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L’orthorexie : actualité et soins d’une pathologie de la modernité

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Abstract

À l’opposé de l’objectif recherché par les personnes orthorexiques, l’orthorexie finit par altérer plus ou moins gravement la santé. Pour ces sujets, souvent mangeurs asociaux à la recherche de l’aliment parfait, cette obsession à se nourrir sainement devient malsaine. Entre psychopathologie et certaines incitations alimentaires modernes, ce trouble encore mal connu doit être dépisté, évalué et pris en charge afin de prévenir ses conséquences délétères. Orthorexia: News and treatment of a modern-day pathology . Contrary to the objective sought by orthorexics, orthorexia ends up aff ecting health more or less seriously. For these subjects, who are often asocial eaters in search of the perfect food, the obsession with healthy eating becomes unhealthy. Between psychopathology and certain modern eating incentives, this still relatively unknown disorder must be detected, evaluated and treated in order to prevent its harmful consequences.

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Anorexia nervosa affects people of all ages, and has the highest mortality rate of all psychiatric disorders, following medical complications inherent in the disease or suicide. Early and appropriate treatment is crucial to prevent the risk of chronic disease, which may affect one in two anorexics. Severe undernutrition linked to a complex psychopathology calls for the necessary theoretical and clinical knowledge on the part of the caregiver, applied to the dynamics of care, ideally conceived in a transdisciplinary way and involving nursing teams.
Article
Objectif L’orthorexie, définie comme l’obsession pour l’alimentation saine, est un phénomène en pleine émergence. De plus en plus de chercheurs s’intéressent au sujet mais à ce jour aucun dispositif thérapeutique n’existe pour prendre en charge les personnes qui en souffrent. Il s’agit ici d’expérimenter et d’évaluer un programme thérapeutique auprès de patients souffrant de troubles des conduites alimentaires et ayant des symptômes orthorexiques : le programme ORTO-TCA. Méthode Constitué de cinq séances d’ateliers psychothérapeutiques collectifs, ce programme s’inspire des thérapies brèves avec une approche intégrative. Des questionnaires auto-rapportés ont permis d’obtenir une évaluation du programme. Les participantes (n = 5) ont répondu en test-retest à l’Échelle Française d’Orthorexie (EFO-12), à une échelle d’estime corporelle (BES), au questionnaire d’acceptation et d’action (AAQ-II) et en fin de prise en charge à l’Échelle Clinique de Thérapies Médiatisées (ECTM-16). Résultats Les analyses quantitatives ne permettent pas d’objectiver des différences significatives pour le niveau d’orthorexie, d’estime corporelle et de flexibilité psychologique. En revanche, les analyses qualitatives du vécu de l’atelier montrent que les participantes du programme expriment globalement des opinions positives. Elles ont ressenti une amélioration, se sont appropriées les outils et ont trouvé que l’atelier était agréable et utile. Discussion Cette recherche expérimentale peut être davantage considérée comme une étude de faisabilité et d’acceptabilité en milieu ouvert qu’une évaluation d’un programme psychothérapeutique quant à son impact. Elle soulève d’ailleurs quelques limites méthodologiques (comme l’absence de groupe contrôle) et le contenu du programme gagnerait à être enrichi par d’autres approches (thérapies médiatisées, approche cognitive, etc.). Conclusion L’expérimentation de ce dispositif thérapeutique constitue une avancée clinique significative dans la prise en charge de la symptomatologie orthorexique des TCA. Le programme ORTO-TCA peut être considéré comme une piste de traitement sérieuse de l’orthorexie.
Article
À la croisée des influences sociales et de la psychopathologie de la vie quotidienne, l’orthorexie est une notion peu connue. Cette obsession pour une alimentation saine, aux conséquences délétères, pose des questions d’évaluation clinique différentielle. Les analyses de cas et les illustrations cliniques permettent de mieux comprendre ce que pensent, ressentent, font et vivent certaines personnes orthorexiques qui ont des rapports restrictifs et déviants à l’alimentation. Orthorexia: Psychopathological profiles and life trajectories . At the crossroads of social influences and the psychopathology of everyday life, orthorexis is a little-known concept. This obsession with a healthy diet with deleterious consequences raises questions of differential clinical evaluation. Case studies and clinical illustrations provide a better understanding of what some orthorexic people think, feel, do and experience in having these restrictive and deviant relationships to food.
