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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] [What about the content of this article? (0)] [Affiliation(s)] [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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2
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Intra- and Interpersonal Dimensions of Orthorexia: Preliminary Development and Validation of an Intra- and Interpersonal Effects Scale for Orthorexia. Nutrients 2024; 16:1010. [PMID: 38613043 PMCID: PMC11013874 DOI: 10.3390/nu16071010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Orthorexia nervosa (ON) is a disorder characterized by dietary restrictions and an obsessive focus on "healthy" eating. The present study analyzes two aspects of ON. One related to the inner experiences of the individual (intrapersonal). The other concerns the impact of ON on interpersonal relationships (interpersonal). The developed scale was named the Intra- and Interpersonal Effects Scale of Orthorexia (IIESO). The analysis showed an average correlation between the INTER and INTRA factors (r = 0.46). Both the INTER and INTRA scales correlated strongly with both subscales of the TOS but weakly with the ORTO-R score. Females obtained higher scores on the INTER scale (p < 0.01), while no differences were shown for the INTRA subscale or the overall scale score (p < 0.01). Subjects using supplements had higher mean scores on the INTER and INTRA subscales and for the total score. Among the analyzed results, the greatest strength effect was shown for the total score on the IIESO scale (INTER+INTRA) and the TOS scale. The questionnaires used to date have not distinguished between behaviors from interpersonal and intrapersonal perspectives. Research on these dimensions could expand our knowledge of the disorder and refine diagnostic criteria.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-059 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
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3
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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4
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Mitchell J, Tilbrook M, Kiropoulos L, Krug I. Australian elite sport coaches' mental health literacy of eating disorders, orthorexia, and muscle dysmorphia in athletes: A qualitative study. Body Image 2024; 48:101670. [PMID: 38150783 DOI: 10.1016/j.bodyim.2023.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
Athletes have an increased risk of developing eating disorders (EDs) compared to non-athletes. Coaches are in a unique position to identify symptoms and promote timely support; however, research has not yet explored coaches' mental health literacy about DSM-5 EDs and related orthorexia and muscle dysmorphia conditions in elite athletes. Eighteen Australian elite sport coaches from aesthetic, weight-class, and endurance sports participated in individual semi-structured interviews to investigate their mental health literacy of EDs and related conditions. Four themes emerged from the data. Theme 1 (knowledge of EDs and related conditions) highlighted coaches' awareness of maladaptive perfectionism as a key risk factor, limited awareness of EDs without observable weight loss, and conceptualisation of EDs as a nutritional issue. Theme 2 (facilitators to managing EDs) highlighted the helpfulness of building trust with athletes, accessing support staff, emphasising body functionality, and lived experience. Theme 3 (barriers to managing EDs) highlighted coaches' challenges with communicating about body image, responding to denial, and funding constraints. Theme 4 (future ED education and training) highlighted coaches' desire for in-person, interactive training and to support junior-level coaches. These findings may assist in developing tailored educational resources to improve coaches' ability to identify and manage eating-related concerns in athletes.
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Affiliation(s)
- Jardine Mitchell
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Molly Tilbrook
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Litza Kiropoulos
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Isabel Krug
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia.
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5
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Lupi M, Carano A, Carlucci M, Acciavatti T, Pettorruso M, Cinosi E, De Berardis D, Martinotti G. Prevalence of Orthorexia Nervosa in a sample of italian young adults. Clin Ter 2024; 175:125-127. [PMID: 38571470 DOI: 10.7417/ct.2024.5044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Abstract There is only limited epidemiological information on Orthorexia Nervosa; the aim of the present study is, therefore, to assess the prevalence of ON in a population of young adults and to identify possible specific features and eventual psychopatological dimensions. 1317 participants (732 females and 585 males; mean age 22.36 yrs) completed a battery containing the orthorexia measure (ORTHO-15), statements about demographic characteristics as well as physiological parameters. The mean ORTO-15 score was 31.89; considering the cut-off of 40 in the reference test, our results showed a 11.9% prevalence of ON. Analyzing the characteristics of the orthorexic group, the prevalence in females compared to males appears to be statistically very significant (115 vs 43; 72.8% vs 27.2%); moreover shows higher and statistically significant scores in each of the 15 items of the reference test compared to the non-orthorexic group. Our data confirming that ON might be a relevant and potentially underestimate phenomenon in the community. Further studies are warranted in order to explore the diagnostic boundaries of this syndrome, its course and outcome, and the possible therapeutic strategies.
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Affiliation(s)
- M Lupi
- NHS, Mental Health Department, Psychiatric Service of Diagnosis and Treatment, "Madonna del Soccorso" Hospital, San Benedetto del Tronto, AST Ascoli Piceno, Italy
| | - A Carano
- NHS, Mental Health Department, Psychiatric Service of Diagnosis and Treatment, "Madonna del Soccorso" Hospital, San Benedetto del Tronto, AST Ascoli Piceno, Italy
| | - M Carlucci
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, San Benedetto del Tronto, Italy
| | - T Acciavatti
- NHS, Mental Health Department, Psychiatric Service of Diagnosis and Treatment, "Santo Spirito" Hospital, ASL Pescara, Italy
| | - M Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - E Cinosi
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - D De Berardis
- NHS, Head of Mental Health Department, ASL Teramo, Italy
| | - G Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Huynh PA, Miles S, de Boer K, Meyer D, Nedeljkovic M. A systematic review and meta-analysis of the relationship between obsessive-compulsive symptoms and symptoms of proposed orthorexia nervosa: The contribution of assessments. Eur Eat Disord Rev 2024; 32:257-280. [PMID: 37838984 DOI: 10.1002/erv.3041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to update the literature on orthorexia nervosa (ON), a proposed diagnosis of pathologically 'healthy' eating, by critically analysing the current evidence for the relationship between ON and obsessive-compulsive (OC) symptoms. Further, this paper aimed to compare the ON/OC relationship significance and strength based on when the ON measurement tool was developed. METHOD PsycINFO, PubMed and Web of Science databases were queried for quantitative, peer-reviewed studies recruiting adult participants, published in English up to April 2023. Studies not directly comparing ON and OC symptoms were excluded. After full-text review and quality assessment, 40 studies were included in the systematic review and 31 studies in the meta-analysis. RESULTS ON assessments created prior to the 2016 revised ON diagnostic criteria do not appear to fully capture OC symptoms. Studies using earlier developed ON assessments demonstrated inconsistent ON/OC relationships whereas studies implementing more recent assessments (from 2018 onwards) found consistently significant, larger relationships, highlighting a previously underrated OC component of ON. CONCLUSIONS Early ON studies, and studies utilising early ON assessments should be interpreted with caution, particularly in relation to OC symptom involvement in ON. Future research should validate novel ON assessments and investigate common underlying factors.
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Affiliation(s)
- Phillipa Ann Huynh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Stephanie Miles
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
| | - Kathleen de Boer
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Denny Meyer
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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8
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Liu C, Messer M, Anderson C, McClure Z, Linardon J. Body appreciation predicts lower levels of orthorexia nervosa symptoms: Prospective findings. Body Image 2024; 48:101684. [PMID: 38377760 DOI: 10.1016/j.bodyim.2024.101684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
Recent evidence shows that negative body image may be a potential risk factor for symptoms of orthorexia nervosa (ON). However, whether positive body image plays a protective role against symptoms of ON remains unclear. Although prior research has established associations between body appreciation (a core component of positive body image) and ON symptoms, this research is limited to cross-sectional designs, precluding inferences of temporal precedence. Thus, the present study overcomes this limitation by testing whether body appreciation prospectively predicts ON symptoms. Data were analysed from 1253 adult women (M age = 34 years (SD = 9.4), 81.3% Caucasian) who completed the Orthorexia Nervosa Inventory (ONI) and Body Appreciation Scale 2-Short Form (BAS2-SF) at baseline (T1) and at three-month follow-up (T2). Multiple linear regressions were used to test whether body appreciation scores at T1 predicted ONI subscale scores (behaviours, emotions, and impairments) at T2. Results revealed that higher body appreciation scores at T1 significantly predicted decreased scores on each ONI subscale at T2, though effect sizes were small. Findings provide preliminary evidence that body appreciation may protect against ON symptoms. If replicated, efforts to address ON symptoms may be enhanced by promoting body appreciation.
