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Orthorexia nervosa. A new eating behavior disorder?

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Abstract

New eating behavior disorders such as bigorexia (muscle dysmorphia) and orthorexia are appearing in developed countries. These disorders have not been officially recognized so that they are not classified as independent entities. The term orthorexia comes from the Greek word orthos (straight, proper) and orexia (appetite). It is characterized by the pathological obsession for biologically pure food, which leads to important dietary restrictions. Orthorexic patients exclude foods from their diets that they consider to be impure because they have herbicides, pesticides or artificial substances and they worry in excess about the techniques and materials used in the food elaboration. This obsession leads to loss of social relationships and affective dissatisfactions which, in turn, favors obsessive concern about food. In orthorexia, that patient initially wants to improve his/her health, treat a disease or lose weight. Finally, the diet becomes the most important part of their lives. We present a clinical case that responds to the characteristics of orthorexia. The differential diagnosis with chronic delusional disorder, anorexia nervosa and obsessive-compulsive disorder is carried out.

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... Such different approaches, and indeed, the lack of one consistent one, are reflected in the ON measurement tools used. A systematic review by Valente et al. indicates that the most commonly used are the Bratman Orthorexia Test (BOT), the Questionnaire for the Diagnosis of Orthorexia (ORTO-15), the Eating Habits Questionnaire (EHQ), the Düsseldorf Orthorexia Scale (DOS), the Barcelona Orthorexia Scale (BOS), and the Teruel Orthorexia Scale (TOS) [5]. The BOT scale is based on the concept of an obsession with healthy eating, which seems to acquire features of the ED [6]. ...
... The ORTO-15 and ORTO-R scales, on the other hand, are based on the conceptualization of ON as abusive eating behavior, characterized by a combination of eating, behavioral, and obsessive-phobic personality traits [7]. The EHQ scale speaks of an overwhelming preoccupation with healthy eating, and the DOT and BOS scales are based on the concept of fixation on healthy eating [5]. And finally, the TOS scale describes extreme or excessive preoccupation with eating foods considered healthy [8]. ...
... And finally, the TOS scale describes extreme or excessive preoccupation with eating foods considered healthy [8]. The tools described are based on different conceptualizations of ON and diagnostic criteria, but, importantly, all conceptualizations were derived from Bratman's initial definition of ON in 1997 [5]. ...
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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.
... They spend most of their time researching the properties of the foods they will consume and preparing pure foods. This obsessive approach to healthy eating negatively affects the health of individuals with ON and may cause them to lose weight even though they do not calculate calories (3)(4)(5)(6). ...
... Orthorexic individuals often lead a life away from society because they do not eat food prepared by others. This situation limits their lives over time, negatively affects their social relationships, and reduces their quality of life (6). Sometimes efforts starting as just a healthy diet can turn into ON over time (7). ...
... However, this has become a very advanced obsession in individuals with ON. When this obsession exceeds a certain duration, it can become a disorder that concerns the dimensions of personality and behavior (6). In this respect, the relationship between ON and OCD is interesting. ...
Article
Aim: This study aimed to determine medical students' tendency to orthorexia nervosa (ON) and investigate the role of obsessive-compulsive symptoms on these attitudes. Materials and methods: This descriptive study was conducted with 822 medical students. The data were collected via an online survey. A sociodemographic information form, the ORTO-11 scale, and the Maudsley Obsessive Compulsive Symptom Inventory (MOCI) were used as data collection forms. Results: The mean age of the students was 20.5±2.1 (range 18-32) years, and 50.7% (n=417) were female. Orthorexia tendency was detected as 19% (n=156). A significant negative relationship was found between the students' ORTO-11 and MOCI scores (p
... According to the consensus document on the definition and diagnostic criteria for orthorexia nervosa (ON) [1], this problem is characterized by its focus on food quality, overplanning of meals, and prioritization of nutritional value and perception of purity over taste [1][2][3][4][5][6][7][8][9]. This obsession with health is associated with inflexible beliefs and excessive control of their eating behaviors [4,9,10]. ...
... According to the consensus document on the definition and diagnostic criteria for orthorexia nervosa (ON) [1], this problem is characterized by its focus on food quality, overplanning of meals, and prioritization of nutritional value and perception of purity over taste [1][2][3][4][5][6][7][8][9]. This obsession with health is associated with inflexible beliefs and excessive control of their eating behaviors [4,9,10]. A transgression of self-imposed rules is followed by emotions like guilt, low self-esteem or anxiety [1,5]. ...
... However, an excessive attention to intake healthy foods, following a diet or excessive physical activity could lead to an obsession with healthy habits. An extreme focus on healthy eating is usually related with physical, psychological and social deterioration [3,4,19]. All of these factors are involved on the appearance, development and current definition of ON, although this problem has not been considered as an official diagnosis yet [3,5,10,17,[19][20][21]. ...
Article
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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.
... Pode-se definir ortorexia como a obsessão por alimentos biologicamente puros, livre de herbicidas, pesticidas e demais substâncias artificiais. Há uma preocupação excessiva com relação às técnicas e materiais utilizados no preparo dos alimentos ocasionando perda de relações sociais e pensamentos obsessivos sobre comida [8,9]. ...
... Há diversos motivos que podem desencadear a ortorexia como a busca incessante por uma melhor saúde, tratamento de alguma doença ou para perda de peso, o medo de que a indústria alimentar possa envenená-los através de seus aditivos e também razões espirituais para que se alimentem com um tipo especifico de alimento [8,9]. ...
... Os indivíduos com ortorexia apresentam características de personalidades semelhantes àqueles com anorexia nervosa como rigidez, perfeccionismo, necessidade de controle da vida transferida à alimentação, ansiedade intensa em relação a certos alimentos e também apresentam hipocondria [8]. ...
Article
A ortorexia é caracterizada por uma obsessão compulsiva por alimentos considerados saudáveis. Há diversos fatores de risco para o desenvolvimento deste transtorno como conhecimento sobre nutrição, pessoas restritivas e exigentes, indiví­duos que a partir de uma doença relacionada í má alimentação começam a buscar alimentos saudáveis e atletas com preocupação relacionada í sua composição corporal. As pessoas acometidas por este transtorno evitam alimentos com corantes, conservantes, agrotóxicos, alto teor de gordura, açúcar e sal, tendo também preocupação excessiva no que vão comer no dia seguinte. Sendo assim, este hábito alimentar pode causar desnutrição, anemias, carência de nutrientes essenciais, hipotensão, entre outras doenças. Assim, esse artigo tem como objetivo apresentar uma revisão sobre a ortorexia, para isso foi realizada uma busca nas bases de dados online Scielo, Lilacs e Pubmed utilizando os termos: ortorexia, transtornos alimentares, compulsão e alimentos saudáveis.Palavras-chave: comportamento alimentar, transtornos da alimentação, transtorno obsessivo-compulsivo, alimentos saudáveis.
... Those suffering from orthorexia limit or eliminate specific types of foods from their diet, e.g., meat, dairy products, cereals, ready-prepared products, non-seasonal products, or products rich in fat, salt, or sugar [3,4]. A common practice is also a strict reliance on organic foods [5,6]. A list of acceptable products may vary from person to person; however, what is typical of the group is the progressive character of the imposed food restrictions. ...
... Any violation of the self-imposed eating rules may result in a want to discipline oneself, either through the intensification of food restrictions or through fasting, negatively impacting one's self-esteem. Furthermore, any deviations from the diet lead to a strong feeling of guilt and shame [6,8,9]. A total fixation on healthy eating results in neglecting personal goals and values, school assignments, professional duties, or interpersonal relationships. ...
... Both ON and AN are characterized by a tendency toward perfectionism, high coexisting anxiety, and the need to control [2,3,9,19,20]. In both cases, there is also an excessive focus on eating [3,6,13]; however, a few differences in this respect can be observed. People with ON focus on the quality and purity of food whereas people with AN primarily focus on the amount of food consumed [8,11,21]. ...
Article
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The aim of the study was to determine the level of nutrition knowledge and diet quality, understood in terms of healthy and unhealthy eating habits, among young people with orthorexic tendencies. The participants were school students, university students, and those employed in the Lublin region (N = 473). The data were collected by means of a questionnaire. The participants were asked to provide socio-demographic data through filling in the ORTO-15 questionnaire and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). The participants obtained results ranging from 9.3 to 100 (M = 31.15; SD = 11.81) in the non-healthy diet index, from 0.4 to 78.6 in the pro-healthy diet index (M = 21.79; SD = 11.08), and from 0 to 23 in the domain of nutrition knowledge (M = 13; SD = 4.23). A variance analysis showed no significant differences between the pro-healthy diet index and the level of nutrition knowledge. The group with orthorexia obtained statistically higher results in the pro-healthy diet index. Those with a tendency toward orthorexia obtained statistically higher results in the non-healthy diet index. The variance analysis showed that the level of nutrition knowledge of those not focused on healthy foods was significantly lower than in the other groups. The results of the ORTO-15 questionnaire correlated negatively with the pro-healthy diet index and the level of nutrition knowledge, and positively with the non-healthy diet index. We concluded that: 1. the orthorexic group and the group with a tendency toward orthorexia could be characterized with a moderate intensity of a healthy diet and a low intensity of a non-healthy diet; and 2. the level of nutrition knowledge in the orthorexic group did not significantly differ from that of the other groups.
