyses. RESULTS A positive association was observed between perfectionism and ON. Moreover, perfectionism demonstrated a significant negative correlation with three out of four ME facets, with "eating without distraction" displaying the highest correlation. The "eating with awareness" facet of ME demonstrated a significant relationship with ON, in a negative direction. An unexpected relationship was observed between the focused eating facet of ME and ON, with a positive association being found. A further regression analysis revealed both perfectionism and ME to predict orthorexic tendencies. CONCLUSION These findings identify a relationship between ON, ME, and perfectionism. It offers suggestion for the complexity of ME, and how it should be recognised by its different components, estimating a differential predictability and estimation of ON. Further research is required to clarify the direction of causality in the relationships observed, to inform the clinical diagnoses and intervention of ON. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Molly Miley
- Department of Psychology, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK.
| | - Helen Egan
- Department of Psychology, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Deborah Wallis
- Department of Psychology, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
| | - Michail Mantzios
- Department of Psychology, Birmingham City University, The Curzon Building, 4 Cardigan St., Birmingham, B4 7BD, UK
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Steinmann A, Ruf A, Ahrens KF, Reif A, Matura S. Bacon, Brownie, or Broccoli? Beliefs about Stress-Relieving Foods and Their Relationship to Orthorexia Nervosa. Nutrients 2022; 14:nu14183673. [PMID: 36145049 PMCID: PMC9505357 DOI: 10.3390/nu14183673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Nutritional beliefs play an important role when it comes to food choice. However, little attention has been paid to which foods individuals believe to be comforting when experiencing stress. With increasing health awareness in the general public, this study aims to examine whether the nutritional belief exists that only healthy foods relieve stress. If so, we are interested in its relationship to Orthorexia Nervosa (ON) tendencies. Methods: 175 participants (mean age 28.5 ± 7.8 years, 124 females) completed questionnaires to assess beliefs about stress-relieving foods and ON tendencies. Principal component analysis was used to reduce foods to food groups. Subsequently, a latent profile analysis was performed to identify groups with distinct nutritional beliefs. Results: Among eight distinct groups, one group (8% of the sample) reported the belief that exclusively healthy foods relieve stress. Multinominal logistic regressions showed that higher ON tendencies were associated with that group. Conclusions: Our findings suggest that individuals with stronger ON tendencies believe that, in particular, healthy foods relieve stress. This indicates that nutritional beliefs in ON concern not only the somatic consequences of certain foods, but also psychological consequences, which might also drive orthorexic behaviour. This offers a new target for the diagnosis and treatment of ON.
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Negative body image components as risk factors for orthorexia nervosa: Prospective findings. Appetite 2022; 178:106280. [PMID: 35988801 DOI: 10.1016/j.appet.2022.106280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/01/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022]
Abstract
Emerging theoretical and empirical evidence indicates that negative body image might be implicated in the onset or maintenance of ON symptoms. However, existing research investigating associations between negative body image and ON is limited to cross-sectional designs and has failed to consider the independent role of distinct components of body image. To overcome these limitations, the present study examined the prospective associations between five components of body image (i.e., overvaluation, dissatisfaction, preoccupation, body checking, and body image avoidance) and ON symptoms in community-based adult women. Participants were assessed at baseline and at a three-month follow-up, with 558 women included in the final analyses. After adjusting for baseline ON symptoms, higher scores on each of the five body image components at baseline significantly predicted greater increases in ON symptoms in univariate analyses. However, in multivariate analyses, overvaluation with weight and shape was the only component of body image to uniquely predict ON symptoms. Findings suggest that certain components of negative body image may increase the risk for ON symptoms. Findings also lend support to recent proposals that ON may be better viewed as a variant of an existing eating disorder, given that both appear to share similar underlying risk factors.
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Obeid S, Awad E, Wachten H, Hallit S, Strahler J. Temperaments and orthorexia nervosa: a cross-cultural study between Germany and Lebanon. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03467-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThe aim of this study was to explore the association between affective temperaments and orthorexic eating and whether temperament may explain cross-cultural differences in this behavior while considering the two dimensions of orthorexic eating, healthy (HeOr) and nervosa (OrNe). To accomplish this, 337 and 389 individuals were recruited in Lebanon and Germany, respectively. The brief version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego explored depressive, hyperthymic, cyclothymic, anxious and irritable temperaments, and the Teruel Orthorexia scale explored orthorexic eating. HeOr appeared comparable between countries but OrNe was higher in Lebanon. In terms of affective temperaments, the higher the depressive, cyclothymic, irritable, and anxious temperaments, the higher were the levels of OrNe. Only the hyperthymic temperament scale was positively associated with HeOr. Three-step regression analysis indicated only gender as a unique predictor for HeOr. By contrast, gender, depressive, hyperthymic, and anxious temperament as well as the two-way interactions country*depressive temperament and country*hyperthymic temperament were significant predictors of OrNe. The positive association between OrNe and depressive temperament was only found for the German sample while the negative association between hyperthymic temperament and OrNe was somewhat stronger in the Lebanese sample. Overall, a higher healthy interest in diet was linked to the hyperthymic temperament. Findings emphasized the role of temperaments in pathological orthorexic eating in general as well as in explaining cross-cultural differences in these behaviors. The assessment of temperaments could help to fit treatments for eating pathologies to individuals from different cultures, focusing interventions more on these aspects.