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Affiliation(s)
- Claudia Liu
- School of Psychology, Deakin University, 221 Burwood Hwy, Victoria 3125, Australia.
| | - Mariel Messer
- School of Psychology, Deakin University, 221 Burwood Hwy, Victoria 3125, Australia
| | - Cleo Anderson
- School of Psychology, Deakin University, 221 Burwood Hwy, Victoria 3125, Australia
| | - Zoe McClure
- School of Psychology, Deakin University, 221 Burwood Hwy, Victoria 3125, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, 221 Burwood Hwy, Victoria 3125, Australia; Centre for Social and Early Emotional Development, Deakin University, Burwood, Victoria 3125, Australia
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Gaździńska A, Jagielski P, Baran P. The Risk of Orthorexia and the Prevalence of Emotional Eating Behaviours among Polish Military Flying Personnel in Relation to Body Mass Index (BMI) and Sociodemographic Factors. Nutrients 2024; 16:682. [PMID: 38474809 PMCID: PMC10934470 DOI: 10.3390/nu16050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Proper nutrition has a positive impact on health. Paradoxically, excessive preoccupation with healthy eating may lead to the emergence of abnormal eating behaviours and increase the risk of developing disorders. The aim of this study was to assess the risk of orthorexia (ON) and the prevalence of emotional eating (EE) in military flying personnel of the Polish Air Force in relation to BMI and sociodemographic factors. METHODS This study included 760 soldiers (including 60 females) taking part in the National Health Programme 2021-2025. The ORTO-15 questionnaire and EEQ were used to assess the risk of ON and EE. RESULTS The risk of ON occurred in 28.9% of military flying personnel and was significantly more frequent in soldiers with a normal weight (46.4%), under 40 years of age (42.7%), and with higher education (42.7%). The prevalence of EE was found in approximately 12.3% of the respondents and was significantly more common in soldiers with diagnosed obesity (17.5%), women (21.7%), and soldiers with higher education (13.6). Other sociodemographic variables did not differentiate the results of the ORTO-15 questionnaire and EEQ. CONCLUSIONS The obtained results indicate that the problem of eating disorders also occurs in military populations. The necessity of continuing research in this area is discussed.
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Affiliation(s)
- Agata Gaździńska
- Laboratory of Dietetics and Obesity Treatment, Department of Psychophysiological Measurements and Human Factor Research, Military Institute of Aviation Medicine, Krasińskiego 54/56, 01-755 Warsaw, Poland
| | - Paweł Jagielski
- Faculty of Health Science, Department of Nutrition and Drug Research, Jagiellonian University Medical College, Skawińska 8, 31-066 Cracow, Poland;
| | - Paulina Baran
- Department of Psychophysiological Measurements and Human Factor Research, Military Institute of Aviation Medicine, Krasińskiego 54/56, 01-755 Warsaw, Poland;
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10
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Barrada JR, Meule A. Orthorexia nervosa: Research based on invalid measures is invalid. J Glob Health 2024; 14:03007. [PMID: 38304978 PMCID: PMC10835515 DOI: 10.7189/jogh.14.03007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Affiliation(s)
- Juan Ramón Barrada
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Rossi AA, Mannarini S, Donini LM, Castelnuovo G, Simpson S, Pietrabissa G. Dieting, obsessive-compulsive thoughts, and orthorexia nervosa: Assessing the mediating role of worries about food through a structural equation model approach. Appetite 2024; 193:107164. [PMID: 38103790 DOI: 10.1016/j.appet.2023.107164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/11/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. OBJECTIVE This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. METHODS Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessive-compulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). RESULTS Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. CONCLUSION These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.
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Affiliation(s)
- Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy; Center for Intervention and Research Studies on the Family, University of Padova, Padova, Italy.
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy; Center for Intervention and Research Studies on the Family, University of Padova, Padova, Italy
| | | | - Gianluca Castelnuovo
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milano, Italy; IRCCS Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, Milano, Italy
| | - Susan Simpson
- NHS Forth Valley Eating Disorder Service, Stirling, Scotland, UK; Department of Justice & Society, University of South Australia, Australia
| | - Giada Pietrabissa
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milano, Italy; IRCCS Istituto Auxologico Italiano, Clinical Psychology Research Laboratory, Milano, Italy
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Atsizata M, Sögüt SC. The relationship between orthorexia nervosa and cyberchondria levels in nurses: A cross-sectional study. Arch Psychiatr Nurs 2024; 48:30-35. [PMID: 38453279 DOI: 10.1016/j.apnu.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/12/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The study was conducted with the aim of investigating the relationship between orthorexia nervosa and cyberchondria levels among nurses. METHODS This cross-sectional study was conducted with 399 nurses through face-to-face interviews. The data were collected using a participant information form, the Cyberchondria Severity Scale, and the Orthorexia Nervosa-11 scale (ORTO-11). RESULTS The mean score of the nurses' cyberchondria severity scale was 73.95 ± 18.53, while the mean score of the Orthorexia Nervosa-11 scale was 28.23 ± 4.76. In the study, a low negative correlation was found between the cyberchondria and orthorexia nervosa levels (p < 0.05). CONCLUSIONS The increase in the level of cyberchondria among nurses increases the risk of orthorexia nervosa. Therefore, it is recommended that nurses receive proper nutritional education and psychosocial support to reduce their tendency towards orthorexia nervosa and cyberchondria.
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Affiliation(s)
| | - Seda Cangöl Sögüt
- Department of Midwifery, Faculty of Health Sciences, Çanakkale Onsekiz Mart University, Turkey.
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Barlow IU, Lee E, Saling L. Orthorexia nervosa versus healthy orthorexia: Anxiety, perfectionism, and mindfulness as risk and preventative factors of distress. Eur Eat Disord Rev 2024; 32:130-147. [PMID: 37670425 DOI: 10.1002/erv.3032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/15/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Orthorexia nervosa is a recently conceptualised pathological entity presenting as an obsessive focus on healthy eating with associated psychosocial impairment. AIMS The present study investigated the differential associations between orthorexia nervosa and healthy orthorexia with distress and impairment. MATERIALS & METHODS With a community sample (N = 268) multiple measures of orthorexia nervosa and health orthorexia were compared as explanatory variables in mediation structural equation modelling (SEM). Outcome variables assessed and investigated were psychological distress while demographic variables were controlled. The mediating roles of perfectionism and health anxiety on orthorexia nervosa were examined with further preventative mediation role of mindfulness on distress. RESULTS Distinctive to other eating disorders, gender showed no significant effects on orthorexia nervosa and healthy orthorexia. Signalling measurement issues for this disorder, the different measures of orthorexia nervosa resulted in mixed findings regarding body mass index and age. Findings supported perfectionism and health anxiety as risk factors, as well as mindfulness acceptance as a preventative factor in both orthorexia nervosa and healthy orthorexia. Orthorexia nervosa and healthy orthorexia assessed by most measures, contrary to the expectations, had significant positive associations with psychological distress indicated by stress, anxiety, and depression. DISCUSSION & CONCLUSION The complexity in differentiating orthorexia nervosa from healthy orthorexia calls for further investigation. This research effort should serve to substantiate the status of orthorexia nervosa as a distinct clinical disorder.