... More precisely, individuals with ON are thought to have unrealistic beliefs about the properties and the potential health benefits of food (i.e., believing that eating and/or avoiding several nutrients can help treat or avoid certain diseases) [3,4], and therefore spend most of their time planning, purchasing, and eating "healthy" meals and avoiding or even eliminating entire categories of food perceived as unhealthy [5]. When their personal dietary rules are transgressed, individuals with ON are believed to experience excessive concern and guilt and to further engage in subsequent compensatory behaviors (e.g., intensifying restrictions, excessive exercice or 'cleanses' which reflects a highly restrictive and selective food and/or liquid consumption aiming to rid the body of substances perceived as unhealthy) [4,6]. ...
... When their personal dietary rules are transgressed, individuals with ON are believed to experience excessive concern and guilt and to further engage in subsequent compensatory behaviors (e.g., intensifying restrictions, excessive exercice or 'cleanses' which reflects a highly restrictive and selective food and/or liquid consumption aiming to rid the body of substances perceived as unhealthy) [4,6]. These behaviors are further suggested to result in significant physical, psychological, and social impairments [3,4,7]. Indeed, many studies reported that ON could result in significant weight loss, malnutrition, and other medical complications (e.g., bradycardia, metabolic acidosis etc.) [3,4,7], as well as disruption of social relationships and social isolation (i.e., hiding away, avoiding friends and family who do not share similar beliefs and eating patterns, refusing other's opinions on diet) [8,9]. ...
... These behaviors are further suggested to result in significant physical, psychological, and social impairments [3,4,7]. Indeed, many studies reported that ON could result in significant weight loss, malnutrition, and other medical complications (e.g., bradycardia, metabolic acidosis etc.) [3,4,7], as well as disruption of social relationships and social isolation (i.e., hiding away, avoiding friends and family who do not share similar beliefs and eating patterns, refusing other's opinions on diet) [8,9]. ...
Article
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Background The profile of adolescents with orthorexic eating behaviors remains to be explored. This study is the first to explore the typology of Lebanese adolescents from a large non-clinical sample based on orthorexia nervosa (ON) and healthy orthorexia (HO). Method A total of 555 adolescents (aged between 15 and 18 years) completed a set of questionnaires assessing orthorexic behaviors, self-esteem, stress, depressive and anxiety symptoms. Cluster analysis based on ON and HO scores was used to identify the typology of the sample. More precisely, this analysis was used to reveal and distinguish between naturally occurring subgroups of individuals with different orthorexic eating profiles, within the studied sample. Further, a series of one-way ANOVA was used to compare observed clusters based on their scores on used questionnaires. This analysis was used to capture the behavioral and psychological differences between previously yielded subgroups of individuals. Results Cluster analysis based on ON and HO scores yielded 3 distinct groups: “Low orthorexia”, “Moderate in-between orthorexia” and “High in-between orthorexia”. While the first group represented individuals with no particular (healthy or pathological) interest in healthy eating, the two latter groups represented those with respectively moderate and high degrees of an interest in healthy eating that has both pathological and healthy aspects. Significant differences between clusters regarding their levels of stress, depression, anxiety and self-esteem was observed, yet they were found to be negligible due to poor effect sizes. Conclusion Findings from this study suggest that ON and HO can indeed co-occur among adolescents, that this co-occurrence can be experienced at different severity levels. Low effect sizes for ANOVA comparisons may suggest the possibility of the co-occurrence of ON and HO reducing the negative effects of ON behavior to some degree. The potential role of confusion around what constitutes "healthy eating" in the emergence of these "in-between orthorexia" profiles is put forward.
... Those with the symptoms of orthorexia nervosa eliminate products containing preservatives, colour additives, food flavouring, pesticides, excessive fat, sugar, salt, or genetically modified food from their diets [2][3][4]. They rely on foods coming from ecological farming [5,6]. A list of acceptable foods may be subject to individual variation, yet what is characteristic of ON is a gradual intensification of imposed diet ary restrictions. ...
... A list of acceptable foods may be subject to individual variation, yet what is characteristic of ON is a gradual intensification of imposed diet ary restrictions. A cause of obsessive thoughts can be the process of food preparation itself (e.g., use of natural materials, preference of earthenware and wooden products over aluminum) or a menu preparation and food purchase [1,[6][7][8]. Meals are prepared with the utmost care and attention, and any deviation from the imposed norms leads to a feeling of fear, guilt, shame, and further dietary restrictions [1,6,9]. ...
... A cause of obsessive thoughts can be the process of food preparation itself (e.g., use of natural materials, preference of earthenware and wooden products over aluminum) or a menu preparation and food purchase [1,[6][7][8]. Meals are prepared with the utmost care and attention, and any deviation from the imposed norms leads to a feeling of fear, guilt, shame, and further dietary restrictions [1,6,9]. ...
Article
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The aim of this article is to present the up-to-date diagnostic tools of orthorexia and markers of its prevalence on the basis of the available literature. The authors searched PubMedCentral (PMC) and Google Scholar with the search entry of “orthorexia”, “orthorexia nervosa”, and “orthorexicbehaviours”. We describe the tools of evaluation of orthorexicbehaviour (i.e., orthorexia self-test—BOT, the ORTO-15 questionnaire, Eating Habits Questionnaire—EHQ, Düsseldorf Orthorexia Scale—DOS, Teruel Orthorexia Scale—TOS, Barcelona Orthorexia Scale—BOS, and Orthorexia Nervosa Inventory—ONI), and offer a review of the studies on orthorexia nervosa. We conclude that there are no reliable data regarding the prevalence of orthorexia nervosa. The available studies point to significant differences in the prevalence depending on the value of cut-off points and tools used. The prevalence varies across countries and across populations, ranging from 6.9% in the Italian population to 88.7% in the group of Brazilian students of dieting. Thus, it indicates that some groups seem to be susceptible to the risk of ON more than others. It is a challenge to determine the prevalence of orthorexia, and any obtained results should be treated with caution. Consequently, we claim that the use of the ORTO-15 questionnaire to diagnose orthorexia is questionable due to a high percentage of falsely positive results.
... In the book, he describes the symptoms that characterize this disorder, including an obsessive focus on the quality of consumed products and the ways in which meals are prepared [1]. Additional symptoms of the orthorectic disorder include thoroughly analyzing the source, production and packaging process of foods available on the market [2,3] and excluding foods considered unhealthy or impure [4][5][6][7]. People with orthorectic disorders often limit or completely eliminate specific food groups, such as meat, dairy products, grains, ready meals, non-seasonal products [1], genetically modified foods high in fat, salt or sugars, foods that contain pesticides and sensitizing substances [8]. ...
... People with orthorectic disorders often limit or completely eliminate specific food groups, such as meat, dairy products, grains, ready meals, non-seasonal products [1], genetically modified foods high in fat, salt or sugars, foods that contain pesticides and sensitizing substances [8]. It is also common practice to eat food derived exclusively from organic farming that does not contain artificial substances or preservatives [2,9]. For people with an ON disorder, food is primarily a source of health, not pleasure. ...
... The development of ON may be triggered by a doctor's/dietitian's recommendations regarding the use of a proper diet, the desire to overcome chronic diseases, negative life events and mental disorders. Risk factors can include the use of alternative diets (e.g., vegetarian, vegan, macrobiotic), nutritional restrictions or a desire to live in harmony with nature [1,2]. From a medical point of view, a direct effect of a selective approach to diet may cause nutrition deficiency, leading to malnutrition and weight loss [1,2,[10][11][12]. ...
Article
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The aim of this work was to assess orthorectic behaviors among young people and to evaluate their attitudes towards caring for their health. The study was conducted in 2019 on a group of 538 respondents aged 16–35. After analysis, 65 questionnaires were eliminated from further research, and the assessment of orthorectic disorders was performed using a method based on the modified ORTO-15 questionnaire on a group of 473 respondents. A large percentage of them exhibited an increased risk of orthorectic behaviors (32.8), which was higher among women than men (34.7% and 28.2%, respectively). People with higher risks of orthorectic disorders significantly more often reduced their consumption of foods high in fats and sugars. Attitudes of people with orthorectic disorders towards health care proved neutral, with a tendency to be positive. Nutritional behaviors observed in the studied group show some irregularities, which indicates the need for preventive and educational measures aimed at increasing awareness of the role of proper nutrition among young people. The obtained results may be the basis for further research on ON symptoms. One of the major areas of future research would be to create a reliable diagnostic tool which would allow for distinguishing between orthorexia and overdiagnosis.
... El paciente con ortorexia nerviosa, inicialmente desea mejorar su salud, tratar una enfermedad o perder peso, convirtiéndose finalmente la dieta, en el centro de su existencia: las actividades cotidianas están dominadas por la planificación, la compra y la preparación de comidas "adecuadas", con extrema rigidez respecto a los estándares de nutrición auto-impuestos 10,11 . Atribuye características que muestran sus sentimientos específicos hacia los alimentos: "peligrosos" (para describir un producto conservado), "artificiales" (para aquellos producidos industrialmente), "saludables" (para los biológicos) y demuestra un fuerte o incontrolable deseo de comer cuando se siente nervioso, emocionado, feliz o culpable 12 . ...
... Se le aumentó la dosis de fluoxetina a 50 mg/ día, principalmente por su efecto anti-obsesivo y anti-bulímico, observándose una mejoría de su sintomatología (en el sentido de flexibilizar sus horarios, su modalidad de cocinar y tipos de nutrientes), conjuntamente con sesiones de psicoterapia cognitivo-conductual. en los más deprimidos, sin diferencias de género o edad. Las mujeres, los adolescentes y quienes practican deportes como el físico-culturismo o enfatizan la estética, también son grupos con mayor riesgo, conjuntamente con varones estudiantes de medicina, en los que hubo una tendencia mayor estadísticamente significativa para la ortorexia nerviosa 11,19 . ...