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Albery IP, Shove E, Bartlett G, Frings D, Spada MM. Individual differences in selective attentional bias for healthy and unhealthy food-related stimuli and social identity as a vegan/vegetarian dissociate "healthy" and "unhealthy" orthorexia nervosa. Appetite 2022; 178:106261. [PMID: 35931214 DOI: 10.1016/j.appet.2022.106261] [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: 04/13/2022] [Revised: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
Previous work identified the operation of an attentional bias (AB) towards healthy food related stimuli among those with increasing tendencies towards orthorexia nervosa (ON) using a modified Stroop task. The current work aimed to replicate and extend our understanding of this effect by incorporating alternative measures of AB (i.e., the dot probe task) and ON (i.e., the Teruel Orthorexia Scale [ToS]) in a sample of self-defined vegans/vegetarians. The theoretical assertion of the ToS is the conceptual broadening of orthorexia with differentiable dimensions - one characterised as a "healthy" preoccupation with healthy food/eating patterns (HeOr) and the other by a more underlying pathology (OrNe). This study also aimed to examine the pattern of responding across these two dimensions according to factors known to predict ON. Eighty-six participants (mean age = 33.0 years; 20 males, 66 females) completed measures of obsessive compulsivity, perfectionism, state/trait anxiety and ToS as well as a dot probe designed to measure AB for healthy and unhealthy-related food stimuli, threat ratings of each of words utilised and perceived identity centrality as a vegan/vegetarianism. Results showed a dissociation of predicted determinants for "healthy" ON (HeOr) and pathological ON (OrNe). HeOr was predicted by increasing identity centrality whereas OrNe was predicted by increased OCD and perfectionism, and increased interference for healthy-related food words (in particular slowed disengagement) and not unhealthy related food words. Threat-related ratings of unhealthy food words was shown to be common across both dimensions. This pattern highlights cognitive and individual differences-based correlates of pathological and non-pathological ON.
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Affiliation(s)
- Ian P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK.
| | - Emma Shove
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Georgina Bartlett
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Daniel Frings
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Marcantonio M Spada
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
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34
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Novara C, Pardini S, Visioli F, Meda N. Orthorexia nervosa and dieting in a non-clinical sample: a prospective study. Eat Weight Disord 2022; 27:2081-2093. [PMID: 34993925 PMCID: PMC8739027 DOI: 10.1007/s40519-021-01353-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Orthorexia Nervosa (ON) is characterised by excessive attention to a dietary regimen perceived as healthy. A critical factor in the distinction between ON and other eating disorders (EDs) is the dichotomy of quality-versus-quantity of food intake. We investigated whether specific types of diet or dieting frequency are associated with orthorexic features, explored the overlap between ON and EDs symptoms, and examined which constructs are predictive of ON after 6 months. METHODS A total of 1075 students (75.1% female, mean age 20.9) completed a set of questionnaires assessing Orthorexia, Eating Disorders, Obsessions and Compulsions, Anxiety and Depression; 358 individuals (79.9 female, mean age 20.9) agreed to participate in the study and completed the same questionnaires after 6 months. Different regression models were defined to investigate our hypothesis. RESULTS Findings suggest that ON is associated with the number and type of diets followed over a lifetime. Moreover, participants with EDs, body dissatisfaction, or a dysfunctional idea of thinness are more likely to report a greater degree of ON features. After 6 months, the best predictors of ON characteristics are the same ON characteristics assessed at the first administration, with a significant role in the ideal of thinness. CONCLUSIONS ON is more frequent in individuals with a previous diagnosis of EDs and in individuals who followed a restrictive diet or a vegan/vegetarian one; the number of lifetime diets, beliefs, and behaviors related to the ideals of thinness or body dissatisfaction is common features of ON. Moreover, considering that having ON features in the past is the best ON predictor in the present, we can presume that ON is a construct stable over time. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy
| | - Francesco Visioli
- Department of Molecular Medicine, University of Padova, Viale G. Colombo 3, Padova, Italy.,IMDEA-Food, CEI UAM + CSIC, Carr. de Canto Blanco 8, E, Madrid, Spain
| | - Nicola Meda
- Department of Medicine, University of Padova, Via Giustiniani 2, Padova, Italy