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Purpose: To the best of our knowledge, no scientific publications on orthorexia nervosa have been based on a French population. The goal of our study was to confirm the factor structure of the French version of the ORTO-15 questionnaire. Methods: An online survey (N = 768) was conducted asking participants (84.77% were women) to answer several questions about their dietary habits and to assess orthorexia nervosa using the ORTO-15 scale. Confirmatory factor analysis (CFA) was used for the validation. Results: Given our results, we deemed it necessary to adapt the French version of the ORTO-15 questionnaire by omitting three items. The CFA supported the ORTO-12-FR (composed of 12 items and addressing three domains: rational, emotional, and behavioral) as the better-fitting model, with an internal consistency of 0.73. The Comparative Fit Index value was 0.93, the Tucker-Lewis Index was 0.90, and the Root Mean-Square Error of Approximation was 0.05. Conclusions: Our results provide evidence for the reliability of ORTO-12-FR with a French population. Level of evidence: V, descriptive cross-sectional study.
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Purpose: Orthorexia nervosa is a currently investigated eating disorder proposed by US physician Steve Bratman, defined as pathological fixation on eating healthy food. This study aimed to develop, by consensus of experts, the basic items for a new questionnaire to evaluate some defining psychological features of orthorexia nervosa in English and Spanish language, the so-called Barcelona Orthorexia Scale (BOS). Methods: The initial item pool was composed of 105 items divided into six different content areas. To analyse the content of the items, a three-round Delphi study was developed, in which participants had to evaluate the representativeness and clarity of each item. Participants were chosen because of their knowledge on orthorexia and/or eating disorders. Results: 58 experts, from 17 different countries, participated in the initial round and 30 in the last round. Items were added, rephrased, changed into another content area, modified or eliminated according to the participants' suggestions, partly due to the group's response, analysed statistically, and partly due to participants' recommendations. Conclusions: 64 items were obtained, with two versions in Spanish and English. The future BOS aims to provide a possible solution to the shortage of valid instruments to evaluate psychological features of orthorexia and to promote research on this field. Further analysis regarding validity and reliability is necessary to prove the BOS' value on this matter.
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Purpose: Health Sciences, and in particular Nutrition and Dietetics students, have been shown to exhibit an increased prevalence of disordered eating. The aim of the present cross-sectional study was to evaluate other specified feeding and eating disorders (OFSEDs), including stress-related eating, food-addiction and orthorexia, in relation to the dietary intake, among nutrition/dietetics students. Methods: A total of 176 undergraduate students from a Department of Nutrition & Dietetics, in Greece participated in the study. Dietary intake was recorded, and the prevalence of Eating and Appraisal Due to Emotion and Stress (EADES), food-addiction (with the modified Yale Food Addition scale mYFAS), and orthorexia were assessed. Chi-square and t-tests were performed between sexes, orthorexic and non-orthorexic students, as well as between food-addicted and non-addicted participants. Multiple linear regression analysis assessed relationships between energy intake, BMI or waist circumference, and the food-related psychometric scales. Results: Among participating students 4.5% had food-addiction and 68.2% demonstrated orthorexia. No differences were observed between men and women, concerning the prevalence of food addiction and orthorexia, the sum of mYFAS symptoms, or individual EADES factors. Orthorexic students exhibited increased BMI, reduced energy and SFA intake. Additionally, orthorexic men consumed more vegetables. Multiple linear regression analysis revealed that orthorexic behavior was associated with increased BMI, waist circumference and energy intake. Lower BMI was associated with increasing ability to cope with emotion-and-stress-related eating and increasing appraisal of ability and resources to cope with emotions and stress. Emotion-and-stress-related eating was negatively associated with BMI. Appraisal of ability and resources to cope with emotions and stress was associated with the energy intake. Finally, age was positively correlated with the appraisal of outside stressors/influences, indicating increased ability to cope with outside stressors among older students. Conclusions: The study shows that despite the suggested interventions, the problem of OFSEDs among nutrition and dietetics students is still valid. Regular screening, counseling and education is needed to reduce its prevalence.