... En la práctica clínica, la ortorexia nerviosa se debe diferenciar principalmente con los siguientes trastornos 11,20,21,22,23 : ...
Article
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Background: Several studies have provided evidence on orthorexia nervosa, a syndrome characterized by an extreme and drastic healthy eating pattern, which has been the focus of growing interest. However, there is a scientific debate as to whether it is simply a behavioural phenomenon, a lifestyle or a mental disorder. Objective: A descriptive analysis of the evidence about orthorexia nervosa: epidemiological, nosological, clinical and therapeutic aspects were discussed. Method: A narrative qualitative bibliographic search on orthorexia nervosa and other eating disorders was carried out using Medline/ PubMed, SciELO databases and specialized texts. Results: It is controversial whether orthorexia nervosa is a unique eating disorder or a consequence of its outcome or an obsessive-compulsive process. It can precede, occur, or coexist along with eating disorders and also may affect eating habits. A history of eating disorder is a significant predictive factor for the development of orthorexia nervosa. Some authors have differentiated between an orthorexia oriented towards the interest in a healthy diet (healthy orthorexia) and another related to a pathological concern about eating healthy (orthorexia nervosa). Conclusions: Many psychological and behavioural features of eating disorders are shared by orthorexics. Future longitudinal research is needed to analyse the temporal relationship between these and other issues to include orthorexia nervosa within the spectrum of eating disorders.
... Specific and stringent behaviours around food may be accompanied by magical beliefs about and a hierarchizing of food types, items, and groups (Moroze et al., 2015;Saddichha et al., 2012). Amongst "orthorexic" behaviours, controlling times of day (Moroze et al., 2015) or the mechanics of chewing and swallowing (Zamora et al., 2005) have been reported. Despite a focus on "health", these behaviours can lead to significant psychosocial impairment and medical complications (e.g. ...
... Despite a focus on "health", these behaviours can lead to significant psychosocial impairment and medical complications (e.g. hormone imbalances, malnutrition, gastrointestinal issues, osteoporosis, etc.) Moroze et al., 2015;Saddichha et al., 2012;Zamora et al., 2005). ...
Article
There is a fine line between eating and exercising “for one's health” and adopting obsessive dietary practices. Not currently recognised in the DSM-5, Orthorexia Nervosa is a proposed eating disorder characterized by an unhealthy obsession with eating healthy foods. In this study, we explored people's self-identified experiences of highly significant dietary and exercise practices, which whilst considered to be healthful may paradoxically have become problematic or resulted in dysfunction. Fifteen participants took part in semi-structured interviews. We used reflexive thematic analysis through a post structuralist theoretical lens to analyze the data, and developed three key themes: (1) feeling good and looking good; (2) relationality; (3) disordered or healthy. Daily health practices were understood as positive acts of self-care which were motivated by a range of embodied experiences and entangled within social relationships. Each theme also highlighted how sociocultural influences such as healthism and post-feminist discourses impacted upon participants food choices, exercise engagement and appearance goals—often producing contradictory understandings of what was considered to be (un)healthy. Overall, findings indicate that achieving ‘a healthy balance’ may be easier said than done and points to the need for nuanced analyses of the tensions that exist within first-person accounts of engaging with “health” in both “healthful” and potentially problematic ways.
... They care about the healthy and additive-free foods they will use at an extremely obsessive level. They are also concerned about the methods and materials used during food preparation, and they refuse the consumption of different foods according to their composition or preparation [9]. For this reason, most of what they will consume is raw. ...
... According to the literature, women and adolescents are in the higher risk group for ON [8,9]. In terms of gender factor, literature data show that ED is seen 8-12 times more frequently in female population than men [19]. ...
... Any deviation from the strict norms can lead to feelings of fear, guilt, shame, and further dietary restrictions. [16,17,18,19] According to Varga et al., ON should be viewed not as a separate condition but as a spectrum, with one end representing a healthy diet and the other a pathological obsession with healthy eating habits. [20] Bratman proposed two stages in the development of ON: a normal interest in healthy eating without pathological features, and orthorexia nervosa, marked by an obsessive focus on healthy eating. ...
Article
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Introduction: Eating disorders have expanded rapidly in recent years, with social media platforms like Instagram and TikTok playing a significant role. These platforms often showcase idealized images of healthy eating and body image, exposing young people to an overwhelming amount of information. This overstimulation can contribute to the development of various eating disorders. In our study, we focus particularly on orthorexia nervosa. Review methods: Our study was conducted as a literature review, with data gathered from PubMed and Embase. The state of knowledge: Orthorexia Nervosa (ON), introduced by Steven Bratman in 1997, could be defined as an unhealthy obsession with healthy eating. This obsession leads to strict dietary restrictions, where individuals often exclude certain food types, such as preservatives and GMOs, and experience significant stress and anxiety over food choices, planning, and preparation methods. The fixation on food purity can result in social isolation, anxiety, and major disruptions to daily life. In comparison to other eating disorders like anorexia nervosa and obsessive-compulsive disorder (OCD), ON is characterized by its focus on food quality rather than body image or weight. Conclusions: The classification of orthorexia as a mental disorder and the need for its recognition in DSM-5 are still debated. However, growing concern about its impact on mental and physical health has led to increased research and awareness.
... El paciente ortoréxico, comienza tratando de optimizar su salud, pero progresivamente su quehacer cotidiano va supeditándose a la planificación, la adquisición y la preparación de comidas con acentuada inflexibilidad en pro de la mantención de sus pautas nutricionales auto-asignadas (10,11) , clasificando los alimentos en "peligrosos" (productos conservados), "artificiales" (producidos industrialmente), "saludables" (orgánicos) (12) . La falta de cumplimiento de estas reglas, le provoca ansiedad, culpa y mayor empeño en redoblar sus esfuerzos para lograr su cometido. ...
Article
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Introducción: Existe una creciente evidencia investigativa sobre la relación entre el síndrome ortoréxico y el perfeccionismo. Objetivo: Se efectúa un análisis descriptivo interpretativo e integrador acerca de la relación entre el perfeccionismo con la ortorexia nerviosa, destacando los aspectos clínicos, etiopatogénicos y nosológicos. Método: Se realizó una búsqueda bibliográfica sobre la relación entre el síndrome ortoréxico y el perfeccionismo mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: El término ortorexia se ha concebido como una fijación patológica hacia una alimentación equilibrada y saludable (Bratman, 1997), implicando restricciones dietéticas drásticas, con interferencia significativa en las relaciones sociales e insatisfacciones afectivas, que, además favorecen la conducta alimentaria desadaptativa. Etiopatogénicamente, existe controversia respecto a si es un mero estilo de vida, o puede incluirse definitivamente como un trastorno en los espectros alimentario u obsesivo-compulsivo. De hecho, posee similitudes, diferencias e incluso traslapes con ambas entidades psicopatológicas. Se destaca como rasgo relevante común, el perfeccionismo, orientado hacia sí mismo, hacía los demás, y socialmente prescrito, que favorece la tendencia a desarrollar conductas ortoréxicas elevadas. Conclusiones: El perfeccionismo surge como una característica sobresaliente, positivamente correlacionada con el síndrome ortoréxico, cuya presencia se superpone con los ámbitos, tanto alimentario (especialmente la anorexia nerviosa) como obsesivo-compulsivo.
... As such, consuming "unhealthy" foods is emotionally distressing and often associated with a fear of disease, shame, and/or anxiety [1]. Subsequently, individuals demonstrating orthorexic tendencies can become socially isolated, avoiding situations where they are unable to control food quality [12,13]. Further, individuals can eliminate entire food groups resulting in malnutrition [6]. ...
Article
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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).
... Orthorexia nervosa is defined as an excessive mental preoccupation with healthy eating and healthy foods [28]. The term orthorexia is derived from the Greek words "orthos," meaning "right, appropriate," and "orexis," meaning "appetite" [29]. Orthorexia nervosa was first described by Steven Bratman in 1997 [30]. ...
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Food neophobia, known as an avoidance of the consumption of unknown foods, can negatively impact nutritional quality. In orthorexia nervosa, there is an excessive mental effort to consume healthy food. Individuals exhibiting symptoms of food neophobia and orthorexia nervosa may experience food restrictions. This study aimed to assess food neophobia levels and orthorexia nervosa tendencies among university students, investigate the potential association between the two constructs, and explore the effect of the demographic characteristics of the participants on the variables. This is a descriptive cross-sectional study. The study sample consisted of 609 students enrolled at Recep Tayyip Erdoğan University. The data were collected through Google Forms using a sociodemographic information form, the Food Neophobia Scale, and the ORTO-11 scale. Ethics committee approval and institutional permission were obtained for the study. Of the students participating in the survey, 71.9% were female, 14.6% were classified as neophobic, and 47.1% had orthorexia nervosa symptoms. The mean scores from the Food Neophobia Scale (39.41 ± 9.23) and the ORTO-11 scale (27.43 ± 5.35) were in the normal range. Food neophobia was significantly higher among those who did not consume alcohol. Orthorexia nervosa symptoms were significantly more common among married people. In the correlation analysis, no significant relationship was found between age, food neophobia, and orthorexia nervosa. It can be said that food neophobia in this study is similar to in other studies conducted on university students. In addition, about half of the participants had symptoms of orthorexia nervosa. This result is higher compared to other studies conducted with university students. The findings of this study indicate that the participants care about the healthfulness of food.