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Yardımcı H, Demirer B. The effect of orthorexia nervosa on food label reading habits among university students. Eat Weight Disord 2022; 27:2173-2180. [PMID: 35113357 DOI: 10.1007/s40519-022-01366-x] [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: 11/05/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This observational cross-sectional study aimed to evaluate university students' food label reading habits with and without orthorexia nervosa (ON) tendency. METHODS Data were collected online with a questionnaire. The questionnaire form included sociodemographic variables, the ORTO-11 scale, the reading frequency of some components on the food label, and the evaluation of some opinions about the food label. The obtained data were evaluated with SPSS 25.0 statistical package program and GraphPad Prism program. RESULTS A total of 674 university students (mean age: 21.03 ± 2.43 years), 537 women (79.7%) and 137 men (20.3%) were included in the study. It was determined that individuals with ON tendency read some nutrients, content information, serving size, health information, instructions for use, additives and brand more frequently compared to individuals without ON tendency (p < 0.05). At the same time, it was determined that individuals with ON tendency were more likely to agree with the idea that reading food labels is important for a healthy diet, compared to individuals with normal eating behavior (p < 0.001). CONCLUSION The study findings show that individuals with ON tendency have a higher habits of reading food labels compared to individuals with normal eating behavior. To reach a decision on this issue and to determine the diagnostic criteria for ON, future studies should be conducted on different groups and samples with higher participation, as well as studies using different screening tools to determine the tendency for ON. LEVEL OF EVIDENCE V, Cross-sectional descriptive study.
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Affiliation(s)
- Hülya Yardımcı
- Faculty of Health Sciences, Nutrition and Dietetic, Ankara University, Ankara, Turkey
| | - Büşra Demirer
- Faculty of Health Sciences, Nutrition and Dietetic, Karabuk University, Karabuk, Turkey.
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Chace S, Kluck AS. Validation of the Teruel Orthorexia Scale and relationship to health anxiety in a U.S. sample. Eat Weight Disord 2022; 27:1437-1447. [PMID: 34379313 DOI: 10.1007/s40519-021-01272-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Scholarly investigation into orthorexia nervosa is relatively new, leading several scholars to develop new measures to adequately assess the concerns thought to underlie this condition. A promising new measure of orthorexia, the Teruel Orthorexia Scale (TOS), was developed using a Spanish sample. PURPOSE This study was the first to investigate the psychometric properties of the English version of the TOS in a U.S. SAMPLE This study also examined the long-hypothesized relationship between orthorexia and health anxiety. METHODS We used exploratory factor analysis (EFA) to evaluate the factor structure of the TOS. We also used correlational methods to test theorized relationships with related concerns. RESULTS ESEM supported a 16-item, 2-factor model. Correlations between the modified TOS (i.e., TOS-16) subscales and measures of obsessive-compulsive and eating disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS-16. There was a moderate positive correlation between orthorexia nervosa and health anxiety and, together, pursuit of healthy eating and preoccupation with healthy eating accounted for a significant amount of variance in health anxiety after controlling for eating disorder symptoms. CONCLUSION Overall, this research suggests that the TOS-16 demonstrates psychometric properties as good as or better than other measures commonly used to assess the construct in a U.S. SAMPLE In addition, findings support the consideration of health anxiety as a possible feature of orthorexia nervosa. LEVEL OF EVIDENCE Level V, descriptive research.
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Orthorexia nervosa vs. healthy orthorexia: relationships with disordered eating, eating behavior, and healthy lifestyle choices. Eat Weight Disord 2022; 27:1313-1325. [PMID: 34275120 PMCID: PMC8286169 DOI: 10.1007/s40519-021-01263-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/28/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Orthorexia nervosa (OrNe) is a pattern of disordered eating behavior characterized by excessive preoccupation with overvalued ideas about healthy eating. Healthy orthorexia (HeOr) refers to a non-pathological interest in healthy eating and nutrition. Despite converging evidence that OrNe is correlated with measures of psychopathology and personality traits, there is relatively little empirical data relating OrNe and HeOr to eating and health-promoting behavior. METHODS Aim 1: exploratory structural equation modeling was used to evaluate the factor structure of an English-language version of the Teruel Orthorexia Scale, the only measure of OrNe that also assesses HeOr in two samples (Yoga practitioners, N = 469, and Mechanical Turk workers, N = 453). Aim 2: conducted in the Mechanical Turk sample, partial correlation and linear regression analyses were used to evaluate the relationships of OrNe and HeOr with other symptoms of, and clinical impairment from, disordered eating, food choices, diet quality, body mass index (BMI), nutrition knowledge, alcohol/tobacco/vaping use, and sedentary behavior. RESULTS The two-factor structure of the TOS was replicated. HeOr and OrNe had opposing relationships with measures of disordered eating behavior and distress, food choices, diet quality, and nutrition knowledge. HeOr was negatively related to BMI, whereas OrNe was positively related to substance use and sedentary behavior. CONCLUSIONS OrNe and HeOr are distinct latent constructs, with the latter reflecting non-pathological behavior. Only OrNe is related to elevated disordered eating and clinical impairment. Despite involving obsessions and compulsions related to healthy eating, OrNe was associated with relatively unhealthy eating and other lifestyle behaviors. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Abstract