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Affiliation(s)
- Isabella Uma Barlow
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Eunro Lee
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Lauren Saling
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Testino G, Pellicano R, Balbinot P. Orthorexia, lifestyle and social media pressure: what to do? Minerva Gastroenterol (Torino) 2023; 69:581-582. [PMID: 37013387 DOI: 10.23736/s2724-5985.23.03393-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
- Gianni Testino
- Unit of Addiction and Hepatology, Alcohological Regional Center, IRCCS San Martino University Hospital, University of Genoa, ASL3 Liguria, Genoa, Italy -
- Mutual-Self-Help, Community Programs and Caregiver Training Study Center, ASL3 Liguria, Genoa, Italy -
| | - Rinaldo Pellicano
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Patrizia Balbinot
- Unit of Addiction and Hepatology, Alcohological Regional Center, IRCCS San Martino University Hospital, University of Genoa, ASL3 Liguria, Genoa, Italy
- Mutual-Self-Help, Community Programs and Caregiver Training Study Center, ASL3 Liguria, Genoa, Italy
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López-Gil JF, Tárraga-López PJ, Soledad Hershey M, López-Bueno R, Gutiérrez-Espinoza H, Soler-Marín A, Fernández-Montero A, Victoria-Montesinos D. Overall proportion of orthorexia nervosa symptoms: A systematic review and meta-analysis including 30 476 individuals from 18 countries. J Glob Health 2023; 13:04087. [PMID: 37917875 PMCID: PMC10622118 DOI: 10.7189/jogh.13.04087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Background To date, no previous meta-analysis has determined the overall proportion of orthorexia nervosa symptoms on a global scale. The aim of the present study was 2-fold: first, to establish the overall proportion of orthorexia nervosa symptoms on a global scale, assessed with the ORTO-15 questionnaire; and second, to determine the role of sex, type of population, mean age, body mass index, and the temporal trend in relation to orthorexia nervosa symptoms. Methods Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) with date limits from January 2005 to June 2023. Studies assessing the proportion of orthorexia nervosa assessed using the ORTO-15 questionnaire with a cutoff of <35 or <40 points were included in this review. Results The overall proportion of orthorexia nervosa symptoms (using the cutoff <35 points) was 27.5% (95% confidence interval (CI) = 23.5-31.6, I2 = 97.0%). In addition, no significant differences were observed between females (34.6%, 95% CI = 29.5-39.8, I2 = 96.1%) and males (32.1%, 95% CI = 26.5-38.1, I2 = 93.1%). According to the type of population, the highest overall proportion was found in people focused on sports performance or body composition (34.5%, 95% CI = 23.1-47.0, I2 = 98.0%). Notwithstanding, caution should be exercised in interpreting this result, as reverse causality could be a potential pitfall in this relationship. Conclusions We found that approximately three out of 10 study participants showed orthorexia nervosa symptoms according to the ORTO-15 tool. This overall proportion was higher in those participants who were athletes or fitness practitioners. Over the years, the proportion of orthorexia nervosa symptoms seems to be increasing. These high percentages and their increase are worrisome from a public health perspective and highlight the need to develop psychometric instruments to aid in clinical diagnosis and treatment efficacy. Registration PROSPERO (CRD42022350873).
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Pedro Juan Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha, Albacete, Spain
| | - Maria Soledad Hershey
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | | | - Antonio Soler-Marín
- Faculty of Pharmacy and Nutrition, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Alejandro Fernández-Montero
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Occupational Medicine, University of Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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Cosh SM, Olson J, Tully PJ. Exploration of orthorexia nervosa and diagnostic overlap with eating disorders, anorexia nervosa and obsessive-compulsive disorder. Int J Eat Disord 2023; 56:2155-2161. [PMID: 37615059 DOI: 10.1002/eat.24051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is characterized as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, ON shares theoretical overlap with eating disorders (EDs), especially anorexia nervosa (AN), as well as obsessive-compulsive disorder (OCD). This study aimed to further understand ON and its overlap with related disorders by assessing the ability of ON for detecting the presence/absence of threshold ED, AN, and OCD symptoms. METHOD An observational survey was completed by 197 participants recruited through eating disorder, dieting, and mental health support groups. Receiver operating characteristic (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by Eating Habits Questionnaire [EHQ] orthorexia nervosa [OrNe] and healthy orthorexia [HeOr] subscales, and the Orthorexia Nervosa Inventory [ONI]) for detecting disordered eating symptoms (determined by Eating Disorder Examination Questionnaire [EDE-Q] global cut-scores), probable AN (determined by EDE-Q cut-scores and body mass index [BMI] <18.5), and OCD symptoms and obsessional thinking (assessed by the Revised Obsessive-Compulsive Inventory [OCI-R]). RESULTS Results showed both the ONI and EHQ OrNe measures are able to adequately predict ED symptoms and AN; however, both were poor to moderate at detecting OCD symptoms and obsessional thinking. Healthy orthorexia was poor to moderate at detecting outcomes. DISCUSSION These results suggest that ON, as it is currently operationalized, may be more closely related to EDs than OCD, and that ON may represent a subtype of AN. Results also support healthy orthorexia as a distinct construct to ON. While results are limited by the lack of definitive ON diagnostic criteria, findings suggest that treatments developed for EDs might be most suited to ON. PUBLIC SIGNIFICANCE ON has been proposed as a psychiatric disorder, and it shares theoretical overlap with several existing disorders. This study adopts a novel approach to assessing and exploring the overlap of ON with EDs, AN and OCD. Results suggest that ON shares more overlap with EDs and might best be understood as a subtype of EDs or AN.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Jemma Olson
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
- Freemasons Centre for Male Health and Wellbeing, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Bulut A, Bulut A. Evaluation of the recipient and donor in organ transplantation in terms of orthorexia nervosa. Eur Rev Med Pharmacol Sci 2023; 27:10531-10538. [PMID: 37975376 DOI: 10.26355/eurrev_202311_34329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate recipients and donors undergoing organ transplantation in terms of orthorexia nervosa. SUBJECTS AND METHODS The population of the study consisted of individuals over the age of 18 who were donors or recipients undergoing organ transplantation at the Organ Transplantation Centre of Research-Application Hospital of Gaziantep University in Turkey (n=74). A questionnaire consisting of 3 parts was used as a data collection tool. While the first part includes questions that ask socio-demographic characteristics of the participants and constitute the independent variables of the study (21 questions), the second and third parts include the Orthorexia Nervosa-15 (ORTO-15) and the Eating Attitude Test (EAT-40), respectively. RESULTS Based on the cut-off point of the ORTO-15 scale, it was determined that while 78.4% (n=58) of the participants were normal in terms of orthorexia nervosa, 21.6% (n=16) were orthorexic. In terms of the cut-off point of EAT-40, 37.8% (n=28) of the participants did not have an eating disorder and 62.2% (n=46) suffered from an eating disorder. The ORTO-15 mean ranks were high in those who were females (p=0.035), were suffering from chronic diseases (p=0.002), did not consume fast food (p=0.004), were making arrangements before eating their daily meals (p=0.018), and were doing regular physical activity (p=0.042). CONCLUSIONS Consequently, it was determined that those who were females, were suffering from chronic diseases, were making arrangements before eating their daily meals and were doing regular physical activity showed a more orthorexic tendency. It is recommended for healthcare professionals to determine the orthorexic tendency level of patients, who are female, suffer from chronic diseases, adhere to a regular diet and do a regular physical activity, and evaluate the whole patient group in terms of eating disorders while healthcare professionals conduct early diagnosis screenings of the patients (recipient/donor) in the organ transplantation process or referring them.
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Affiliation(s)
- A Bulut
- Department of Public Health, Faculty of Medicine, Gaziantep Islamic Science and Technology University, Gaziantep, Turkey.
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22
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Navarro A, Varela C, Fusté A, Andrés A, Saldaña C. The validation of the Barcelona Orthorexia Scale-Spanish version: evidence from the general population. Eat Weight Disord 2023; 28:90. [PMID: 37891414 PMCID: PMC10611628 DOI: 10.1007/s40519-023-01616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE To validate the Spanish version of Barcelona Orthorexia Scale (BOS) in general population, analyzing its items and both its internal structure and psychometric properties (internal consistency and temporal stability). In addition, the relationship between ON and external measures of attitudes towards food was assessed. METHOD The general population sample consisted of 446 women and 104 men, aged between 18.31 and 69.44 years (M = 36.03; SD = 12.46). Of these, 39 participants answered again the questionnaires after one month from the first application. The assessment instruments were a sociodemographic questionnaire, the BOS, the Eating Attitudes Test-26 (EAT-26) and the Dutch Eating Behavior Questionnaire (DEBQ). RESULTS The final version of the BOS is composed of 35 items. Exploratory factor analysis extracted an internal structure of 5 factors (Behavioral, Concern for healthy food, Attitudes and beliefs about food, Vital achievement and Emotional discomfort). The BOS-35 and the factors presented good internal consistency (α = .80-.90), and an adequate temporal stability (r = .62-.88). The highest association was observed between the Emotional Distress (BOS) and the Diet subscale (EAT-26; r = .51). CONCLUSIONS This first validation of the BOS has shown adequate psychometric properties, being a valid and reliable instrument to assess ON in the general population. Level of evidence Level II: Evidence obtained from well-designed controlled trials without randomization.