... Most studies have shown that vegetarians (including vegans) are more likely to exhibit orthorexic tendencies than omnivores, regardless of the assessment tool (Missbach et al. 2015;Dell'Osso et al. 2016;Dittfeld et al. 2016;Dell'Osso et al. 2018;Brytek-Matera et al. 2019;Heiss et al. 2019;Luck-Sikorski et al. 2019;Parra-Fernández et al. 2020;Brytek-Matera 2020a;2020b;Hessler-Kaufmann et al. 2021;Dell'Osso et al. 2022;Gwioździk et al. 2022;Maïano et al. 2022;Novara et al. 2022;Şentürk et al. 2022). More specifically, ON was reported more frequently in vegetarians, pesco-vegetarians, vegans, and fruitarians (a fortiori vegans), but also in individuals following a paleo, gluten-free, or raw-food diet (Catalina et al. 2005;Dittfeld et al. 2017;Strahler et al. 2018;Ferreira and Coimbra 2021). ; These results are consistent with those reporting a stronger health motivation for food choices among vegetarians Siebertz et al. 2022). ...
Article
The vegetarian diet is becoming increasingly popular among the general population and has been accompanied by an increasing number of publications in the last twenty years. However, the spread of selective diets raises some questions, especially with regard to health. This review examines studies on vegetarianism published between 2000 and 2022 that investigated the associations between this diet, weight, and eating disorders. The descriptive studies conclude that vegetarians have a lower body mass index, and the interventional studies show the value of a vegetarian diet for weight loss. While some studies suggest that vegetarianism may be associated with orthorexia nervosa, the results regarding the association between vegetarianism and eating disorders are more heterogeneous and depend on the type of samples and dimensions studied. The heterogeneity of these findings is discussed in light of the methodological limitations of the studies to provide perspectives for future research.
... Zamora et al. stated that the obsessive-compulsive mechanisms and personality traits of patients with ON were similar to those of patients with the restrictive anorexia nervosa type [11]. Arusoğlu et al. found that deterioration in eating attitudes and obsessive-compulsive symptoms were associated with orthorexic tendencies [12]. ...
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Background: In recent years, there has been a dramatic increase in awareness in society that healthy nutrition has positive effects on health. However, obsession with these behaviors towards healthy foods causes negative effects on health and quality of life. Aim: The aim of this study was to elucidate the relationship between the incidence of orthorexia nervosa (ON) in medical school students and the level of conscious awareness, obsessive-compulsive disorder, eating attitudes and behaviors, health anxiety, and body image to clarify the unclear issues in the literature, such as whether orthorexia nervosa is among the psychological disorders, "where" it will take place, and which diagnoses it can be associated with. Methods: Students between the 1st and 6th grades of medical school were invited to participate in this research. The Sociodemographic Data Form, Maudsley Obsessive-Compulsive Question Index (MOCI), Eating Attitude Test Short Form (EAT SF-26), Health Anxiety Inventory-Weekly Short Form (HAI-SF), ORTO-11 scale, Body Perception Scale, and Conscious Awareness Scale have been applied to the students. Results: In univariate analysis, the eating disorder scale, body image scale, and awareness scale total scores all had an impact on orthorexia. Each increase in the eating disorder scale score increased the diagnosis of orthorexia 1.07 times, while each increase in the body image scale score increased the diagnosis of orthorexia 1.09 times. Additionally, each increase in the conscious awareness scale score decreased the diagnosis of orthorexia by 0.92 times. When all variables were re-evaluated in the multivariate analysis, it was seen that the total scores of the body image scale and conscious awareness scale affected the diagnosis of orthorexia. There was a weak inverse relationship between the orthorexia scale score and only the health anxiety inventory total score (p<0.05). Conclusion: Regarding the outcomes of this research, one can say that orthorexia affected the eating disorder scale, body image scale, and awareness scale total scores. While the increase in the eating disorder and body image scale scores increased orthorexia, the increase in the conscious awareness scale score had a decreasing effect.
... Several definitions and diagnostic criteria for ON have since been proposed, but consensus has so far not been reached, and ON is yet to be included as a formally recognised disorder in any psychiatric diagnostic system [22]. Papers about its prevalence and its correlates as well as case studies seemed to make up a major proportion of the academic literature regarding ON [21,[23][24][25]. ...
Article
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Aim Orthorexia Nervosa (ON) describes a pathological obsession with proper and high-quality nutrition that is necessary to research further in order to elucidate its prevalence and correlates which may bear implications for prevention and treatment. The aim of this study was to review studies that report the prevalence of ON in people who exercise, calculate an overall prevalence through a random-effects meta-analysis approach and investigate the association of ON prevalence using a random-effects meta-regression. In addition, a sub-group-analysis based on ON-instruments and a sensitivity analysis excluding students samples, were conducted. Method Systematic searches were conducted in the following online databases: PubMed, Embase, Web of Science, PsychInfo, CINAHL, Google Scholar and OpenNet. The following search terms were used: Orthore* AND (prevalenc* OR incidenc* OR frequen* OR cut-off OR epidem*). A total of 613 unique hits were reviewed by two blinded authors, and 24 studies were coded and assessed for risk of bias (Holy et.al). The meta-regression included three independent variables (sex, type of sport, and sample size). Results The overall prevalence of ON in the exercising population was 55.3% (95% CI 43.2–66.8). Cochran’s Q was 11,436.38 (df = 23, p < 0.0000), and the I² was 98.4%, indicating high heterogeneity across studies. The sensitivity showed an overall prevalence of 51.3% (95% CI 51.3–70.0). There was a significant difference in prevalence estimates based on the instruments used (Qbet = 33.6, df = 2, p < 0.01). Discussion The overall prevalence of ON in exercising populations was very high. The between-study disparity was large and was partly explained by the ON-instrument administered. One fourth of the studies had a moderate risk of bias. The majority of the studies did not specify relevant demographic information about the sample, and information about the type of sport was frequently missing.
... ON has several symptoms, including avoidance of food additives such as preservatives, colors, avorings, pesticides, excessive fat, sugar and salt, or genetically modi ed organism [3,4]. In addition, individuals with ON may be obsessed with cooking methods and tools in the food preparation process, and may feel guilt and fear when they go beyond their norms in this process [1,5]. Thoughts on healthy nutrition, food preparation, and labeling of foods can negatively affect both quality of life and social life in individuals with ON [6]. ...
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Background There are several scales to evaluate orthorexia nervosa (ON), a pathological obsession, fixation or preoccupation with healthy foods. However, studies report that some of these scales have poor internal consistency and some do not have test-retest reliability, therefore new scales are needed to evaluate ON correctly. This study aims to adapt the Test of Orthorexia Nervosa-17 (TON-17) into Turkish and verify its validity and reliability. Methods The study included a total of 539 adults, 131 men (24.3%) and 408 women (75.7%), with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed and a confirmatory factor analysis (CFA) to test its construct validity. Time invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test relationships between the scale and other theoretically relevant instruments (EAT-26 and OBQ-9). Analyses were conducted using SPSS Version 23 and the AMOS program. Results The Cronbach's α internal consistency coefficient of the total scale was found to be 0.820, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.681 for the Factor 1, 0.643 for the Factor 2, and 0.726 for the Factor 3. In addition, the test-retest reliability was found as 0.868 for the total scale, suggesting an excellent reliability. The most of fit indices (CMIN/df, RMSEA, AGFI, NFI and TLI) of the scale were acceptable, and the GFI indicated a good model fit. Conclusion This study has shown that the Turkish version of TON-17, which is a new tool with three-factor structure to evaluate both healthy and unhealthy orthorexia, is valid and reliable scale. Studies of TON-17 on diverse cultures will contribute to the literature. Therefore, examining the validity and reliability of TON-17 in diverse cultures and populations may contribute to developing the gold standard scale for evaluating ON in future studies.
... Orthorexia is characterized by a pathologic obsession for biologically pure foods, free of herbicides, pesticides, and other artificial substances. Excessive worry about the techniques and materials used in the food elaboration leads to obsession, loss of social relationships, affective dissatisfactions, and obsessive thoughts about foods [3]. Tendency of Orthorexia Nervosa is estimated using ORTHO-15 questionnaire. ...
Article
Background: Orthorexia nervosa (ON) is characterised by an obsession with healthy eating, which may lead to severe physical, psychological and social disorders. It is particularly important to study this problem in order to improve early detection and treatment. Aim and Objective: The aim of this study was to estimate the prevalence of Orthorexia Nervosa in among medical students in Chennai. Materials and Methods: Cross-sectional study done at a medical college, among undergraduate medical students. After institutional ethical committee approval, the study was conducted on 306 students. Sociodemographic details were collected and ORTHO-15 questionnaire was used to estimate the prevalence of Orthorexia Nervosa. Data was entered in excel and analysed using SPSS version 22. Chi-square test and Multiple logistic regression were used for data analysis. p- value < 0.05 was considered as statistically significant. Results: The prevalence of Orthorexia Nervosa among undergraduate medical students was 69.93% (95% CI 64.46 to 75.02%). No significant association was found between age group, gender, BMI category, place of stay and Orthorexia Nervosa. Conclusion: Orthorexia Nervosa tendency is common among medical students. Better awareness of healthy eating will help prevention of the problem.
... Unlike AN or BN, ON is not formally recognized as a mental health disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [27] or in the International Classification of Diseases, Eleventh Revision (ICD-11) [28] A potential reason is mixed findings in the literature about the distinction between ON, AN, and BN [5]. For instance, several case reports showed that body image concerns were absent among people with ON and that any weight loss was simply a by-product of striving to eat healthily [5,29,30]. In contrast, other research found an association between ON symptoms and body image constructs, such as implicit and explicit body image attitudes [31], and body dissatisfaction [1,32,33]. ...