The aim of this review is to summarise the common barriers and motivations for healthy food choice among adolescents, with a specific focus on the Irish context where available. It will also discuss other concerns adolescents have, which may influence their food choices and eating habits. Adolescence represents a period of rapid physical, mental and social development, and many health-related habits developed during adolescence tend to persist into adulthood, making the teenage years an optimal time to encourage healthy eating and health-promoting behaviours. Adolescents are concerned about the health impact of their diet, but their understanding of health is often seen in the context of their physical appearance or body image. Body image concerns are prevalent in adolescents, and this can affect their food choices. Taste, price and convenience are commonly noted factors influencing adolescents' food choices, and as they grow, their level of independence increases and spending more time with their peers means that social desirability and social norms about food become increasingly important factors in adolescent food choice. However, their limited autonomy means their supporting food environment also plays an important role. When developing more targeted interventions in adolescent populations, information on adolescent nutrition needs, their concerns for health and body image, and the barriers and motivations for healthy eating and food choice should be considered. Such a holistic approach should help support healthy eating and the prevention of overweight and obesity in the population, whilst also supporting a healthy relationship with food and their bodies.
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Validation of the Arabic version of the Teruel Orthorexia Scale (TOS) among Lebanese adolescents. Eat Weight Disord 2022; 27:619-627. [PMID: 33939127 PMCID: PMC8091151 DOI: 10.1007/s40519-021-01200-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study aimed at examining the reliability and validity of the Teruel Orthorexia Scale (TOS) among a sample of Lebanese adolescents (15 to 18 years old). METHODS This is a cross-sectional study that was conducted between May and June 2020 and had enrolled 555 Lebanese adolescents. To assess the internal structure of the TOS scale, we administered the confirmatory factor analysis based on polychoric correlation matrix using Weighted Least Squares with Means and Variance Adjusted estimation (WLSMV) method in Mplus v 7.2 as suggested in the original validation paper. To assess the degree to which the Lebanese adaptation converges with the original scale, we have conducted the Multigroup Confirmatory Factor Analysis (MGCFA; estimated as CFA) between the data reported in the current paper and from the original validation paper. RESULTS The mean age of the participants was 16.66 ± 1.01 years, with 76.1% females. The bi-dimensional model fitted the data well (χ2(118) = 429.09; p < 0.001; CFI = 0.954; RMSEA = 0.069[0.062, 0.076]). The latent factors were highly correlated (ρ = 0.74; p < 0.001), and the strength of the standardized factor loadings was adequate on both factors (i.e., all > 0.60). The fit indices of the scalar model were at the boundary of the threshold and thus, with some pinch of caution, it might be interpreted as invariant (i.e., having equal item intercepts across groups). We have identified latent mean differences in orthorexia nervosa (0.30; p < 0.001), where Spanish individuals scored higher, but we did not find any differences in the healthy eating (0.03; p = 0.636). Higher DOS scores were significantly correlated with higher scores on the TOS subscale OrNe (r = 0.715; p < 0.001) as well as with higher scores on the TOS subscale HeOR (r = 0.754; p < 0.001). Higher ORTO-R scores were significantly associated with less TOS OrNe (r = - 0.437; p < 0.001) and TOS HeOr (r = - 0.305; p < 0.001) scores, respectively. CONCLUSION The Arabic version of the TOS can be considered a reliable valuable instrument to assess the ON tendencies and behaviors in Lebanese adolescents, emphasizing the fine contrast between ON's two dimensions: healthy vs. pathological. LEVEL V Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Awad E, Obeid S, Sacre H, Salameh P, Strahler J, Hallit S. Association between impulsivity and orthorexia nervosa: any moderating role of maladaptive personality traits? Eat Weight Disord 2022; 27:483-493. [PMID: 33840074 DOI: 10.1007/s40519-021-01186-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To explore the possible moderating relation between impulsive behavior and maladaptive personality traits in regards to orthorexia nervosa (ON). METHODS This cross-sectional study was conducted between July and December 2019 and recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. The Teruel Orthorexia Scale (TOS) was employed to assess orthorexic eating tendencies, the I-8 measured impulsivity and the Personality Inventory for DSM-5 (PID) evaluated maladaptive personality traits. RESULTS Our results showed that, for I-8 subscales, only higher perseverance (B = 0.31) was significantly associated with higher ON. In regard to PID-5 subscales, only higher negative affect (B = - 0.34) was significantly associated with lower ON. Furthermore, significant interactions were found between personality traits and impulsivity to predict TOS-ON. CONCLUSION The current results show that female gender, maladaptive personality traits and impulsivity present contributing factors regarding orthorexic eating. Certain impulsivity dimensions were confirmed to interact with personality traits in the prediction of orthorexic eating thereby highlighting possible risk factors and psychopathological mechanisms. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Emmanuelle Awad
- Faculty of Social Sciences, Psychology Department, Lund University, Lund, Sweden
| | - Sahar Obeid
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon. .,Research and Psychology Departments, Psychiatric Hospital of the Cross, Jall-Eddib, Lebanon.