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Orthorexia nervosa could be conceptualized as extreme or excessive preoccupation with eating food believed to be healthy. Orthorexia nervosa and healthy orthorexia (interest in healthy eating) can be distinguised. Up to now, there is no available instrument evaluating every aspect of orthorexia with sufficient psychometric guarantees. The objective of the present study was two-fold. First, to develop and validate a new questionnaire of orthorexia –the Teruel Orthorexia Scale– and, second, to analyze the association with other psychological constructs and disorders theoretically related to orthorexia nervosa: eating disorder symptoms, obsessive-compulsive disorder symptoms, negative affect, and perfectionism. Participants were 942 mainly university students who completed a battery of online questionnaires. Of them, 148 provided responses in a retest 18 months later. Starting with an initial item bank of 31 items, we proposed a bidimensional test of orthorexia. This final version, with 17 items, encompassed two related, although differentiable (r = .43), aspects of orthorexia. First, Healthy Orthorexia, which evaluates the “healthy” preoccupation with diet, which is independent of psychopathology, and even inversely associated with it. Second, Orthorexia Nervosa, which assesses the negative social and emotional impact of trying to achieve a rigid way of eating. This dimension represents a pathological preoccupation with a healthy diet. This study presents a new instrument that offers promising possibilities in the study of orthorexia.
Article
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Orthorexia nervosa has recently been defined as excessive preoccupation with healthy eating, causing significant nutritional deficiencies and social and personal impairments. The ORTO-15 is the most widely used instrument to evaluate orthorexia nervosa, although previous studies obtained inconsistent results about its psychometric properties, and there are no data on the Spanish version. Thus, the main objective of the present study was to analyze the psychometric properties of the Spanish adaptation of the ORTO-15. In order to cross-validate the results, two independent samples were used (Sample 1: n = 807, 74.1% women; Sample 2: n = 242, 63.2% women). The results did not support the original recoding and reversal of the items; thus, the original scores were maintained. The analysis of the internal structure showed that the best interpretable solution was unidimensional, and due to low loadings, four items were removed. The internal consistency (α = .74) and temporal stability (r = .92; p < .001) of the final ORTO-11 version were adequate, higher than the 15-item version. The questionnaire showed significant associations with eating psychopathology (EAT-26 and SR-YBC-EDS; range r = .64 – .29; p < .05). However, this result should be interpreted with caution due to the redundancy observed between the ORTO- 5 and the EAT-26. Our results suggest that the psychometric properties of the Spanish version of the ORTO-15 are not adequate. Moreover, the instrument detects people who are on diets, but it is not efficient in detecting the severity of orthorexic behaviors and attitudes. New instruments are needed to continue the study of orthorexia nervosa.
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Background Orthorexia nervosa (ON) is defined as pathological healthful eating. The aim of this study was to investigate whether there is any difference in orthorexic behaviours between clinical and non-clinical groups, and in different cultural contexts. . Methods Recruitment involved both female patients with anorexia nervosa (AN) and healthy controls (HC) from Italy and Poland (N = 23 and N = 35 AN patients; and N = 39 and N = 39 HCs, in Italy and Poland, respectively). Assessment of orthorexic behaviours was performed with the ORTO-15 test. Results Statistically significant differences were found between Italian women in the AN and HC group, whereas no difference between Polish women in the AN and HC group was found. Both Italian groups scored significantly higher than the Polish ones on the ORTO-15. Conclusions Differences have been found between the Italian and Polish samples, both in the percentage of individuals with orthorexic behaviours as suggested by an ORTO 15 score below the cutoff, and in the mean ORTO 15 scores in the AN and HC groups, suggesting cross-cultural differences in orthorexic behaviours, whose meaning is currently difficult to understand.
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Purpose: We investigated whether perfectionism, body image, attachment style, and self-esteem are predictors of orthorexia nervosa. Methods: A cohort of 220 participants completed a self-administered, online questionnaire consisting of five measures: ORTO-15, the Multidimensional Perfectionism Scale (MPS), the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS), the Relationship Scales Questionnaire (RSQ), and Rosenberg's Self-Esteem Scale (RSES). Results: Correlation analysis revealed that higher orthorexic tendencies significantly correlated with higher scores for perfectionism (self-oriented, others-oriented and socially prescribed), appearance orientation, overweight preoccupation, self-classified weight, and fearful and dismissing attachment styles. Higher orthorexic tendencies also correlated with lower scores for body areas satisfaction and a secure attachment style. There was no significant correlation between orthorexia nervosa and self-esteem. Multiple linear regression analysis revealed that overweight preoccupation, appearance orientation and the presence of an eating disorder history were significant predictors of orthorexia nervosa with a history of an eating disorder being the strongest predictor. Conclusions: Orthorexia nervosa shares similarities with anorexia nervosa and bulimia nervosa with regards to perfectionism, body image attitudes, and attachment style. In addition, a history of an eating disorder strongly predicts orthorexia nervosa. These findings suggest that these disorders might be on the same spectrum of disordered eating.