Article
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Purpose Orthorexia nervosa (ON) involves a maladaptive preoccupation with healthy eating through strict dietary rules that negatively affect physical and mental health. Recent evidence suggests that ON symptoms may stem, in part, from having a health-focused self-concept (i.e., overvaluing the importance of health for self-definition and self-worth). Herein, fear of losing control over eating unhealthy foods and disgust for unhealthy foods were examined as potential mediators of the association between health-focused self-concept and ON symptoms. Methods The parallel mediation model was tested using a community sample of people who believe they are currently following a healthy eating diet plan and/or believe they are leading a healthy eating lifestyle (N = 442). Participants were recruited from Amazon’s Mechanical Turk and completed a questionnaire battery that included the Health-Focused Self-Concept Scale, questionnaires assessing fear of losing control over eating unhealthy food and disgust with unhealthy food, and the Orthorexia Nervosa Inventory. Results As expected, a health-focused self-concept was indirectly and positively associated with ON symptoms via fear and disgust. Conclusion The findings conceptually replicate and extend prior research on anorexia nervosa supporting the transdiagnostic utility of a focused self-concept, fear of losing control, and disgust across eating disorders. Level of evidence Level V, cross-sectional descriptive study.
... Orthorexia is characterized by a pathologic obsession for biologically pure foods, free of herbicides, pesticides, and other artificial substances. Excessive worry about the techniques and materials used in the food elaboration leads to obsession, loss of social relationships, affective dissatisfactions, and obsessive thoughts about foods [3]. Tendency of Orthorexia Nervosa is estimated using ORTHO-15 questionnaire. ...
Article
Background: Orthorexia nervosa (ON) is characterised by an obsession with healthy eating, which may lead to severe physical, psychological and social disorders. It is particularly important to study this problem in order to improve early detection and treatment. Aim and Objective: The aim of this study was to estimate the prevalence of Orthorexia Nervosa in among medical students in Chennai. Materials and Methods: Cross-sectional study done at a medical college, among undergraduate medical students. After institutional ethical committee approval, the study was conducted on 306 students. Sociodemographic details were collected and ORTHO-15 questionnaire was used to estimate the prevalence of Orthorexia Nervosa. Data was entered in excel and analysed using SPSS version 22. Chi-square test and Multiple logistic regression were used for data analysis. p- value < 0.05 was considered as statistically significant. Results: The prevalence of Orthorexia Nervosa among undergraduate medical students was 69.93% (95% CI 64.46 to 75.02%). No significant association was found between age group, gender, BMI category, place of stay and Orthorexia Nervosa. Conclusion: Orthorexia Nervosa tendency is common among medical students. Better awareness of healthy eating will help prevention of the problem.
... Previous studies assessing the prevalence of OrNe among vegetarians and vegans report contradictory results. Some studies have suggested that OrNe is more common in people who follow a plant-based diet than an omnivorous diet [21,22], whereas others do not report significant differences between groups [23,24]. ...
Article
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Purpose The obsession with healthy eating associated with restrictive behaviors is called Orthorexia Nervosa (OrNe). Nevertheless, some studies suggest that orthorexia can also be a non-pathological interest in healthy eating which is called Healthy Orthorexia (HeOr). First, one of the main objectives of this study is to compare HeOr, OrNe and eating behaviors in different dietary patterns (vegan, vegetarian and omnivore). Second is to reveal the relationship between HeOr, OrNe and eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating). Lastly, to determine the potential predictors of HeOr and OrNe. Methods Participants (N = 426 with an omnivorous diet; N = 415 with a vegan diet, N = 324 with a vegetarian diet) completed a web-based descriptive survey, the Teruel Orthorexia Scale and the Three-Factor Eating Questionnaire-R 21. Results HeOr and OrNe were more common in individuals following both vegan and vegetarian diets. Individuals following a vegan or a vegetarian diet had lower body mass index and higher body image satisfaction than individuals following an omnivorous diet. Cognitive restraint and following a vegan or a vegetarian diet were the two main predictors of both HeOr and OrNe. Cognitive restraint was positively associated with both HeOr and OrNe (more strongly correlated with OrNe), whereas uncontrolled eating and emotional eating behaviors were positively related to OrNe and negatively related to HeOr. Conclusion The present study contributes to a better understanding of the some similarities and differences between HeOr and OrNe. It also points to higher rates of orthorexia in individuals following a vegan or vegetarian diet and represents a further step towards developing prevention and intervention programs by identifying risk factors for OrNe. Level V Cross-sectional descriptive study.
... Orthorexic individuals, unlike other nutritional disorders, are concerned with the content and quality of the food, not the quantity (Gezer and Kabaran, 2013). Orthorexic individuals are worried not only about the purity of the food, but also about the food preparation process, the cooking technique applied, the sterilization of the tools used, and they do not consume the foods they do not trust (Zamora et al., 2005). This situation causes nutritional deficiencies after a while and causes serious diseases such as bradycardia, hyponatremia, osteopenia, and metabolic acidosis observed in other eating disorders (Koven and Abry, 2015). ...
Article
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Bodybuilding is a sport that challenges the individual both physically and mentally. The fact that this sport demands significant investment to one's body can affect the perception of the body over time. Such investments can be shaped by physical activities as well as by diet. The main purpose of this study is to investigate the relationship between sports motivation, muscle perception disorder and orthorexia nervosa in male individuals engaged in bodybuilding. 200 male individuals actively engaged in bodybuilding in TRNC participated in the study. Sociodemographic information form, Sports Motivation Scale-II, Ortho-11 and Muscle Perception Disorder Inventory were applied to the individuals participating in the study. SPSS 26 program was used to analyze the data. Descriptive analyzes of demographic variables of individuals, lowest and highest scores, mean and standard deviations were included in the study. In the study, relationships between scale scores were determined by using Pearson correlation, comparisons t-test analysis method. The results show that individuals who are engaged in bodybuilding have higher intrinsic motivation rather than external motivation. Significant difference is observed between use of ergogenic supplements and muscle perception disorder. As muscle perception disorder increases orthorexia neurosis will also increase (p<0.05). Motivations of individuals who are engaged in bodybuilding should be examined and proper information should be given to trainers and students about both muscle perception disorder, orthorexia neurosis and the use of ergogenic supplements
... In line with Zikgraf et al., [24], we anticipated that the EDs-related symptomatology is more associated with functional impairments. We also expect the number and qualities of diets (i.e., vegetarians, vegans) to be associated with any ON construct [32,54,55]. ...
Article
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Purpose Orthorexia Nervosa (ON) is characterised by excessive attention to a dietary regimen perceived as healthy. A critical factor in the distinction between ON and other eating disorders (EDs) is the dichotomy of quality-versus-quantity of food intake. We investigated whether specific types of diet or dieting frequency are associated with orthorexic features, explored the overlap between ON and EDs symptoms, and examined which constructs are predictive of ON after 6 months. Methods A total of 1075 students (75.1% female, mean age 20.9) completed a set of questionnaires assessing Orthorexia, Eating Disorders, Obsessions and Compulsions, Anxiety and Depression; 358 individuals (79.9 female, mean age 20.9) agreed to participate in the study and completed the same questionnaires after 6 months. Different regression models were defined to investigate our hypothesis. Results Findings suggest that ON is associated with the number and type of diets followed over a lifetime. Moreover, participants with EDs, body dissatisfaction, or a dysfunctional idea of thinness are more likely to report a greater degree of ON features. After 6 months, the best predictors of ON characteristics are the same ON characteristics assessed at the first administration, with a significant role in the ideal of thinness. Conclusions ON is more frequent in individuals with a previous diagnosis of EDs and in individuals who followed a restrictive diet or a vegan/vegetarian one; the number of lifetime diets, beliefs, and behaviors related to the ideals of thinness or body dissatisfaction is common features of ON. Moreover, considering that having ON features in the past is the best ON predictor in the present, we can presume that ON is a construct stable over time. Level of evidence Level IV: Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).
... Case studies (e.g., [37]) and quantitative research link orthorexic symptoms to somatic disorders [38,39], and researchers have suggested that hypochondriasis should be a differential diagnosis for orthorexia nervosa [7,10]. Despite the theorized connection (e.g., [8,18,40]), scant research explores the relationship between somatic concerns and orthorexia nervosa. ...
Article
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Background Scholarly investigation into orthorexia nervosa is relatively new, leading several scholars to develop new measures to adequately assess the concerns thought to underlie this condition. A promising new measure of orthorexia, the Teruel Orthorexia Scale (TOS), was developed using a Spanish sample. Purpose This study was the first to investigate the psychometric properties of the English version of the TOS in a U.S. sample. This study also examined the long-hypothesized relationship between orthorexia and health anxiety. Methods We used exploratory factor analysis (EFA) to evaluate the factor structure of the TOS. We also used correlational methods to test theorized relationships with related concerns. Results ESEM supported a 16-item, 2-factor model. Correlations between the modified TOS (i.e., TOS-16) subscales and measures of obsessive–compulsive and eating disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS-16. There was a moderate positive correlation between orthorexia nervosa and health anxiety and, together, pursuit of healthy eating and preoccupation with healthy eating accounted for a significant amount of variance in health anxiety after controlling for eating disorder symptoms. Conclusion Overall, this research suggests that the TOS-16 demonstrates psychometric properties as good as or better than other measures commonly used to assess the construct in a U.S. sample. In addition, findings support the consideration of health anxiety as a possible feature of orthorexia nervosa. Level of evidence Level V, descriptive research.