| | - Hala Sacre
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Jana Strahler
- Department of Health Psychology and Applied Diagnostics, Faculty of Human-Social Sciences, University of Wuppertal, Wuppertal, Germany.,Department of Psychotherapy and Systems Neuroscience, Faculty of Psychology and Sport Science, University of Giessen, Giessen, Germany
| | - Souheil Hallit
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Yakın E, Raynal P, Chabrol H. Distinguishing between healthy and pathological orthorexia: a cluster analytic study. Eat Weight Disord 2022; 27:325-334. [PMID: 33826119 DOI: 10.1007/s40519-021-01178-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study represents a first attempt to explore the typology of female adults from a large non-clinical sample based on healthy orthorexia (HO) and pathological orthorexia (orthorexia nervosa, ON). METHODS 1245 female adults (Mage = 38.04, SD = 9.73) completed a set of questionnaires assessing orthorexic behaviors, intuitive eating, self-esteem, perceived social support as well as eating disorders, depressive and anxiety symptoms. RESULTS Cluster analysis based on HO and ON scores yielded 4 distinct groups: "Healthy orthorexia cluster" (HO), "Orthorexia Nervosa cluster" (ON), "Low Orthorexia cluster" (LO) and "In-between Orthorexia cluster" (IBO). The HO and ON clusters represented individuals with, respectively, healthy and pathological interest in healthy diet. The LO cluster represented those with no particular interest in healthy eating and the IBO cluster showed that ON and HO behaviors can be associated in some individuals. Among all clusters, the ON cluster displayed highest levels of ED, anxiety and depressive symptoms. Inversely, the HO cluster displayed highest levels of intuitive eating, self-esteem and perceived social support. CONCLUSION Altogether, findings from this study support the bidimensional structure of orthorexic eating behavior and further suggest that ON and HO behaviors can be associated in some individuals. Our findings further provide evidence for the assumption that ON and HO could be seen, respectively, as maladaptive and protective eating behaviors. LEVEL OF EVIDENCE V, descriptive study.
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Affiliation(s)
- Ecem Yakın
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France.
| | - Patrick Raynal
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Henri Chabrol
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
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Awad E, Salameh P, Sacre H, Malaeb D, Hallit S, Obeid S. Association between impulsivity and orthorexia nervosa / healthy orthorexia: any mediating effect of depression, anxiety, and stress? BMC Psychiatry 2021; 21:604. [PMID: 34861836 PMCID: PMC8640965 DOI: 10.1186/s12888-021-03594-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a lack of studies investigating the possible mediating role of psychological factors, such as depression, anxiety and stress on orthorexic eating behaviors. Given that personality attributes might affect the manifestation of psychological disorders, it was hypothesized that depression, anxiety and stress mediate the relationship between impulsivity-related traits and orthorexic eating, noting that previous research had evaluated the role of depression as a mediator between impulsivity and other pathological eating behaviors. The study objectives were to explore the mediating effect of depression, anxiety, and stress, on impulsivity and orthorexia nervosa, and healthy orthorexia. METHODS This cross-sectional study conducted between July and December 2019 recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. RESULTS Our results showed that depression and anxiety were positively correlated with ON. We also found a notable gender difference in findings: higher anxiety and female gender were significantly associated with higher TOS healthy orthorexia, while higher stress was associated with lower TOS healthy orthorexia. Finally, higher urgency was associated with lower TOS healthy orthorexia, while higher perseverance was significantly associated with higher TOS healthy orthorexia. Depression and anxiety partially mediated the association between perseverance and ON while anxiety and stress partially mediated the association between urgency and healthy orthorexia. CONCLUSION Our study suggests that depression, anxiety and stress play a mediating role between impulsivity and orthorexia nervosa/healthy orthorexia. Our findings provide a ground for future investigations of impulsive behaviors, psychopathology, and orthorexia in different populations.