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Background The construct of orthorexia in eating disorders (EDs) has received very little attention despite clinical observations of a possible overlap between the two. The aim of this study was: 1) to assess orthorexic behaviours, eating disorder pathology and attitudinal body image in ED patients; 2) to identify possible predictors of orthorexia nervosa among ED patients. Methods Fifty-two women diagnosed with EDs were recruited. Patients’ assessment included the following: the ORTO-15 test (Polish version) for orthorexic behaviours; the Eating Attitude Test-26 (EAT-26) to identify ED symptoms; the Multidimensional Body-Self Relations Questionnaire (Polish version) to assess body image. Results A latent class analysis was performed and differences between identified classes were assessed. The main differences concerned weight, ED pathology and orthorexic behaviours within the same group of ED patients. In order to examine predictors of orthorexia nervosa, we investigated a structural equation model, which excellently fitted to the data (χ2(17) = 23.05; p = .148; CFI = .962; RMSEA = .08; p = .25; SRMR = .05). In ED patients, orthorexic behaviour was negatively predicted by eating pathology, weight concern, health orientation and appearance orientation. Conclusion The assessment of the orthorexia construct in EDs may add to the paucity of studies about this issue and may help to clarify the relationship between the two. Differences and similarities seem to exist between these disorders, and may benefit from specific treatment approaches. Moreover, these preliminary findings open tracks for future research in the field of the psychology of eating.
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BACKGROUND: The pursuit for healthy food consumption is considered a laudable habit. This attitude can turn into pathological when cognitions and worries about healthy nutrition lead to such an accurate food selection that correct diet becomes the most important part of one's own life leading to important dietary restrictions, stereotyped eating or impairment in important areas of functioning. This behaviour is coined orthorexia nervosa (ON) and can share common characteristics with anorexia nervosa (AN) and bulimia nervosa (BN). The purpose of the present study was to examine the frequency of ON among women with eating disorders (EDs) and to evaluate if it changed after treating the ED. METHODS: Thirty-two patients with AN or BN were evaluated by means of the ORTO-15, the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) and the Eating Attitude Test (EAT-26) before (t0) and 3 years after the treatment of their ED (t1), and compared to 32 female healthy controls (HC) matched by gender, age, and BMI at t1. RESULTS: A significantly higher percentage of patients either at t0 (28 %) or t1 (58 %) resulted positive to ORTO-15 compared to controls (6 %). YBC-EDS and EAT-26 scores were higher among ED patients than in HC, but they decreased from t0 to t1. CONCLUSIONS: Orthorexia nervosa symptoms are highly prevalent among patients with AN and BN, and tend to increase after treatment. ON seems associated both with the clinical improvement of AN and BN and the migration towards less severe forms of EDs. It is necessary to clarify if ON residual symptomatology can be responsible for a greater number of relapses and recurrences of EDs.
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Striving for enhancing athletic performance many sportsmen undergo rigid dietary habits, which could lead to eating disorders (EDs) or Orthorexia Nervosa (ON), a psychopathological condition characterized by the obsession for high quality food. The aim of the study was to examine the occurrence of ON in athletes and to verify the relationship between ON and EDs. Five-hundredseventy- seven athletes and 217 matched controls were administered the following tests: ORTO-15, Eating Attitude Test 26 (EAT-26), Body Uneasiness Test (BUT) and Yale-Brown-Corner Eating Disorder Scale (YBC-EDS). High positivity to ORTO-15 (28%) and EAT-26 (14%) emerged in athletes, whereas a high rate of BUT positivity was evident among controls (21%). Multivariate logistic regression analysis revealed that independent predictors of ON are previous dieting, age, positivity to YBC-EDS, positivity to EAT-26, competition level, and number of YBC-EDS preoccupations and rituals. Sharing many features with both EDs and Obsessive-Compulsive Spectrum, ON represents a crossroad between these pathologic conditions and might compromise the health state of an athlete. Therefore, coaches should consider it important to detect symptoms of EDs and ON in their athletes.