... Enfin, cette étude ne permet pas d'identifier les cognitions impliquées dans l'apparition, le maintien ou l'aggravation du comportement orthorexique. Si certains auteurs (Catalina Zamora, Bote Bonaechea, Garcia Sanchez & Rios Rial, 2005 ;Lopes, Melo, & Dias Pereira, 2018 ;Moroze et al., 2015) ont mis en évidence la présence de cognitions dysfonctionnelles telles que la rigidité cognitive, la catégorisation rigide des aliments comme étant « bons » ou « mauvais pour la santé », l'attribution d'un caractère magique et spirituel à la nourriture ou encore la peur exagérée de la maladie, leurs travaux reposent sur des études de cas qui ne peuvent faire l'objet de généralisations à l'ensemble des individus souffrant d'orthorexie. La prise en compte de ces cognitions et de leur évolution constitue un point central en vue de la mise en place d'interventions psychologiques adaptées afin de prendre en charge les patients orthorexiques. ...
Article
Résumé Introduction L’orthorexie est décrite comme l’obsession pathologique pour l’alimentation saine. Les résultats de la majorité des études, utilisant principalement l’échelle ORTO-15, restent limités à certains pays et ne peuvent être généralisés à toutes les cultures. Des études récentes suggèrent d’inclure l’image du corps dans la recherche sur l’orthorexie, en plus des troubles de conduites alimentaires. Objectif L’objectif de cette étude était de proposer une adaptation française de l’échelle ORTO-15 en utilisant la procédure de validation transculturelle de Vallerand, d’explorer ses propriétés psychométriques et les liens entre le comportement orthorexique, les symptômes des troubles de conduites alimentaires et l’image du corps. Méthode Quatre cent neuf jeunes adultes (89 % de femmes), ont complété les échelles suivantes en ligne : ORTO-15, les affirmations de Dunn et al. (2016), le Eating-Attitudes Test (EAT-26), le Binge Eating Scale (BES) et le Multidimensional Body Self Relations Questionnaire-Appearance Scale (MBSRQ-AS). Les analyses factorielles exploratoire (AFE) et confirmatoire (AFC) ont été réalisées sur deux échantillons aléatoires et les liens entre différentes variables ont été explorés avec des coefficients de corrélation de Spearman. Résultats L’AFE propose une structure unidimensionnelle (11 items expliquant 24 % de variance), les indices de l’AFC sont excellents. La stabilité de la mesure est satisfaisante (ICC = 0,71), malgré une consistance interne questionnable (α = 0,50). Les liens avec d’autres échelles indiquent une bonne validité de structure. Conclusion L’ORTO-11-Fr présente des propriétés psychométriques satisfaisantes. De futures études sont nécessaires pour identifier les déterminants de l’orthorexie, améliorer sa définition et son évaluation.
... The DSM-5 recognises three primary EDs: anorexia nervosa (AN), bulimia nervosa, and binge-eating disorder (NIMH, 2016). 'Orthorexia Nervosa' is not currently formally recognised as an ED but it is characterised by an obsession over extremely healthy or biologically 'pure' food, which leads to dietary restriction (Zamora et al., 2005). There are multiple biopsychosocial infl uences on the aetiology of EDs including the sociocultural idealisation of thinness variables through media exposure, personality traits, such as self-esteem and perfectionism, genetics and dieting (Culbert et al., 2015). ...
... 11 Physical examination and laboratory studies are warranted, as excessive dietary restrictions can lead to weight loss and medical complications similar to those seen in AN, including osteopenia, anemia, hyponatremia, pancytopenia, bradycardia, and even pneumothorax and pneumomediastinum. [19][20][21] There are no reported studies exploring the efficacy of psychotherapy or psychotropic medications for patients with ON. However, several treatments have been proposed given the symptom overlap with AN. ...
Article
Despite a focus on eating, orthorexia nervosa may lead to malnourishment, loss of relationships, and poor quality of life.
... Most research on ON has focused on epidemiological studies in the general population or at-risk samples and has discussed ON in terms of differential diagnosis with eating disorders (EDs), obsessive-compulsive disorder (OCD), and psychotic disorder. Clinical studies were limited to a few case reports [4,[8][9][10][11] describing the clinical presentation and management of cases falling into the ON diagnosis. To this extent, the Orthorexia Nervosa Task Force (ON-TF) is actually demanding more qualitative studies to help in outlining clinical aspects and diagnostic controversies [2]. ...
Article
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Background Orthorexia nervosa (ON) has gained increasing interest in the last 2 decades. Although a consensus on the diagnostic boundaries of ON has not yet been reached, there is some evidence for an overlap with eating disorders, obsessive–compulsive disorder, and psychotic disorder. Most of the knowledge about ON has emerged from studies of non-clinical and at-risk populations and is focused on differential diagnosis; therefore, further clinical studies are needed to better outline the ON phenomenon in a real-life setting.Objective This case series aims at describing clinical cases that developed symptoms suggestive of ON after being diagnosed with a prior psychiatric disorder and then discussing them in light of possible clinical pathways.Methods Four women consecutively admitted to an outpatient unit for the treatment of eating disorders were diagnosed with ON through a clinical interview, according to Dunn and Bratman’s criteria and self-administered questionnaire assessment (ORTO-15), and were considered to be eligible for this case series study. Psychiatric anamnestic data were collected retrospectively.ResultsThe anamnesis revealed that all patients were previously diagnosed with a psychiatric disorder (i.e. obsessive–compulsive disorder, bulimia nervosa, illness anxiety disorder, and psychotic disorder) before developing ON.Conclusion Past literature focused on differential diagnosis between ON and other psychiatric disorders. This is the first description of clinical cases in a real-life setting that started with different psychiatric disorders and later developed symptoms suggestive of ON. These cases have generated a new research question on the possibility that different psychiatric disorders may associate with a later onset of ON.Level of evidenceLevel V, descriptive study.
... Also, being influenced by beauty ideals was shown to predict lower preoccupation with healthy eating. This finding underlines the idea of ON not being driven by appearancerelated reasons, and this is in accordance with what is reported by Moroze et al. (2015), Catalina Zamora et al. (2005) and Park et al. (2011). Conversely, the study from Depa, Barrada, and Roncero (2019) in support of the bidimensional nature of orthorexia (i.e. ...
Article
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This study aimed to understand the factors influencing people’s choice to follow a diet considered healthy, and if and how these factors may contribute progress toward a higher (unhealthy) degree of preoccupation with healthy eating: orthorexia nervosa. This was achieved through mixed methods (interviews, n = 12; questionnaire, n = 82). The target group was young females in the Netherlands. Several biological, psychological, and social factors contribute to people’s healthy eating. Having concerns about chronic conditions were found to be significantly associated with a higher degree of preoccupation with healthy eating, resulting implicated in the possible onset of orthorexia nervosa.
Article
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Orthorexia nervosa represents a controversial phenomenon in the realm of eating practices, characterized by an obsessive fixation on consuming only foods deemed ’healthy’, and a preoccupation with food purity. While the existing literature has identified the presence of stressful behaviors among individuals with orthorexia, the precise factors and circumstances eliciting these stress-inducing emotions remain the subject of ongoing inquiry. This study aims to explore the triggers and situations that precipitate stressful beliefs and emotions among individuals who self-identify as preoccupied with healthy eating, as well as the coping mechanisms developed to manage these feelings. Through conducting one-to-one interviews with thirteen individuals, thematic analysis was employed to elucidate the nuances of their experiences. Participants articulated concerns regarding the contamination of foods available in supermarkets and restaurants, thereby prompting the meticulous selection of food sources and aversion to dining out. The prospect of trying new foods and engaging in social gatherings involving food emerged as anxiety-inducing scenarios, prompting individuals to adhere to monotonous dietary patterns and impose self-isolation. Additionally, medical appointments were perceived as stressful, driven by health concerns underpinning the adoption of stringent dietary practices. These findings underscore the spectrum of fears and coping mechanisms exhibited by individuals with orthorexia nervosa, which hold profound implications for their overall well-being.
Article
Orthorexia nervosa is described as a pathological fixation with healthy eating. Many risk factors contribute to the development of orthorexia nervosa. This study aimed to better understand the role of perfectionism in the development of orthorexia nervosa. In this context, studies on the relationship between orthorexia nervosa and perfectionism were reviewed. In the databases of PubMed, Wiley Online Library and Sage Journals and were searched. The keywords “orthorexia”, “orthorexia nervosa”, “pathologically healthy eating” and “perfectionism” were used in the search. As a result of the scanning, 17 articles on the relationship between orthorexia nervosa and perfectionism were examined. Studies were evaluated in terms of sample characteristics, study design, orthorexia nervosa measurement tools and study results. The results indicate that orthorexia nervosa and perfectionism are related. In addition, only one study found a weak relationship between ON and perfectionism. However, for more comprehensive findings on the relationship between orthorexia nervosa and perfectionism, cross-cultural studies are needed. Finally, the concept of perfectionism, which is effective in the development of orthorexia nervosa, may be a guide for effective treatment techniques.