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Affiliation(s)
- Anna Navarro
- Departament de Psicologia Clinica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Carmen Varela
- Departament de Psicologia Clinica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Departmento de Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Burgos, Burgos, Spain.
| | - Adela Fusté
- Departament de Psicologia Clinica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Ana Andrés
- Facultat de Psicologia, Ciències de l'Educació i de l'Esport, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Carmina Saldaña
- Departament de Psicologia Clinica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain
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Dil S, Yıldırım T, Öztürk PÇ. The mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19. Sci Rep 2023; 13:15491. [PMID: 37726435 PMCID: PMC10509189 DOI: 10.1038/s41598-023-42825-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023] Open
Abstract
The COVID-19 (SARS-CoV-2) pandemic has jeopardized humanity worldwide and has considerably altered the healthy lifestyle behaviors of societies. This study examined the possible mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19 among Turkish adults. This study used an observational and descriptive design. It was carried out online with 1,130 participants across Turkey between April and August 2021. The data were collected using a questionnaire, the Fear of COVID-19 Scale (FC-19S), the Pittsburgh Sleep Quality Index (PSQI), and Orthorexia Nervosa-R (ON-R). The participants had an ON-R mean score of 3.08 ± 0.90 and a mean PSQI score of 8.03 ± 2.80. Likewise, their mean FC-19S score was 18.24 ± 6.55. There was a significant positive correlation between the FC-19S and the PSQI (r = 0.208; p = 0.000) as well as a significant negative correlation between the ON-R and the PSQI (r = - 0.145; p = 0.000). In addition, the results of the process model analysis supported our hypotheses that the PSQI was a predictor of ON-R and that its direct and indirect effects were moderated by FC19S and the PSQI. A one-unit increase in FC-19S scores causes an average 1% increase on the ON-R scale, while it generates an 8% increase on the PSQI. It was determined that the PSQI total score caused an average of 6% increase in the ON-R scale score. The findings of this study showed that sleep quality has a mediating role in the relationship between orthorexia nervosa and fear of COVID-19 experienced by Turkish adults during the pandemic. For this reason, governments need to take the necessary precautions concerning this subject when creating action plans for possible global crisis situations that may adversely affect public health in the future.
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Affiliation(s)
- Satı Dil
- Faculty of Health Sciences, Universtiy of Çankırı Karatekin, Çankırı, Turkey.
| | - Tuğba Yıldırım
- Faculty of Health Sciences, Universtiy of Çankırı Karatekin, Çankırı, Turkey
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24
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Gerges S, Azzi V, Bianchi D, Laghi F, Pompili S, Malaeb D, Obeid S, Soufia M, Hallit S. Exploring the relationship between dysfunctional metacognitive processes and orthorexia nervosa: the moderating role of emotion regulation strategies. BMC Psychiatry 2023; 23:674. [PMID: 37715193 PMCID: PMC10504706 DOI: 10.1186/s12888-023-05183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Dysfunctional metacognitive processes and emotional dysregulation have been widely documented in the eating disorder literature. Despite numerous research and recent consensus suggesting the categorization of orthorexia nervosa as a form of eating disorder, no previous study has examined whether aberrant metacognitive processes also correlate with orthorexia nervosa tendencies. This paper investigates potential associations between symptoms of orthorexia nervosa and dysfunctional metacognitive processes while also exploring whether such relationships may be influenced by adaptive/maladaptive emotion regulation strategies. METHODS We conducted a cross-sectional study in all Lebanese governorates. In total, 423 Lebanese adults completed an online questionnaire including the Teruel Orthorexia Scale, the Emotion Regulation Questionnaire, the Difficulties in Emotion Regulation Scale - 16 Item Version, and the Metacognitions Questionnaire - Short Form. RESULTS Higher physical activity, expressive suppression, emotion regulation difficulties, positive metacognitive beliefs about worry, and need to control thoughts were significantly associated with higher orthorexia nervosa. Additionally, the emotion regulation strategies moderated the relationships between two dysfunctional metacognitive processes and orthorexia nervosa. Specifically, cognitive self-consciousness was negatively related to orthorexia nervosa only in individuals with low (versus higher) emotion suppression (maladaptive emotion regulation strategy). In contrast, negative beliefs about worry uncontrollability and danger positively predicted orthorexia nervosa only in individuals with lower (versus high) cognitive reappraisal (adaptive emotion regulation strategy). Lower socio-economic status and having a university level of education compared to secondary level were significantly associated with lower orthorexia nervosa. CONCLUSION Our study provides the first empirical evidence for the existence of significant associations between dysfunctional metacognitive processes and orthorexia nervosa. It also highlights that these pathways are considerably modulated by individuals' ability to regulate their emotions adaptively versus maladaptively. Our findings thus suggest that therapies aimed at improving thought monitoring and emotional regulation may be beneficial for individuals with symptoms of orthorexia nervosa.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Michel Soufia
- 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.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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25
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Horovitz O, Argyrides M. Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment. Nutrients 2023; 15:3851. [PMID: 37686883 PMCID: PMC10490497 DOI: 10.3390/nu15173851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/02/2023] [Accepted: 09/02/2023] [Indexed: 09/10/2023] Open
Abstract
Orthorexia nervosa is an emerging and controversial eating disorder characterized by an obsessive preoccupation with healthy eating and an extreme fixation on food purity. Despite growing public interest in orthorexia, its classification as a distinct eating disorder remains a subject of ongoing debate in the mental health community. This paper comprehensively reviews the current literature on orthorexia nervosa, exploring the prevalence rates, risk factors, diagnosis, and treatment options. The paper offers an overview of orthorexia and its historical context and explores the challenges and considerations in diagnosing orthorexia and orthorexia nervosa. Specifically, the distinction between "orthorexia" and "orthorexia nervosa" is a debated issue in eating disorder research due to a lack of clear diagnostic criteria, making it challenging to accurately differentiate between an obsession with healthy eating and a more severe form with potential distress and impairment. Given the absence of formal diagnostic criteria, developing valid and reliable assessment tools is crucial to accurately identify and treat individuals experiencing these disorders. The paper's final section covers the existing treatment approaches for orthorexia nervosa. Overall, the paper highlights the complex and multifaceted nature of orthorexia nervosa. This review contributes to the ongoing discourse surrounding orthorexia and provides valuable insights for clinicians, researchers, and stakeholders in the mental health and eating disorders fields.
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Affiliation(s)
- Omer Horovitz
- The Physiology and Behavior Laboratory, Tel-Hai Academic College, 9977 North Districts, Qiryat Shemona 1220800, Israel
- Psychology Department, Tel-Hai Academic College, 9977 North Districts, Qiryat Shemona 1220800, Israel
| | - Marios Argyrides
- Psychology Department, Neapolis University Pafos, 2 Danais Avenue, Paphos 8042, Cyprus;
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Turan B, Yıldırım S, Bilginer SÇ, Akıncı MA. Psychometric properties of Turkish Orthorexia Nervosa Inventory in a clinical adolescent sample. Eat Weight Disord 2023; 28:70. [PMID: 37656322 PMCID: PMC10474185 DOI: 10.1007/s40519-023-01601-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE Orthorexic tendencies are increasingly prevalent among children and adolescents. This study set out to investigate the reliability and validity of the Turkish version of the Orthorexia Nervosa Inventory (ONI) in a clinical adolescent sample. METHODS 266 adolescents aged 12-18 years, who applied to the Department of Child and Adolescents Psychiatry were included in the study. Participants completed sociodemographic data form, ONI, Eating Attitude Test, Revised Child Anxiety and Depression Scale-Child Version and ORTO-15. RESULTS The Cronbach's alpha coefficient for the ONI reached 0.92, indicating very good internal consistency. Total factor scores and Cronbach alpha values for behaviors, impairments, and emotions were found to be 0.84, 0.84, and 0.83, respectively. The CFA performed supported the three-factor structure of the ONI obtained in the first sample. The minimum discrepancy per degree of freedom = 1.89 and the model generally fit well to the structure (RMSEA = 0.058, SRMR = 0.033, CFI = 0.92, TLI = 0.91). DISCUSSION This study has shown that the Turkish version of the ONI is a valid and reliable scale for specifying the tendency for Orthorexia Nervosa in a Turkish adolescent population. These findings contribute in several ways to our understanding of orthorexic tendencies and provide a basis for more concrete research data that can be obtained by using the ONI, which is a reliable scale in studies to be conducted among adolescents. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Bahadir Turan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, 61000, Trabzon, Türkiye.