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Orthorexia is a new term about eating behavior disorder and consists of pathologic obsession for biologically pure foods, free of herbicides, pesticides, and other artificial substances. It is not an independent diagnostic category, but it has some similarities with other eating disorders. This study was conducted to examine the orthorexia among 878 medical students. Of 878 students, 464 (52.8%) were male and 359 (40.9%) were female. The mean age, height, weight, and body mass index were 21.3 +/- 2.1 years, 171.0 +/- 8.5 cm, 65.6 +/- 12.3 kg, 22.4 +/- 2.99, respectively. The rates of the ORTO-11 scores between 0 and 15 was 1.9%; between 16 and 30, 57.5%; and between 31 and higher, 21.1%. There were 17 students with a score of 0 to 15. The mean score for the ORTO-11 test was 27. There were statistically significant differences between age, sex, and smoking habit of the students. In the male students, there was a statistically significantly higher tendency for orthorexia (P = .001), and there was a statistically significant difference between the age groups for tendency for orthorexia (P = .025). In logistic regression analysis, age, sex, Eating Attitude Test-40 (EAT-40), and height affected the ORTO-11 scores.
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The aim of the study was to determine the prevalence of orthorexia nervosa among the performance artists in the State Opera and Ballet and in the Bilkent University Symphony Orchestra. The study population consisted of 39 men and 55 women for a total of 94 artists with mean age of 33 years. The ORTO-15 test was used to determine the prevalence of orthorexia nervosa. Those subjects who scored below 40 in the ORTO-15 test were classified as having orthorexia nervosa. Mean score of the participants in the ORTO-15 test was 37.9+/-4.46. A total of 56.4% of the artists involved in the research scored below 40 in the ORTO-15 test. While the highest prevalence of orthorexia nervosa was recorded among opera singers (81.8%), it was 32.1% among ballet dancers and 36.4% among symphony orchestra musicians. The differences between the three groups were statistically significant. No difference was noted between mean ORTO-15 score by baseline characteristics as gender, age, educational level, work experience, body mass index, smoking and alcohol consumption. The research group have a higher socio-economic and education level than the majority of the general public in Turkey. Additionally, being an artist in Turkey means being a role model for the general public both in terms one's physical appearance and lifestyle. These may be the reason why artists are more sensitive to this issue.
Article
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To validate a questionnaire for the diagnosis of orhorexia oervosa, an eating disorder defined as "maniacal obsession for healthy food". 525 subjects were enrolled. Then they were randomized into two samples (sample of 404 subjects for the construction of the test for the diagnosis of orthorexia ORTO-15; sample of 121 subjects for the validation of the test). The ORTO-15 questionnaire, validated for the diagnosis of orthorexia, is made-up of 15 multiple-choice items. The test we proposed for the diagnosis of orthorexia (ORTO 15) showed a good predictive capability at a threshold value of 40 (efficacy 73.8%, sensitivity 55.6% and specificity 75.8%) also on verification with a control sample. However, it has a limit in identifying the obsessive disorder. For this reason we maintain that further investigation is necessary and that new questions useful for the evaluation of the obsessive-compulsive behavior should be added to the ORTO-15 questionnaire.
Article
Objectif L’orthorexie est un trouble mis en évidence récemment qui désigne les préoccupations obsessionnelles concernant l’alimentation saine et engendre une altération significative du fonctionnement ainsi qu’une souffrance. Il s’agit dans cette étude d’exposer la conception et la validation d’une Échelle Française d’Orthorexie (EFO). Méthode Le développement du questionnaire a eu lieu en trois étapes : recueil du point de vue d’une population française afin de tester les items, réalisation d’une analyse factorielle exploratoire pour élaborer la structure du questionnaire et vérification de cette structure grâce à une analyse confirmatoire. Le protocole de questionnaires a été diffusé en ligne. Les participants ont répondu à trois échelles d’orthorexie, ainsi qu’à la Hospital Anxiety and Depression Scale. Résultats Les analyses ont permis de créer un questionnaire d’orthorexie (EFO-12) se composant de 12 items et ayant des qualités psychométriques correctes ainsi qu’une structure factorielle stable (χ² = 143 ; p < 0,001 ; CFI = 0,942 ; TLI = .921 ; SRMR = 0,0459 ; RMSEA = 0,0670). La cohérence interne (α = 0,82) et la validité convergente avec les autres échelles d’orthorexie (r = 0,57 ; p < 0,001 avec le BOT et r = −0,55 ; p < 0,001 avec l’ORTO-12-FR) sont très satisfaisantes. Discussion Les différentes échelles d’orthorexie existantes à ce jour sont critiquables. L’EFO-12 se veut aussi complète que spécifique à la culture française. La méthodologie utilisée ici est mixte et s’appuie sur les critères les plus récents de l’orthorexie. Les résultats obtenus concernant la validation de l’échelle sont très satisfaisants. Conclusion Cette étude présente la création et la validation d’un questionnaire d’orthorexie français. Il s’agit d’un outil simple, pragmatique et utile pour les praticiens et les chercheurs en Psychologie qui s’intéressent à cette pathologie émergente.