Article
Introduction Orthorexia nervosa (ON) is characterized by a relentless, uncomfortable intrusive thought pattern, stereotyped behavior, and an extreme worry about maintaining a healthy diet that pulls all consideration to food. This compulsive behavior may affect daily functioning. Medical complications of orthorexic behavior include malnutrition, anemia, digestion problems, electrolyte, hormonal imbalance, severe weight loss and excessive anxiety. Like other eating disorders, this condition causes many psychological and medical complications, and research in this area is limited. Therefore, the reason for conducting this research was to determine the prevalence and severity of ON in medical students. Aims and Objectives To determine the prevalence of ON in the 263 research samples, to compare prevalence among undergraduates and postgraduates, and to determine the association between demographic variables and a 15 item questionnare for diagnosis of orthorexia nervosa ORTO-15 scores. Materials and Methods A cross-sectional study was carried out to determine the prevalence of ON on the ORTO-15 scale among medical students. Sociodemographic details such as age, gender, body mass index, and level of physical activity were obtained from the study sample. Results ON was prevalent in 29.86% of the study population (ORTO-15 score ≥40). Females had more tendency than males. ON was more prevalent in postgraduates and undergraduates, with a prevalence of 26.7% and 26.98%, respectively. Eating habits and ORTO-15 scores had a significant association. Conclusion The propensity for ON is widespread among medical students. Increased knowledge of nutritious eating will aid in problem prevention.
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(1) The objective of the study was to determine the relationship between depressiveness and the occurrence of eating disorders, i.e., emotional eating, uncontrolled eating, cognitive restraint of eating, and the risk of orthorexia. (2) The study was conducted among 556 women from the West Pomeranian Voivodeship (Poland). The study employed the diagnostic survey method using a questionnaire technique: The Beck Depression Inventory, the ORTO—15 Questionnaire, the Three-Factor Eating Questionnaire, and a sociodemographic questionnaire. (3) Higher depressiveness severity is associated with a higher score on the “Cognitive Restraint of Eating” scale. The authors’ original study demonstrated a statistically significant relationship only between depressiveness and the “Uncontrolled Eating” subscale (p = 0.001). (4) The results of this study suggest that depressiveness is an important factor that contributes to a better understanding of eating behaviors. In addition, the results of this study suggest that eating behaviors and psychological factors should be taken into account in psychological interventions in the treatment of eating disorders. The clinical goal can be considered to be an improvement in non-normative eating behaviors, such as a reduction in overeating episodes or eating less frequently in the absence of a feeling of hunger.
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Orthorexia nervosa (ON) refers to a pathological obsession with healthy eating characterized by a restrictive diet, ritualized eating patterns, and strict avoidance of foods believed to be unhealthy or unclean. On the other hand, healthy orthorexia (HO) is defined as an interest in healthy eating and a tendency to eat healthy foods. This study aimed to investigate the relationships between the ON, HO, maternal rejection, perfectionism, self-critical rumination, and body attitude in the women sample. 445 female students from diverse universities in Turkey was attended to our study. Participants completed questionnaires regarding ON and HO, body attitude, maternal rejection, perfectionism, and self-critical rumination. The results showed that negative body attitudes could not predict both HO (B=-.008, SE=.039, p=.791) and ON (B=.008, SE=.032, p=.835). However, perfectionism and self-critical rumination had mediator roles in the relationship between ON and HO with maternal rejection, despite this relationship was positive for ON (B = .014, Boot SE = .007, 95% Boot CI [.003, .029]), but negative for HO (B = -.023, Boot SE = .010, 95% Boot CI [-.042, -.008]). Not a negative body attitude, but maternal rejection, perfectionism, and self-critical rumination played roles in developing orthorexic tendencies.
Article
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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-90Revised (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.
Article
Healthy eating is not a pathological situation, but when it becomes a long-term and excessive preoccupation and causes negativities in daily life, it can cause personality and behavioural disorders. The study is aimed to determine the prevalence of orthorexia among tourism students with and without a nutrition education background and to develop recommendations accordingly. The research population consists of tourism students in associate degree programs (from junior colleges) at various public and private universities and the sample group consists of 581 volunteers. The measurement scale is composed of five constituents, namely, the demographics, nutrition properties, eating under emotional conditions (emotional eating), eating attitudes test and orthorexia test. In the light of the findings it is concluded that the prevalence of orthorexia is higher among tourism students who have nutrition education than those who have not. Eating attitudes test results have shown that tourism students who get nutrition education are at a moderate level compared to those who do not.
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This study aimed to adapt the Test of Orthorexia Nervosa- (TON-17) into Turkish and verify its validity and reliability. The study included 539 adults with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed, along with a confirmatory factor analysis to test its construct validity. The time-invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test the relationships between the scale and Eating Attitudes Test-26 and Obsessive Beliefs Questionnaire-9. Analyses were conducted using SPSS Version 28 and the AMOS-24 software. The Cronbach's α internal consistency coefficient of the total scale was found to be 0.82, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.68 for the "control of food quality", 0.64 for the "fixation on health and a healthy diet", and 0.73 for the "disorder symptoms". In addition, the test-retest reliability was found to be 0.87 for the total scale, suggesting excellent reliability. Most of the fit indices (CMIN/df, RMSEA, AGFI, NFI, and TLI) of the scale were acceptable, and the GFI indicated a good model fit. This study shows that the Turkish version of TON-17, which is a new tool with a three-factor structure to evaluate orthorexia, is a valid and reliable scale.
Article
Background: The prevalence of eating disorders and orthorexia nervosa has steadily increased and this situation may lead to severe physical, psychological, and social disorders. Aim: The aim of this study was to investigate the prevalence of disordered eating attitudes and orthorexia tendencies among university students studying in various Health Sciences departments in Turkey. Subjects and methods: The study subjects were selected from Health Sciences Faculty students. Among the students who accepted the study, 639 people were reached by simple random sampling method. The EAT-40 and ORTO-15 which are validated instruments for the screening of abnormal eating behaviors and orthorexia nervosa respectively, were used as measurement tools. Results: The majority of the students who participated in the study were found to exhibit orthorexic tendencies, and male students had a higher orthorexic tendency in comparison to female students (p = 0.022). More specifically, the students studying in the Department of Nutrition and Dietetics had lower orthorexic tendencies compared with the students from other departments. There was no significant relationship between BMI values and the mean ORTO-15 scores, whereas the mean EAT-40 score was found to increase statistically significantly with increased BMI (p = 0.038). There was a statistically significant difference between the departments and classes in terms of mean EAT-40 scores, whereas no difference was found regarding gender. Conclusion: Orthorexia nervosa is a common problem for university students studying in health-related departments. Interestingly, the orthorexic tendencies of girls and students studying in the Nutrition and Dietetics department were found to be lower in this study. It was determined that all students except the Nutrition and Dietetics department had orthorexia tendencies. More comprehensive studies are needed to better understand orthorexia nervosa and healthy lifestyle interaction.
Conference Paper
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Daily life style, dietary habits, economic condition and social circle are changing rapidly. The change accompanies some issues which pre-exist but stay in indiscernible extent. Eating disorders being considered as disorders that only belonged to industrialized cultures gain wide currency in all cultures as a consequence of "ideal woman" figure which were formed by effects of many factors. On the one hand, the world looks for a solution against malnutrition originating from famine and obesity. On the other hand, clinicians carry on a work against eating disorders which we call as "healthy eating obsession". People choose food for only the criterion whether it is healthy or not for their wishes to live longer. They never consume food that they do not believe to be pure or natural. They spend much time substantially by thinking the preparation and cooking stages of the food they consume daily. Healthy eating obsession turns into a disorder concerning personality and behaviour concepts when it runs rampant in long duration and causes troubles in daily life. Because there is not enough study on the subject, diagnostic criteria have not been determined and it has not included in the classification of DSM-V eating disorders.
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Purpose: This study aimed to determine medical students' tendency to ON and investigate the role of obsessive-compulsive symptoms and gender on these attitudes. Methods: This descriptive study was conducted with 822 medical students. The data were collected via an online survey. The sociodemographic information form, ORTO-11 scale and Maudsley Obsessive Compulsive Symptom (MOCS) Inventory were used as data collection forms. Results: The average age of the students was 20.57±2,071 (18-32), and 50.7% (n=417) were female. Orthorexia tendency was detected 19%. A significant relationship was found between the ORTO-11 and MOCS scores of the students in the opposite direction (P=0.000). There was no significant difference between ORTO-11 and MOCS scores according to gender and years of training. Participants who did not eat at night, did not consume packaged food, looked at the expiration date and content of the food, and had regular meals had significantly lower ORTO-11 scores. There was no significant relationship between the mean body mass index of the students and their ORTO-11 and MOCS scores (P>0.05 for all). Conclusion: The study results show that the tendency to ON is high in medical students. ON is more common in students with obsessive-compulsive symptoms, and interventions to correct obsessive-compulsive symptoms should also be planned in the fight against ON. Level of evidence: Level V, cross-sectional, descriptive study
Article
Objective: The studies on psychological aspects of orthorexia nervosa (ON) are scarce. What has been studied so far is the correlation between ON and self-esteem, perfectionism and personality. The aim of this study is to verify whether those suffering from orthorexia or having a tendency for orthorexia differ in terms of achievement motivation from the healthy control group. Methods: The study was conducted in the group of 252 medical students. The study relied on the ORTO-15 questionnaire, Eating Attitudes Test-26 (EAT-26) and Inventory of Achievement Motivation (Leistungsmotivationsinventar, LMI). Results: Those with a tendency for orthorexia show higher results in terms of: preference of challenging tasks, belief in success, motivation for learning, goal orientation, compensatory effort, care for prestige, achievement satisfaction, general achievement motivation as well as two factors: selfconfidence and ambition. Discussion: Patients suffering from orthorexia differ from the control group in terms of achievement motivation. Their results in some respects are parallel to those obtained by the girls with the Anorexia Readiness Syndrome, which can lead to the conclusion that both orthorexia and anorexia belong to the spectrum of eating disorders.