- Graduate School of Natural and Applied Sciences, Ankara University, Interdisciplinary Artificial Intelligence Technology, Ankara, Türkiye.
| | - Selman Yıldırım
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, 61000, Trabzon, Türkiye
| | | | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Türkiye
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Athanasaki D, Lakoumentas J, Milani GP, Agostoni C, Berghea F, Ionescu MD, Vassilopoulou E. Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students. Nutrients 2023; 15:3577. [PMID: 37630767 PMCID: PMC10460006 DOI: 10.3390/nu15163577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/01/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 dietetics students, with a mean age of 22.94 ± 3.5 years, who completed a series of questionnaires that recorded sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); ON indicators as determined by the ORTO-15 questionnaire; body image flexibility, with the Body Image-Acceptance and Action Questionnaire (BI-AAQ-5); the risk for ED as assessed using the EAT-26; anxiety level according to the STAIT 6 instrument; and recollection of their parents' attitudes towards them during the first 16 years of life, with the Parental Bonding Instrument (PBI). ON risk appeared to be significantly associated with BMI (p = 0.002), exercise frequency (p = 0.023), anxiety level (p = 0.002), risk of ED (p < 0.001), body image inflexibility (p < 0.001), and inversely with the affectionate constraint of maternal bonding (p = 0.036). In conclusion, disordered eating behaviors and body shape concerns are prevalent among dietetics students, with parental attachment to the mother influencing their occurrence. Identification of potential ON and development of prevention mechanisms during childhood could help eliminate these concerns and improve the lives of dietetics students.
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Affiliation(s)
- Dafni Athanasaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
| | - Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Florian Berghea
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Spital Clinic Sf. Maria, Bd. Ion Mihalache 37-39, Et 1 Secretariat, 011172 Bucharest, Romania
| | - Marcela Daniela Ionescu
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- “Marie S. Curie” Emergency Children’s Clinical Hospital, 041451 Bucharest, Romania
| | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
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Noebel NA, Vela RB, Arreguin DH, Oberle CD. Orthorexia nervosa symptomatology in the LGBTQ community: Gender and sexual orientation differences. Eat Behav 2023; 50:101771. [PMID: 37315429 DOI: 10.1016/j.eatbeh.2023.101771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/18/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023]
Abstract
This study investigated whether gender and sexual minority groups exhibit differences in orthorexia nervosa (ON) symptomatology compared to cisgender, straight individuals. A sample of 441 non-clinical participants (65 % White, mean age = 27) reported their gender (104 cisgender men, 229 cisgender women, 28 transgender men, 27 transgender women, 53 nonbinary) and sexual orientation (144 straight, 45 gay, 54 lesbian, 105 bisexual/pansexual, 68 queer), and completed the Orthorexia Nervosa Inventory. The LGBTQ group exhibited greater ON symptomatology compared to the cisgender, straight group. ANOVAs demonstrated significant group differences according to gender and sexual orientation. Post-hoc tests revealed that transgender women exhibited greater ON symptomatology than cisgender men and cisgender women. However, nonbinary individuals exhibited lower ON symptomatology than cisgender women, transgender men, and transgender women. Additionally, lesbians exhibited greater ON symptomatology than straight individuals. Our findings suggest that individuals with an LGBTQ identity, particularly transgender women and lesbians, may experience greater ON symptomatology than cisgender, straight individuals. However, nonbinary individuals appear to experience lower ON symptomatology, which may relate to a lack of alignment with masculine or feminine ideals, such that these individuals may feel a lack of need to conform to a certain appearance ideal based on gender norms.
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Affiliation(s)
- Natalie A Noebel
- Department of Psychology, Texas State University, United States of America
| | - Rheanna B Vela
- Department of Psychology, Texas State University, United States of America
| | - Dilan H Arreguin
- Department of Psychology, Texas State University, United States of America
| | - Crystal D Oberle
- Department of Psychology, Texas State University, United States of America.
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29
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Novara C, Piasentin S, Mattioli S, Pardini S, Maggio E. Perfectionism or Perfectionisms in Orthorexia Nervosa. Nutrients 2023; 15:3289. [PMID: 37571233 PMCID: PMC10421058 DOI: 10.3390/nu15153289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa.
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
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30
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Claudia C, Eleonora R, Laura P, Romina L, Campanino C, Valdo R, Edoardo M, Ilaria D, Rotella F. Orthorexia nervosa and type 1 diabetes: results of a cross-sectional study. Acta Diabetol 2023; 60:681-686. [PMID: 36806923 DOI: 10.1007/s00592-023-02044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
AIM Orthorexia nervosa (ON) is a condition characterized by an excessive importance attributed to the intake of healthy foods. This study was aimed at investigating the prevalence of ON in subjects with type 1 diabetes (T1D) compared to control subjects. METHODS Patient with T1D using either flash glucose monitoring or continuous glucose monitoring were enrolled. For the selection of control group, each patient was asked to indicate one non-diabetic subject of their same sex and approximate age among colleagues at work and school. Patients and controls completed the following questionnaires: ORTO-15, Dusseldorf Orthorexie Scale (DOS), Eating Disorder Examination Questionnaire (EDE-Q) and Brief Symptom Inventory (BSI). The principal outcome was the prevalence of ON among T1D and control subjects. RESULTS We enrolled 44 patients with T1D aged 39.7 ± 15.7 years, with BMI 24.3 ± 4.3 kg/m2, and mean HbA1c 53.5 [49-57] mmol/mol. Control subjects were similar to T1D with respect to sex, age and BMI. Thirty-two [72%] and 29 [65%] subjects among patients and controls, respectively, had ORTO15 < 40 (between-group p = 0.48). Two (4.5%) and zero subjects among patients and controls, respectively, had DOS ≥ 30 (p = 0.29). Median scores of DOS, but not of ORTO-15, were significantly higher in patients than in controls. None of the metabolic variables showed a correlation with psychometric tests in T1D. CONCLUSION Although the prevalence of ON was not significantly higher in T1D than in controls, patients with T1D showed higher scores of some, but not all, tests assessing orthorexia, without any significant correlation with metabolic parameters.
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Affiliation(s)
| | - Rossi Eleonora
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pala Laura
- Department of Diabetology, Careggi Hospital, Florence, Italy
| | - Lelmi Romina
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Chiara Campanino
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Ricca Valdo
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Mannucci Edoardo
- Department of Diabetology, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
| | - Dicembrini Ilaria
- Department of Diabetology, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134, Florence, Italy
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31
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Kalika E, Hussain M, Egan H, Mantzios M. Exploring the moderating role of mindfulness, mindful eating, and self-compassion on the relationship between eating-disordered quality of life and orthorexia nervosa. Eat Weight Disord 2023; 28:18. [PMID: 36808014 PMCID: PMC9941235 DOI: 10.1007/s40519-023-01542-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/12/2023] [Indexed: 02/23/2023] Open
Abstract
Orthorexia nervosa (ON) is characterised by an obsessive focus on healthy eating, following restrictive dietary practices and dietary restrictions escalating over time. The aim of this study was to explore mindfulness, mindful eating, self-compassion and quality of life in a female population. Two hundred eighty-eight participants completed Orthorexia, Self-Compassion, Mindful eating, Mindfulness and Eating Disorder Quality of Life scales. The results indicated that there was a negative relationship between ON and mindfulness, self-compassion and mindful eating. Furthermore, the present study found a positive relationship between lower quality of life and ON, while findings indicated that self-compassion and the awareness facet of mindfulness moderated the relationship between ON and QOL. The present results contribute to a better understanding of orthorexic eating behaviours in a female population, and identify the moderating capacity of self-compassion and mindfulness. Further implications and future directions are discussed.Level of evidence Level V, cross-sectional descriptive study.
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Affiliation(s)
- Eliza Kalika
- Department of Psychology, Birmingham City University, Curzon Building, Office C325, Birmingham, B4 7DE, UK.
| | - Misba Hussain
- Department of Psychology, Birmingham City University, Curzon Building, Office C325, Birmingham, B4 7DE, UK
| | - Helen Egan
- Department of Psychology, Birmingham City University, Curzon Building, Office C325, Birmingham, B4 7DE, UK
| | - Michail Mantzios
- Department of Psychology, Birmingham City University, Curzon Building, Office C325, Birmingham, B4 7DE, UK
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Sifakaki M, Gkiouras K, Lindqvist HM, Marakis G, Petropoulou A, Donini LM, Bogdanos DP, Grammatikopoulou MG. Orthorexia Nervosa Practices in Rheumatoid Arthritis: The DORA Study. Nutrients 2023; 15:nu15030713. [PMID: 36771419 PMCID: PMC9919523 DOI: 10.3390/nu15030713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/03/2023] Open
Abstract
Medical nutrition therapy (MNT) is an indisputable component of the multidisciplinary therapeutic approach in rheumatoid arthritis (RA). Previous research has suggested that in chronic disease where nutrition is an important effector of prognosis, healthy dietary choices might take an unhealthy turn, with patients developing disordered eating in the form of orthorexia nervosa (ON). ON is characterized by a pathological preoccupation with "healthy", "pure" eating, associated with restrictive dietary patterns, nutrient deficiencies and worsening disease outcomes. The aim of the present cross-sectional study was to evaluate ON tendencies in a sample of adult patients with RA. A total of 133 patients with RA were recruited, and completed the ORTO-15 questionnaire for the assessment of ON tendencies. Most of the patients were overweight/obese (53.4%). The results revealed ON tendencies in the sample, with the median ORTO-15 score reaching 36 (IQR: 33-39). Greater ON tendencies were associated with the female gender, and lowered ON tendencies with increasing age and body mass index. The present findings highlight the need for health professional awareness regarding the problem of ON in patients with RA and the importance of screening patients.