Article
Résumé Contextualisation La nécessaire approche pluridisciplinaire et la durée des Troubles des Conduites Alimentaires (TCA) ne favorisent guère l’approche évaluative en follow-up, même lorsqu’il s’agit d’un programme standardisé. Les rares travaux menés sur l’impact de thérapies éclectique, familiale et cognitivo-comportementale, respectivement à un, quatre et cinq ans après la fin de la thérapie, ne parviennent pas à montrer ce qui a été bénéfique pour ces patients dans les thérapies suivies. D’un autre côté, l’art-thérapie est souvent posée comme une démarche non médicamenteuse clef pour ces patients en proie à la maîtrise, la rationalisation et l’anesthésie affective. Mais là aussi, par-delà l’engouement souvent constaté, le manque de preuves est aussi flagrant que l’absence d’une méthodologie évaluative ad hoc. Objectifs Il s’agit dans ce travail de réaliser une évaluation des effets et représentations d’une prise en charge par l’art-thérapie en follow-up (sept ans). Puis de réaliser une typologie différentielle de l’efficacité art-thérapique des sujets guéris (TCA passés) versus sujets non guéris (TCA actuels). Méthode Population : 53 femmes (âge : 32,7 – ET : 9,27) dont 27 TCA actuels et 26 TCA passés de TCA, non hospitalisées depuis cinq ans et ayant bénéficié d’une prise en charge art-thérapique. Outils d’investigation Questionnaire adapté du Vécu de l’Échelle Clinique de Thérapies Médiatisées-Art-thérapie (ECTM) de Sudres. Résultats La psychothérapie analytique est la démarche de soin qui différencie les TCA passés des TCA actuels. Elle est donc un facteur prédictif dans le processus de soin. L’art-thérapie constitue la démarche de base et l’articulation clef pour amener le sujet vers les espaces thérapeutiques essentiels (thérapie psychanalytique et thérapie corporelle). Le rapport coût/bénéfice/efficacité devient probant pour l’art-thérapie. Discussion Des recommandations de bonnes pratiques d’ateliers d’art-thérapie avec des sujets TCA peuvent être esquissées. Par ailleurs, la nécessité d’évaluer ces pratiques avec des outils spécifiques requiert une modélisation ad hoc et une formation des art-thérapeutes.
Article
Othorexia Nevrosa is defined as an obsessive though regarding healthy food consumption, food properties and cooking tools. Orthorexia Nevrosa is not mentioned in the psychiatric nosography and is not considered as a disorder. While no formal diagnostic criteria currently exist, screening tools have been developed to explore characteristics of Orthorexia Nevrosa. While Orthorexia Nevrosa has specific characteristics, an overlapping exists with Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) symptoms. Copyright © 2019. Published by Elsevier Masson SAS.
Article
Orthorexia nervosa (ON)is a condition described as a pathological obsession with healthy eating. This paper will review the prevalence of ON and how ON is measured. The primary objective is to critically analyze findings on the psychosocial risk factors associated with ON, to consider its relation to other mental disorders, and to offer directions for future research. The key words “orthorexia” and “orthorexia nervosa” were searched in the databases PsycINFO and MEDLINE/PubMed. This paper reviewed peer-reviewed articles published up until December 31st, 2018. Quality assessment was conducted on each study reviewed. Results identified psychometric problems with the most common measure of ON. Gender and self-esteem were generally found to be unrelated to ON. Perfectionism, obsessive-compulsive traits, psychopathology, disordered eating, history of an eating disorder, dieting, poor body image, and drive for thinness were positively associated with greater ON. Findings between ON and the following risk factors were mixed: age, SES, BMI, belonging to a health-related field, exercise engagement, vegetarianism/veganism, body dissatisfaction, and alcohol, tobacco, and drug use. We discuss how the literature on risk factors informs understanding the nature of psychopathology of ON. Strengths and limitations of studies are reviewed and directions for future research are identified. Suggestions are made for more psychometrically valid assessment measures of ON that include questions about impairment, so that ON etiology can be accurately studied.