Article
Objective: Orthorexia nervosa (ON) is a putative eating disorder linked to perfectionism among people who eat healthily (or who want to eat healthily). However, little is known about the process by which perfectionism fosters ON symptoms. Like the Transdiagnostic Cognitive-Behavioral Theory of Eating Disorders, we hypothesized that perfectionism among people who eat healthily (or who want to eat healthily) fosters ON symptoms indirectly by cultivating a health-focused self-concept (i.e., placing overriding importance on health for self-definition and self-worth). We also hypothesized that a health-focused self-concept would be associated with ON symptoms among people who have erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. Method: To test this moderated mediation model, a sample of people following a healthy eating diet plan and/or who believe they are leading a healthy eating lifestyle (N = 456) were recruited from Amazon's Mechanical Turk and completed measures that assessed perfectionism, health-focused self-concept, ON symptoms, and erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. They also completed a measure of appearance-focused self-concept. Results: Health-focused and appearance-focused self-concepts were empirically distinct. As expected, perfectionism was indirectly and positively associated with ON symptoms via a health-focused self-concept. Importantly, the indirect association was only observed among participants high, but not low, in erroneous beliefs. Discussion: The findings support the role of perfectionism in ON. The findings also advance knowledge by identifying a health-focused self-concept and erroneous beliefs as potential factors in the etiology and maintenance of ON.
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Amaç: Bu çalışma, pandemi sürecinin ortoreksiya nervoza (ON) üzerindeki etkilerinin anlaşılabilmesi amacıyla, ON eğilimi olan bireyler ile ilişkili faktörlerin belirlenmesi ve bu bireylerin yeme davranışlarının değerlendirilmesi amacıyla yapılmıştır. Bireyler ve Yöntem: Bu kesitsel çalışma çevrimiçi olarak hazırlanmış anket yardımıyla 19 yaş üzeri, kronik hastalığı ve Covid-19 öyküsü olmayan, gönüllü 699 yetişkin bireyin katılımıyla gerçekleştirilmiştir. Oluşturulmuş anket formunda bireylere ilişkin bazı genel bilgiler ve antropometrik ölçümler ile beslenme alışkanlıklarına ilişkin bilgiler toplanmıştır. Ayrıca ORTO-15 ölçeği ile bireylerin ortorektik eğilimleri belirlenmiştir. Araştırma verileri SPSS programında değerlendirilmiştir. Bulgular: Çalışmaya %21.7’si erkek, %78.3’ü kadın olmak üzere toplam 699 birey dahil edilmiştir. Çalışmaya katılan bireylerin %68.2’sinde ortorektik eğilim saptanmış olup, erkeklerde (%75), çalışanlarda (%76.6), lisansüstü mezunlarında (%79.5) ve normal vücut ağırlığına sahip olanlarda (%76.1) ortorektik eğilimin daha yüksek olduğu belirlenmiştir (p<0.05). Ortorektik eğilimin tüketilen yiyecek miktarı, evde yemek yeme sıklığı, yemek siparişi verme sıklığı, vitamin ve mineral tüketimleri, ana ve ara öğün tüketimleri gibi bazı beslenme alışkanlıklarını etkilemediği bulunmuştur (p>0.05). Yapılan regresyon analizi sonuçlarına göre bireylerin ortorektik skor puanını, süt-yoğurt, tavuk ve şeker tüketiminde yaşanan değişimlerin arttırdığı saptanmıştır (p<0.05). Sonuç: Sonuç olarak Covid-19 pandemi sürecinde bireylerin yüksek düzeyde ortorektik eğilime sahip oldukları ve bu eğilimin yüksek eğitim seviyesine sahip ideal vücut ağırlığına yakın olan bireylerde daha fazla olduğu belirlenmiştir. Pandemi gibi stresin fazla olduğu dönemde gelişen yeme bozuklukları uzun vadeli olabileceği için bu beslenme bozukluklarının zamanında teşhis edilmesi ve bireylere bu konuda gereken beslenme tedavisinin verilmesi önemlidir.
Research
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Food selection is an activity related to culture and availability of food, due to culture influence human consumes certain food and follow traditional way to prepare the food that may be known as food choices. Food Choice is complex phenomenon that depends upon number of factor. As per the result of the previous studies of food choice and acceptance or rejection of product depends upon personal meaning (psychological factors). Due to involvement of psychological factors, preferences and food choice arises. Now, a day's market is full of food product and due to this availability food choices are not only based on need of Human body. The food choice are based on the availability and easy approach, this develops improper dietary pattern and unhealthy eating behavior. Malafide attitude towards food and eating develop unfamiliarity from Novel food, this is the biggest drawback in making the food choice effect in developing negative attitudes towards food. This is the reason to study the topic.
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Orthorexia Nervosa (ON) has been a research focus in recent years. Despite the lack of consensus on its defnition and classifcation as a psychiatric disorder, research has shown that ON is linked to certain behaviours (orthorexic behaviours, e.g.: obsessive thinking and compulsive behavior, guilt and self-punishment, restriction), associated with disordered eating. However, very little is known about this relationship. The aim of this study was to explore the eating-related processes inherent to the relationship between orthorexic behaviours and disordered eating, and understand if it is through the adoption of a more infexible and less intuitive eating approach, that an interest in healthy eating develops into a pathological one, while controlling the efect of age and BMI. Additionally, this relationship was explored for two diferent groups: Omnivores and Non-omnivores. Four hundred ffty-one women (281 Omnivores and 170 Non-omnivores) from the Portuguese population participated in this study, by answering a set of self-report measures. Non-omnivores presented signifcant higher levels of orthorexic behaviours and infexible eating. In both groups, orthorexic behaviours and disordered eating were linked positively to infexible eating and negatively to intuitive eating. A path model analyses showed that the preferred eating approach mediated the relationship between orthorexic behaviours and disordered eating, explaining 51% of the variance of disordered eating. A multigroup analysis confrmed the model invariance between Omnivores and Non-omnivores. Our fndings contribute to the better understanding of the relationship between orthorexic behaviours and disordered eating and its eating-related processes. Future research regarding the clinical intervention and prevention of ON in women should focus on encouraging a more intuitive eating approach. Level of evidence: IV, cross-sectional study
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Introducción: El espectro evitativo/restrictivo de la conducta alimentaria, incluye el trastorno evitativo/restrictivo de la ingestión de alimentos (TERIA), y otros desórdenes que implican a veces traslapes, entrecruzamientos y virajes con otros trastornos alimentarios. Objetivo: Se realiza un análisis descriptivo del TERIA, y de otros trastornos alimentarios, en relación a sus aspectos epidemiológicos, etiopatogénicos, clínicos y terapéuticos. Se incluyen viñetas clínicas ilustrativas. Método: Se efectuó una búsqueda bibliográfica sobre el TERIA y otros trastornos alimentarios mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: El TERIA, que en el DSM-5 adquiere la categoría de un trastorno alimentario bien definido, puede ser precedido por el comer selectivo/exigente. Los pacientes son principalmente hombres jóvenes con evolución prolongada del desorden. Otros trastornos alimentarios incluidos en el abanico evitativo/restrictivo son: anorexia nerviosa, alergia e intolerancia alimentaria y ortorexia nerviosa, como un concepto sindromático relativamente reciente. Existe controversia si la ortorexia nerviosa es un trastorno alimentario único o una consecuencia del desenlace de éste o un proceso obsesivo-compulsivo. El antecedente de trastorno alimentario es un factor predictivo significativo para ortorexia nerviosa. Todos estos desórdenes pueden producir diversos niveles de desnutrición e interferencia en el desempeño psicosocial. El manejo terapéutico requiere un equipo multidisciplinario que incluya médicos, psicoterapeutas, nutricionistas, psicoeducación, psicoterapia cognitivo-conductual, asesoría nutricional, y en ocasiones terapia farmacológica anti-serotoninérgica. Conclusiones: Se necesita una mayor evidencia en la investigación de estos nuevos fenotipos de trastornos alimentarios para determinar su impacto en aspectos demográficos, nosológicos, clínicos y terapéuticos.
Article
Although anorexia nervosa may vary widely in its severity and outcome, it is usually regarded as an illness in its own right, as patients do not display major changes in the form of the illness over time (Russell, 1970). It readily lends itself to being accorded clear-cut diagnostic criteria (Russell, 1977) and this is reflected in ICD–10 (World Health Organization, 1987). However, the nosological independence of anorexia nervosa has undergone vigorous assault since its classic description by William Gull (1874). For example, the psychological nature of anorexia nervosa was obscured for 30 years by Simmond's (1914) description of anterior pituitary lesions and cachexia, and Kay & Leigh's (1954) influential study of anorexia nervosa concluded with their doubts about its status as a ‘psychiatric entity’.
A new eating behavior disorder?
  • M L Orthorexia Nervosa
  • Zamora
Orthorexia nervosa. A new eating behavior disorder? M. L. Catalina Zamora, et al.
Ortorexia: un trastorno nutricional de los países desarrollados
  • Calañas Continente
Calañas Continente A. Ortorexia: un trastorno nutricional de los países desarrollados. Revista de Nutrición Práctica 2003;7:47-50.
Health food junkies; orthorexia nervosa: overcoming the obsession with healthful eating
  • S Bratman
  • D Knight
Bratman S, Knight D. Health food junkies; orthorexia nervosa: overcoming the obsession with healthful eating. New York: Broadway Books, 2001.
  • A Fugh-Berman
  • Health
Fugh-Berman A. Health food. JAMA 2001;285:2255-6.
Manual diagnóstico y estadístico de los trastornos mentales
  • Dsm-Iv
DSM-IV. Manual diagnóstico y estadístico de los trastornos mentales. Barcelona: Masson, 1998.