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Affiliation(s)
- Emmanuelle Awad
- grid.4514.40000 0001 0930 2361Faculty of Social Sciences, Psychology Department, Lund University, Lund, Sweden
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Pharmacy, Lebanese University, Hadat, Lebanon ,grid.413056.50000 0004 0383 4764University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Diana Malaeb
- grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon ,grid.466400.0Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon. .,Psychology Department, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Personality profiles in young adults with orthorexic eating behaviors. Eat Weight Disord 2021; 26:2727-2736. [PMID: 33620703 DOI: 10.1007/s40519-021-01124-5] [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: 08/10/2020] [Accepted: 01/20/2021] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Orthorexia nervosa (ON), defined as an excessive preoccupation with healthy eating, has gained more interest in the literature over these past few years. However, little is known about its risk and protective factors, in particular with regards to personality. METHODS A total of 3235 college students (10.32% men, 89.67% women) with a mean age of 21.13 (SD = 2.23) answered self-administered questionnaires assessing ON, psychopathological symptoms, and personality disorders including schizotypal, borderline, paranoid, obsessive-compulsive, and narcissistic personality. A subsample of 106 participants (91.51% women, mean age = 20.91, SD = 2.31) was selected based on the DOS cutoff score, and was then considered as the "orthorexic subsample". RESULTS Hierarchical cluster analysis was performed in the orthorexic subsample and led to the identification of four groups: 1-a cluster with a low level of traits (L); 2-a cluster with moderate traits and low narcissistic traits (MD); 3-a cluster with a low level of traits and moderate narcissistic traits (MN); 4-a cluster with high paranoid and narcissistic traits (PN) and a moderate level of schizotypal and borderline traits. Levels of anxiety, obsessional-compulsive, and depressive symptoms were higher in the PN and MD clusters than in the L and MN clusters. Social phobia was higher and self-esteem lower in the MD cluster and hypochondriasis was higher in the PN and MN clusters. CONCLUSIONS This study suggests that ON can be associated with different personality profiles, some of them displaying significant psychopathological levels. It also emphasizes the importance of taking into account personality disorder traits of young adults with orthorexic eating behaviors. LEVEL OF EVIDENCE Descriptive (cross-sectional) study, Level V.
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Plasonja N, Décamps G. Validation française de l’échelle de mesure de l’orthorexie ORTO-15 et étude des liens avec les troubles des conduites alimentaires et l’image du corps. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Grammatikopoulou MG, Gkiouras K, Polychronidou G, Kaparounaki C, Gkouskou KK, Magkos F, Donini LM, Eliopoulos AG, Goulis DG. Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus. Nutrients 2021; 13:nu13113823. [PMID: 34836080 PMCID: PMC8622186 DOI: 10.3390/nu13113823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/20/2021] [Accepted: 10/24/2021] [Indexed: 12/12/2022] Open
Abstract
Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Τypical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the evidence on the prevalence of ON symptomatology among patients with DM. PubMed, Web of Science, Scopus, and grey literature were searched, and relevant observational studies were screened using the Rayyan software. The quality of the studies was assessed using the appraisal tool for cross-sectional studies (AXIS) and the Newcastle–Ottawa scale (NOS). Out of 4642 studies, 6 fulfilled the predefined criteria and were included in the qualitative synthesis. Most studies relied on the ORTO-15 or its adaptations to identify ON among patients with DM. No apparent sex or age differences exist regarding the prevalence of ON symptoms. None of the studies compared the prevalence of ON in patients with type 1 and type 2 DM. Most of the research was of average to good methodological quality. In conclusion, patients with DM often exhibit ON tendencies, although research is still limited regarding the etiology or mechanistic drivers behind ON and the characteristics of patients with a dual ON–DM diagnosis.
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Affiliation(s)
- Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, GR-57400 Thessaloniki, Greece;
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Georgia Polychronidou
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Chrysi Kaparounaki
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Kalliopi K. Gkouskou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece; (K.K.G.); (A.G.E.)
- Embiodiagnostics Biology Research Company, GR-71305 Heraklion, Greece
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1958 Frederiksberg, Denmark;
| | - Lorenzo Maria Donini
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy;
| | - Aristides G. Eliopoulos
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece; (K.K.G.); (A.G.E.)