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Affiliation(s)
- Maria Sifakaki
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, P.O. Box 141, GR-57400 Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Georgios Marakis
- Nutrition and Food Standards Unit, Hellenic Food Authority, 124 Kifisias Avenue & Iatridou 2, GR-11526 Athens, Greece
| | - Anastasia Petropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, P.O. Box 141, GR-57400 Thessaloniki, Greece
| | - Lorenzo M. Donini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy
| | - Dimitrios P. Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Maria G. Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
- Correspondence:
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33
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Athanasaki D, Lakoumentas J, Feketea G, Vassilopoulou E. The Prevalence of Orthorexia Nervosa among Greek Professional Dancers. Nutrients 2023; 15:nu15020379. [PMID: 36678250 PMCID: PMC9864200 DOI: 10.3390/nu15020379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to determine the prevalence of orthorexia nervosa (ON) among professional dancers in Greece, as well as its relationship with nutrition, body mass index (BMI), body image flexibility, and parental bonding. The participants were 96 professional dancers, with a mean age of 23.41 ± 5.13 years, who completed a battery of questionnaires recording sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); indications of ON, as determined by the ORTHO-15 questionnaire; body image flexibility, using the body image-acceptance and action questionnaire (BI-AAQ-5); and their recollection of their parents’ attitudes towards them during the first 16 years of life, with the parental bonding instrument (PBI). The study population was classified into two groups, based on BMI: normal weight, and underweight. ON was shown to be significantly correlated with BMI (p = 0.006)-present in normal weight subjects- and body image inflexibility (p < 0.001). Parental body image inflexibility was significantly correlated with a low bonding relationship as perceived in childhood. In conclusion, disordered eating attitudes and body shape concerns are prevalent among professional dancers and appear to be associated with their parental relationship during childhood. Identification of potential ON and development of preventive mechanisms could help to eliminate such concerns and improve the nutrition of professional dancers.
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Affiliation(s)
- Dafni Athanasaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Gavriela Feketea
- Department of Hematology, “luliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
- Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patra, Greece
| | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
- Correspondence:
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Abstract
PURPOSE Limited research has explored conceptualisations of health and healthy eating in orthorexia nervosa (ON). This mixed-methods study aimed to investigate how 'health' and 'healthy eating' are conceptualised by individuals at risk for ON. This study examined the potential relationships between health anxiety, beliefs about health controllability and orthorexic symptomatology in our broader sample. METHODS A total of 362 participants took a survey on health anxiety (measured with the HAQ), beliefs about the controllability of one's own health (IMHLC) and ON symptomatology (E-DOS and EHQ). Participants 'at risk' for ON (n = 141), also completed an online qualitative survey about conceptualisations of health and healthy eating. Qualitative data were analysed using thematic analysis (part A). The PROCESS macro for SPSS was used for the quantitative analysis (part B). RESULTS Conceptualisations of health and healthy eating were complex. Four themes were generated from our qualitative data: 'health is more than thin ideals', 'healthy food equals healthy mind', 'a body that works for you' and 'taking control of your body'. Our quantitative analysis revealed that health anxiety and beliefs in health controllability independently predicted ON symptomatology. CONCLUSION A richer understanding of what health means in the context of ON is important, given the centrality of this concept to the proposed classification of this disordered eating style. Our findings highlight that both health anxiety and health controllability are important targets for future investigation, given their potential relevance to the aetiology and treatment of ON. LEVEL OF EVIDENCE Level V, based on a descriptive study.
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Affiliation(s)
- Maddy Greville-Harris
- Department of Psychology Faculty of Science and Technology, Bournemouth University, Poole, BH12 5BB, UK.
| | - Catherine V Talbot
- Department of Psychology Faculty of Science and Technology, Bournemouth University, Poole, BH12 5BB, UK
| | - Rachel L Moseley
- Department of Psychology Faculty of Science and Technology, Bournemouth University, Poole, BH12 5BB, UK
| | - Laura Vuillier
- Department of Psychology Faculty of Science and Technology, Bournemouth University, Poole, BH12 5BB, UK
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Donini LM, Barrada JR, Barthels F, Dunn TM, Babeau C, Brytek-Matera A, Cena H, Cerolini S, Cho HH, Coimbra M, Cuzzolaro M, Ferreira C, Galfano V, Grammatikopoulou MG, Hallit S, Håman L, Hay P, Jimbo M, Lasson C, Lindgren EC, McGregor R, Minnetti M, Mocini E, Obeid S, Oberle CD, Onieva-Zafra MD, Opitz MC, Parra-Fernández ML, Pietrowsky R, Plasonja N, Poggiogalle E, Rigó A, Rodgers RF, Roncero M, Saldaña C, Segura-Garcia C, Setnick J, Shin JY, Spitoni G, Strahler J, Stroebele-Benschop N, Todisco P, Vacca M, Valente M, Varga M, Zagaria A, Zickgraf HF, Reynolds RC, Lombardo C. A consensus document on definition and diagnostic criteria for orthorexia nervosa. Eat Weight Disord 2022; 27:3695-3711. [PMID: 36436144 PMCID: PMC9803763 DOI: 10.1007/s40519-022-01512-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/12/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE Level V: opinions of expert committees.
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Affiliation(s)
| | | | | | | | | | | | - Hellas Cena
- University of Pavia, Pavia, Italy
- ICS MAUGERI IRCCS, Pavia, Italy
| | | | | | | | | | | | | | | | - Souheil Hallit
- Holy Spirit University of Kaslik, Jounieh, Lebanon
- Effat University (KSA), Jeddah, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Sahar Obeid
- Lebanese American University, Beirut, Lebanon
| | | | | | | | | | | | | | | | - Adrien Rigó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Rachel F. Rodgers
- Northeastern University, Boston, USA
- Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | | | | | | | - Jessica Setnick
- International Federation of Eating Disorder Dietitians, Dallas, USA
| | | | | | | | | | | | | | - Martina Valente
- Amedeo Avogadro University of Eastern Piedmont, Vercelli, Italy
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Elias MC, Gomes DL, Paracampo CCP. Associations between Orthorexia Nervosa, Body Self-Image, Nutritional Beliefs, and Behavioral Rigidity. Nutrients 2022; 14:nu14214578. [PMID: 36364840 PMCID: PMC9656974 DOI: 10.3390/nu14214578] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022] Open
Abstract
Possible correlations between orthorexic self-reports, unhealthy nutritional beliefs, behavioral rigidity related to following rules, and distortion of body self-image were investigated. In total, 246 university students of both sexes, from different areas of knowledge, answered a sociodemographic form, the Ortho-15, the Body Shape Questionnaire, the Rigidity Scale, and a Nutritional Beliefs Form. Orthorexic self-reports were observed in 73 men and 106 women. A positive correlation was found between females and orthorexic self-reports (p = 0.036), and severe distortion of body self-image (p = 0.002) and between the latter, the behavioral rigidity scale (p2 = 0.189; p = 0.001), and female sex (p2 = 0.245; p < 0.000). In the logistic regression, women were 1.83 times more likely to present orthorexic behaviors than men. The creation of prevention and treatment strategies aimed at women is suggested and it recommended that studies investigating whether the presence of orthorexic self-reports is a risk factor for the development of eating disorders are carried out.