Article
Disordered eating is prevalent among college student populations, and Orthorexia Nervosa (ON) is being explored as a new type of eating disorder. There is currently no standardized ON diagnostic tool, and the majority of ON research has been conducted among European populations. The present study explored the Bratman Orthorexia Test (BOT) for ON diagnosis, and its relationship to validated tools for assessing disordered eating, body dysmorphic, and obsessive-compulsive tendencies among college students attending a western university. A convenience sample of 448 college students with a mean age of 22 years was recruited to complete an online survey that included the BOT, Eating Attitudes Test-26 (EAT-26), Body Dysmorphic Disorder Questionnaire (BDDQ), Obsessive Compulsive Inventory, Revised (OCI-R) and demographics. Spearman correlation, Mann-Whitney U, Kruskal-Wallis, chi-square, and multiple linear regressions were used for analyses. The average BOT score was 4.71, near the “health fanatic” range, with Hispanic/Latino subjects and overweight/obese students having significantly higher median BOT scores. Gender, age, and college major were not significantly associated with BOT score. Significant positive correlations were observed between total BOT and EAT-26 scores (r=.47, p<0.01), BOT and BDDQ scores (r=.25, p<0.01), and BOT and OCI-R scores (r=.19, p<0.01). ON tendencies may exist among college students and Hispanic/Latino and overweight/obese students may be at increased risk. Further research is needed to determine ON risk factors among diverse student populations in order to inform prevention and treatment approaches on college campuses.
Article
Purpose: it was to know the cognitive and emotional thoughts concerning foods and eating in the general and student population of the region of Dijon.Methods: a questionnaire concerning the cognitive and emotional thoughts was beforehand established, validated and handed or sent to 10 000 students and persons of the population of Dijon drawn lots and paired according to district and family. The analysis concerned 3 732 persons, i.e. the 882 students and the 2 850 people of both genders from the general population who restored a more than 95% completed and coherent questionnaire.Results: in this population, negative thoughts and fear in front of the food were noted in a not exceptional way:–to eat disgusts me: 1.6%;–to eat frightens me: 3.3%;–the glance of the other one when I eat frightens me: 13%;–this food which we propose me make me bad, sink, sad or tightened in 9 at 18% of the cases.Also, a important percentage of eating disorders or abnormalities was found:–binge eating: 8%;–bulimia nervosa: 4.3%;–anorexia nervosa: 2.2%;–low weight (IMC<19 kg/(m)2) and frightens in front of glance of the other one: 13%.These abnormalities were more frequent in young people than in older one’s and in women than in men, but were not so rare in older women (>35 years old) and in men. The questionnaire allowed us to show that a subgroup of people really exists, who are very attentive to the “dietically correct” and anxious about foods. This so-called subgroup “orthorexia” concerned around 1.9% of our total population and 6.1% of thin people (IMC<19 kg/(m)2).Conclusion: the health aspect of the food and the fear of getting fat are important preoccupations of certain number of persons, both in the student population and the general one. This raises the problem of the irrational meaning of the food for a certain number of people, in front of media messages and of the food availability.
Düsseldorf orthorexia scale–construction and evaluation of a questionnaire measuring orthorexic eating behavior
  • Barthels
Pourquoi cette peur au ventre ? Cultures et comportements face aux crises alimentaires. Orthorexie, fast-food, viande, alicaments, pesticides… Paris: JC Lattès
  • P Denoux
Denoux P. Pourquoi cette peur au ventre ? Cultures et comportements face aux crises alimentaires. Orthorexie, fast-food, viande, alicaments, pesticides… Paris: JC Lattès; 2014.
Düsseldorf orthorexia scale-construction and evaluation of a questionnaire measuring orthorexic eating behavior
  • F Barthels
  • F Meyer
  • R Pietrowsky
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