- Biomedical Research Foundation of the Academy of Athens, GR-11527 Athens, Greece
- Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
- Correspondence:
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Rogoza R, Hallit S, Soufia M, Barthels F, Obeid S. Validation of the Arabic version of the Dusseldorf Orthorexia Scale (DOS) among Lebanese adolescents. J Eat Disord 2021; 9:130. [PMID: 34656172 PMCID: PMC8520202 DOI: 10.1186/s40337-021-00488-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding 'pure' eating behaviors. Many scales have been established and display good results regarding reliability and validity measures, including but not limited to ORTO-R (revised version of ORTO-15), Eating Habits Questionnaire, Teruel Orthorexia Scale (TOS) and the Düsseldorf Orthorexia Scale (DOS). Among these, the DOS seems to be a promising measure for multiple reasons. The current paper aims to validate the DOS, a measure of ON, in a non-Western population of Lebanese adolescents. METHODS This was a cross-sectional designed study, conducted between May and June 2020, which enrolled 555 adolescents (15-18 years old; 75.7% females). Due the coronavirus pandemic outbreak, the data were gathered through snowball sampling using an online questionnaire. The DOS, TOS and ORTO-R scales were used in this study to screen for orthorexic tendencies and behaviors. RESULTS We tested four competing structural models of the DOS assessing its factorial validity. The results of the current investigation revealed that the one-factorial model is the best one to represent the structure of the questionnaire. We provided evidence for validity for the DOS through demonstrating that it correlates significantly with other measures of orthorexic behaviours (Teruel Orthorexia Scale and ORTO-R). Finally, we have gathered evidence that the orthorexic behaviours as measured by DOS are not associated with age (r = -.02; p = .589), household crowding index (r = .02; p = .578), and Body Mass Index (r = .04; p = .297). Yet, females as compared to males achieved higher scores (M = 20.07, SD = 6.38 vs M = 18.29, SD = 6.37; p = .005; d = .28). CONCLUSION The Arabic version of the DOS seems to be a structurally valid and internally consistent questionnaire measuring orthorexic eating behavior in a sample of Lebanese adolescents. This tool may be useful for psychologists, psychiatrists, dietitians and other clinicians in the assessment and the treatment of the multidimensional nature of ON.
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Affiliation(s)
- Radoslaw Rogoza
- Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Friederike Barthels
- Institute of Experimental Psychology, Department of Clinical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sahar Obeid
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Roncero M, Barrada JR, García-Soriano G, Guillén V. Personality Profile in Orthorexia Nervosa and Healthy Orthorexia. Front Psychol 2021; 12:710604. [PMID: 34594274 PMCID: PMC8477971 DOI: 10.3389/fpsyg.2021.710604] [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: 05/16/2021] [Accepted: 08/12/2021] [Indexed: 12/18/2022] Open
Abstract
Little is known about orthorexia in both its pathological (orthorexia nervosa, OrNe) and adaptive (healthy orthorexia, HeOr) forms. To date, few studies have been carried out to analyze the personality profile associated with orthorexia, and the results have been contradictory. The aim of the present study was to explore the characteristic pathological personality traits associated with OrNe and HeOr. A total of 297 participants (Mage = 30.8 years; 94.6% women) from the general population completed the Teruel Orthorexia Scale (TOS) and Personality Inventory for DSM-5-Short Form (PID-5-SF) questionnaires. Results showed significant low-medium correlations between OrNe and the four personality factors (Negative Affectivity, Detachment, Disinhibition, and Psychoticism) (rs range [0.08, 0.36]). In the regression analysis, the predictors of OrNe were Neuroticism and, to a lesser extent, Psychoticism. For HeOr, the associations were lower (rs range [−0.13, 0.05]) and negative, except Psychoticism. Only the relationship with Disinhibition was statistically significant, although after controlling for OrNe, Negative Affectivity and Antagonism also became significant. In the regression analysis, the predictors of HeOr were Disinhibition (negative direction) and Psychoticism (positive direction). The findings show that OrNe is associated with a pathological personality pattern characterized by difficulty in regulating emotions and negative affect (Negative Affectivity), as well as eccentricity, feeling special, and holding beliefs outside the norm (Psychoticism). However, HeOr seems to be related to the tendency toward high responsibility, self-control, the ability to maintain the focus of attention (low Disinhibition), and Psychoticism. Future studies should confirm whether this combination is a key component underlying the development and maintenance of orthorexia.
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Affiliation(s)
- María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Juan Ramón Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Verónica Guillén
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
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Dietary Habits and Musculoskeletal Pain in Statin and Red Yeast Rice Users: A Pilot Study. Eur J Investig Health Psychol Educ 2021; 11:1156-1165. [PMID: 34698118 PMCID: PMC8544747 DOI: 10.3390/ejihpe11040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Diet and statins are commonly used to treat high cholesterol (CHOL) levels. (2) Aim: To compare adherence to Mediterranean diet (Med-D), orthorexia nervosa (ON), and musculoskeletal pain in individuals in treatment with statins metabolized by CYP3A4, not metabolized by CYP3A4 or red yeast rice (RYR, containing monacolin K: MON-K). (3) Methods: starting from 80 individuals, after the exclusion of those with other causes of possible pain, 56 individuals were selected and divided into three groups according to the type of statin (CYP3A4, NO-CYP3A4 and MON-K). Adherence to the Med-D was evaluated with the MEDScore and a sub-score was calculated for fruit and vegetables consumption (MEDScore-FV). ON and musculoskeletal pain were assessed with the ORTO-15 and with the Nordic Musculoskeletal questionnaires, respectively. A retrospective analysis of CHOL decrease after treatment was conducted. (4) Results: CHOL levels were lower in CYP3A4 and NO-CYP3A4 after treatment (182.4 ± 6.3 and 177.0 ± 7.8 mg/dL, respectively), compared with MON-K (204.2 ± 7.1 mg/dL, p < 0.05). MON-K and CYP3A4 groups had a high prevalence of reported knee pain (33.3% and 18.8%, respectively) than NO-CYP3A4 group (0%, p < 0.05). A high percentage of individuals in MON-K take supplements and nutraceuticals (87.5%), whereas MEDScore-FV was higher in CYP3A4 (9.4 ± 0.2) compared to NO-CYP3A4 (7.6 ± 0.5, p < 0.05). (5) Conclusions: This study suggests that individuals receiving treatment with statins and RYR should be monitored from the perspective of plant foods’ consumption and nutraceutical use, to prevent musculoskeletal pain.