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Brunett KM, Oberle CD. The dark triad moderates the association between orthorexia nervosa and relationship (dis)satisfaction. Eat Weight Disord 2022; 27:2515-2521. [PMID: 35301690 DOI: 10.1007/s40519-022-01387-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/26/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Past research has revealed a link between orthorexia nervosa (ON) and relationship dissatisfaction, which has in turn been found to be correlated with the Dark Triad traits. The current study investigated the association ON has with seeking out relationships and with relationship satisfaction, while also assessing a potential moderating effect of the Dark Triad. METHODS Recruited from Reddit forums, 788 adults (74% female, 67% White, 63% aged 25-30 years) completed an online survey with the Orthorexia Nervosa Inventory (ONI), Short Dark Triad (SD3), and Relationship Assessment Scale (RAS). RESULTS Greater ON symptomatology was associated with greater levels of all aspects of the Dark Triad (Machiavellianism, narcissism, and psychopathy), as well as with lower levels of relationship satisfaction (among those in committed romantic relationships) and a lower likelihood of seeking new romantic relationships (among single participants). A regression analysis revealed that the Dark Triad moderated the association between ON and relationship satisfaction, whereby this association was not significant at high levels of the Dark Triad. CONCLUSION The current research highlights that at low and medium levels of the Dark Triad, greater ON symptomology is associated with lower levels of satisfaction in romantic relationships. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Kaitlin M Brunett
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA.
| | - Crystal D Oberle
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Grajek M, Krupa-Kotara K, Sas-Nowosielski K, Misterska E, Kobza J. Prevalence of Orthorexia in Groups of Students with Varied Diets and Physical Activity (Silesia, Poland). Nutrients 2022; 14:nu14142816. [PMID: 35889771 PMCID: PMC9318289 DOI: 10.3390/nu14142816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 12/27/2022] Open
Abstract
(1) Background: The literature emphasizes the role of many factors influencing the onset of eating disorders (EDs) and their mutual influence on each other. Therefore, this study aimed to evaluate and compare the prevalence of orthorexic behaviors in groups of health-related and non-health-related students in terms of their differential health behaviors—diet and physical activity levels. (2) The study included 300 individuals representing two equal groups of fields of study, which for the study were called the health-related field (HRF) and the non-health-related field (NRF). (3) Results: Based on the results of the dietary assessment, it was found that the best dietary model was characterized by the HRF group; in this group, 97.2% of students were characterized by a very good and good dietary mode. The NRF group, on the other hand, was dominated by a sufficient dietary mode for 64.4% of all cases in this group (94 people), while the dietary model marked as “good” was less popular, at 24.6% of this group (36 people). (4) Conclusions: Based on the cited self-research and information from the literature, it can be concluded that the problem of orthorexia is still a new issue at the level of social sciences, medical sciences, and health sciences. The psychometric tools used in this study allowed us to demonstrate the prevalence of the aforementioned eating disorders in the sample groups of students.
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Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Katowice, Poland; (M.G.); (J.K.)
- Department of Humanistic Foundations of Physical Culture, Faculty of Physical Education, Jerzy Kukuczka Academy of Physical Education in Katowice, 40065 Katowice, Poland;
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Bytom, Poland
- Correspondence:
| | - Krzysztof Sas-Nowosielski
- Department of Humanistic Foundations of Physical Culture, Faculty of Physical Education, Jerzy Kukuczka Academy of Physical Education in Katowice, 40065 Katowice, Poland;
| | - Ewa Misterska
- Department of Pedagogy and Psychology, Faculty of Social Studies in Poznań, Poznań School of Security, 60778 Poznań, Poland;
| | - Joanna Kobza
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Katowice, Poland; (M.G.); (J.K.)
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Valente M, Cesuroglu T, Labrie N, Syurina EV. " When Are We Going to Hold Orthorexia to the Same Standard as Anorexia and Bulimia?" Exploring the Medicalization Process of Orthorexia Nervosa on Twitter. Health Commun 2022; 37:872-879. [PMID: 33475011 DOI: 10.1080/10410236.2021.1875558] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study contributes to understanding medicalization on social media, by using Conrad's concept of medicalization as a theoretical framework to explore the conversation about Orthorexia Nervosa (ON) on Twitter. The aim of this mixed-methods study was twofold: the quantitative component aimed to provide descriptive information on the type of tweets and users, as well as on the network structure of the ON-related conversation on Twitter, while the qualitative component aimed to explore how the medicalization of ON unfolds on Twitter by performing a thematic analysis of original tweets about ON. Quantitative descriptive findings show that the most popular hashtags associated with orthorexia include #rdchat, #psychology and #doctors, which hints to a link between discourses around ON and the medical profession. Among the most active, prominent and visible users are news accounts, a registered dietitian, a researcher, a professor and an editor. Qualitative thematic analysis shed light on the discursive process of medicalization. Some users bring about medicalization by approaching ON as a medical entity; in contrast, other users resist medicalization by describing ON as a social phenomenon. A discursive struggle emerges, where certain individuals feel confused around what constitutes ON. This leads to stigmatization of non-traditional diets like veganism, which in turn triggers complaints regarding over-medicalization. As the first Twitter investigation on ON, this study serves the purpose of providing insights into how an emerging disorder develops in society in a time of social media.
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Affiliation(s)
- Martina Valente
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Tomris Cesuroglu
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Nanon Labrie
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Elena V Syurina
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
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Gkiouras K, Grammatikopoulou MG, Tsaliki T, Ntwali L, Nigdelis MP, Gerontidis A, Taousani E, Tzimos C, Rogoza R, Bogdanos DP, Donini LM, Goulis DG. Orthorexia nervosa: replication and validation of the ORTO questionnaires translated into Greek in a survey of 848 Greek individuals. Hormones (Athens) 2022; 21:251-260. [PMID: 35092606 PMCID: PMC8799960 DOI: 10.1007/s42000-022-00351-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. METHODS The tool was translated into the Greek language (ORTO-15-GR) using the forward-backward-forward method. A total of 848 adults participated in the validation study by filling in the questionnaires and providing general characteristics (age, gender, educational level, body weight, and height). The internal consistency of the tool was assessed by the omega (ω) coefficient, and confirmatory factor analyses (CFA) examined its factorial structure. Using the original six items of the ORTO-15 tool, a separate CFA model examined the factorial structure of the proposed ORTO-R tool. Furthermore, regression models tested the association of ORTO-R with study variables. RESULTS For ORTO-15-GR, the omega coefficient was 0.70 and for the ORTO-R 0.65. For the latter, the CFA revealed acceptable goodness-of-fit (standardized factor loadings from 0.36 to 0.64); however, all ORTO-15 models were characterized by a poor fit. In addition, there was a negative association between ORTO-R score and female gender, body mass index (BMI), and having a nutrition-related health problem. CONCLUSION The replication of ORTO-R indicates that it is a reliable tool in the field of ON. Therefore, the use of a 6-item questionnaire for ON assessment appears promising in research and clinical settings.
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Affiliation(s)
- Konstantinos Gkiouras
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Tsampika Tsaliki
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Laurette Ntwali
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Gerontidis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftheria Taousani
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Midwifery, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Christos Tzimos
- Northern Greece Statistics Directorate, Hellenic Statistical Authority, Thessaloniki, Greece
| | - Radosław Rogoza
- Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Lorenzo M Donini
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Cerolini S, Vacca M, Zagaria A, Donini LM, Barbaranelli C, Lombardo C. Italian adaptation of the Düsseldorf Orthorexia Scale (I-DOS): psychometric properties and prevalence of orthorexia nervosa among an Italian sample. Eat Weight Disord 2022; 27:1405-1413. [PMID: 34351591 PMCID: PMC9079031 DOI: 10.1007/s40519-021-01278-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Orthorexia Nervosa (ON) is described as an extreme level of preoccupation around healthy eating, accompanied by restrictive eating behaviors. During the years, different assessment instruments have been developed. The aim of the study is to adapt into Italian the Düsseldorf Orthorexia Scale (I-DOS) and to test its psychometric properties. METHOD A total sample of 422 volunteer university students (mean age = 20.70 ± 3.44, women 71.8%) completed a group of self-report questionnaires in large group sessions during their lecture time. The scales assessed ON (the I-DOS and the Orhto-15), disordered eating (Disordered Eating Questionnaire, DEQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), obsessive and compulsive symptoms (Obsessive Compulsive Inventory-Revised, OCI-R), and self-reported height and weight. RESULTS The fit of the unidimensional structure and reliability of the I-DOS was tested trough Confirmatory Factor Analysis (CFA) as well as its criterion validity computing correlation coefficients among Ortho-15, DEQ, BDI-II, OCI-R, BMI. Analyses confirmed the unidimensional structure of the I-DOS with acceptable or great fit indices (CFI = 0.984; TLI = 0.978; SRMR = 0.043; RMSEA = 0.076) and the strong internal consistency (α = 0.888). The correlations path supported the criterion validity of the scale. The estimated total prevalence of both ON and ON risk was 8.1%. CONCLUSIONS This 10-item scale appears to be a valid and reliable measure to assess orthorexic behaviors and attitudes. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
| | - Mariacarolina Vacca
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
| | - Lorenzo Maria Donini
- Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Piazzale Aldo Moro, Rome, Italy
| | - Claudio Barbaranelli
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
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Brytek-Matera A, Pardini S, Modrzejewska J, Modrzejewska A, Szymańska P, Czepczor-Bernat K, Novara C. Orthorexia Nervosa and its association with obsessive-compulsive disorder symptoms: initial cross-cultural comparison between Polish and Italian university students. Eat Weight Disord 2022; 27:913-927. [PMID: 34076878 PMCID: PMC8964579 DOI: 10.1007/s40519-021-01228-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
There is limited evidence of a link between Orthorexia Nervosa (ON) and Obsessive-Compulsive Disorder (OCD), and no definitive conclusions can be drawn. The interplay between socio-cultural context and ON has been poorly investigated as well. Therefore, the objectives of the present study were: (1) to investigate the differences in ON and OCD symptoms and (2) to assess the relationship between ON and OCD symptoms among university students. Six hundred and sixty-six university students participated in the present study: 286 from Poland and 320 from Italy. No age, gender and marital status differences were identified between two samples of university students. However, on average, Polish university students had a higher Body Mass Index than Italian ones. Our findings showed that Polish students present more problems related to obsessive symptomatology, core beliefs of OCD, perfectionism traits, and a major ON symptomatology than Italian ones. Also, Polish students with a higher level of ON exhibited higher levels of OCD symptoms and parental expectations/parental criticism. While Italian students with a higher level of ON showed higher levels of perfectionism features (organization and concern over mistakes). In general, correlations were low as confirmation of partial independence ON from OCD symptoms and core beliefs of OCD in both Polish and Italian university students. The present results highlight a need for further investigation of the correlates of ON across different cultural groups. Future research may screen individuals with ON to determine the comorbidity between ON and OCD symptomology to facilitate appropriate treatment choices. LEVEL OF EVIDENCE: Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527, Wroclaw, Poland.
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Justyna Modrzejewska
- Faculty of Humanities and Social Sciences, University of Bielsko-Biała, Bielsko-Biała, Poland
| | | | - Paulina Szymańska
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527, Wroclaw, Poland
| | | | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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Zemlyanskaya Y, Valente M, Syurina EV. Orthorexia nervosa and Instagram: exploring the Russian-speaking conversation around #opтopeкcия. Eat Weight Disord 2022; 27:1011-1020. [PMID: 34125430 PMCID: PMC8964642 DOI: 10.1007/s40519-021-01230-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/28/2021] [Indexed: 11/27/2022] Open
Abstract
This mixed-methods study explored the conversation around orthorexia nervosa (ON) on Instagram from a Russian-speaking perspective. Two quantitative data sources were implemented; a comparative content analysis of posts tagged with #opтopeкcия (n = 234) and #orthorexia (n = 243), and an online questionnaire completed by Russian-speakers (n = 96) sharing ON-related content on Instagram. Additionally, five questionnaire participants were interviewed, four of which identified with having (had) ON. Russian-speakers who share ON-related content on Instagram are primarily female, around their late-twenties, and prefer Instagram over other platforms. They describe people with ON as obsessed with correct eating, rather than healthy or clean eating. Instagram appears to have a dual effect; it has the potential to both trigger the onset of ON and encourage recovery. Positive content encourages a healthy relationship with food, promotes intuitive eating, and spread recovery advice. Harmful content, in turn, emphasizes specific diet and beauty ideals. Russian-speaking users mainly post pictures of food, followed by largely informative text that explains what ON is, and what recovery may look like. Their reasons for posting ON-related content are to share personal experiences, support others in recovery, and raise awareness about ON. Two main target audiences were people unaware of ON and people seeking recovery support. The relationship between ON and social media is not strictly limited to the global north. Thus, it may be valuable to further investigate non-English-speaking populations currently underrepresented in ON research.Level of evidence: Level V, descriptive study.
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Affiliation(s)
- Yana Zemlyanskaya
- Amsterdam University College, Science Park 113, 1098 XG Amsterdam, Netherlands
| | - Martina Valente
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
| | - Elena V. Syurina
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
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Guglielmetti M, Ferraro OE, Gorrasi ISR, Carraro E, Bo S, Abbate-Daga G, Tagliabue A, Ferraris C. Lifestyle-Related Risk Factors of Orthorexia Can Differ among the Students of Distinct University Courses. Nutrients 2022; 14:nu14051111. [PMID: 35268086 PMCID: PMC8912801 DOI: 10.3390/nu14051111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/21/2022] [Accepted: 03/04/2022] [Indexed: 12/12/2022] Open
Abstract
Orthorexia nervosa (ON) is defined as the excessive attention on healthy eating, and studies especially focused on food quality ON prevalence in university students can be extremely variable. The objective of this study is to investigate whether there was a difference in ON risk between health-scientific, economic-humanistic, sport sciences and dietetics and nutrition students, and to evaluate if lifestyle-related ON risk factors (dieting, physical activity, drugs and supplements use) could have an impact in different ways in determining ON risk among students attending these four programs. Participants were recruited at the University of Pavia and received a two-section questionnaire including demographic and lifestyle information and the ORTO-15 questionnaire. A total of 671 students (54% F e 46% M) completed the questionnaire (median age 21.00 (IQR 20.00−23.00), median BMI 21.77 kg/m2 (IQR 20.06−23.66 kg/m2)). The 31.2% had ORTO-15 test scores < 35, and were considered at risk of having ON. No differences were found in ON risk among the students attending the four university courses. Dieting was confirmed as the major ON risk factor for health-scientific, economic-humanistic and sport sciences students. The type of sport practiced was an important determinant of ON risk only for the economic-humanistic course, while supplements use was statistically different between sport sciences students with or without ON. Our findings may suggest that lifestyle-related risk factors of orthorexia can differ among the students of distinct university courses, but these results need to be supported by further longitudinal and prospective studies.
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Affiliation(s)
- Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Correspondence: (M.G.); (C.F.)
| | - Ottavia Eleonora Ferraro
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy;
| | | | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (I.S.R.G.); (E.C.)
| | - Simona Bo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126 Turin, Italy;
| | - Giovanni Abbate-Daga
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy;
| | - Anna Tagliabue
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Correspondence: (M.G.); (C.F.)
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Oberle CD, Marcell HS, Noebel NA. Orthorexia nervosa and substance use for the purposes of weight control, conformity, and emotional coping. Eat Weight Disord 2022; 27:553-561. [PMID: 33866529 DOI: 10.1007/s40519-021-01190-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/05/2021] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Orthorexia nervosa (ON), characterized by extreme behaviors driven by the goal of eating only healthy and pure foods, could plausibly be associated with avoidance of nicotine, alcohol, and illicit drugs. However, findings from the limited research on these relationships are mixed, and other eating disorders are associated with greater substance abuse. METHOD An online survey was completed by 471 participants (86% women, mean age = 20) recruited from undergraduate courses and through an Instagram advertisement. The questionnaires assessed ON symptomatology; frequency of smoking, alcohol consumption, and illicit drug use; abuse of these substances; and motivations for using these substances. RESULTS ON scores were not significantly related to the level of use or abuse of nicotine, alcohol, or most illicit drugs. Yet, ON scores were positively correlated with frequency of using illicit depressant drugs. Further, among substance users, ON scores were positively associated with smoking or vaping for the purpose of weight control, and with consuming alcohol and using illicit drugs for the purposes of conformity and coping with such negative emotions as anxiety and depression. CONCLUSION Although people who are high in ON symptomatology may be at least partly driven by a strong desire to be as healthy as possible, they are not less likely to use potentially harmful drugs. Instead, many of them may even turn to certain drugs for the same weight control and emotional-coping motives that guide the behaviors of individuals with other eating disorders. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Crystal D Oberle
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA.
| | - Haley S Marcell
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA
| | - Natalie A Noebel
- Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA
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