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Hallit S, Barrada JR, Salameh P, Sacre H, Roncero M, Obeid S. The relation of orthorexia with lifestyle habits: Arabic versions of the Eating Habits Questionnaire and the Dusseldorf Orthorexia Scale. J Eat Disord 2021; 9:102. [PMID: 34391484 PMCID: PMC8364025 DOI: 10.1186/s40337-021-00455-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Some of the commonly used tools to assess orthorexia nervosa (OrNe) do not allow a meaningful interpretation of the scores or yield mixed results about the dimensions needed to represent orthorexia. Since no advancement in the theoretical knowledge can be made without a thorough examination of the measurement aspects, this study aimed to evaluate the correlation between orthorexia nervosa (OrNe) and lifestyle habits, notably alcohol drinking, cigarette and waterpipe smoking, and physical exercise, and to validate and assess the psychometric properties of the Arabic versions of the Eating Habits Questionnaire (EHQ) and Düsseldorf Orthorexia Scale (DOS). METHODS A total of 456 adult participants completed a self-administered questionnaire. Exploratory structural equation models were used to test the internal structure of the instruments. Shorter and more explicit versions were proposed for instruments. Pearson and partial correlations were computed between orthorexia scores and healthy behaviors scores. RESULTS Regarding the internal structure of both EHQ and DOS, evidence favored the bi-dimensional construct of orthorexia. Both tools presented two theoretically clearly interpretable factors (OrNe and Healthy Orthorexia-HeOr-). The two questionnaires presented a high convergent validity, as dimensions with the same interpretation were correlated around 0.80. While OrNe was positively correlated with the use of unhealthy substances (higher alcohol use disorder, cigarette, and waterpipe dependence), HeOr was negatively associated with these behaviors. CONCLUSION Our results emphasize the idea that further attention should be paid to the multidimensional structure of orthorexia, as OrNe and HeOr present an opposite pattern of associations with healthy behaviors. An OrNe etiopathogenesis common to eating disorders can explain these differences.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Juan Ramón Barrada
- Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Pascale Salameh
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
| | - María Roncero
- Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Sahar Obeid
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon. .,Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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DeBois K, Chatfield SL. Misinformation, thin-ideal internalization, and resistance to treatment: an interpretive phenomenological analysis of the experience of orthorexia nervosa. Eat Weight Disord 2021; 26:1963-1973. [PMID: 33074459 DOI: 10.1007/s40519-020-01049-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Orthorexia nervosa (ON) is an emerging pattern of disordered eating which may be driven by a pathological desire to consume only highly nutritious foods, absent concern over body weight, as is noted in anorexia nervosa (AN). This study seeks to clarify the development and progression of ON and add to researchers' understanding of this potential disorder. METHOD Utilizing Interpretive Phenomenological Analysis to guide data collection and analysis, interviews were conducted with 18 individuals who self-identified as having ON. RESULTS Participants described a clear distinction between orthorexia nervosa and clinically recognized eating disorders, with which they had prior experience. In addition, they demonstrated patterns of inflexible thinking that guided their perceptions of themselves and others. As a result, participants rapidly integrated newly acquired nutritional information, which led to escalations in restriction, social isolation, and physical symptoms of malnutrition. While prior findings on the relationship between ON and weight are conflicting, previously proposed criteria for ON emphasize an absence of weight-related concerns. The results of the present study suggest that weight control is a primary motivating factor in the escalating pattern of restriction. CONCLUSION The nuanced results from this work evidence the value of interpretive qualitative approaches to improve understanding of ON. In particular, participants' described inflexible thinking with respect to eating behaviors may help inform or revise screening instruments and provide important insights for treatment of ON. LEVEL OF EVIDENCE Level V, qualitative descriptive research.
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Affiliation(s)
- Kristen DeBois
- Kent State University College of Public Health, Moulton Hall, 800 Hilltop Drive, Kent, OH, 44242, USA.
| | - Sheryl L Chatfield
- Kent State University College of Public Health, Moulton Hall, 800 Hilltop Drive, Kent, OH, 44242, USA
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