Evaluation of Orthorexia Nervosa and Symptomatology Associated with Eating Disorders among European University Students: A Multicentre Cross-Sectional Study

Abstract

The objectives of the present study were to (1) evaluate prevalence of orthorexia nervosa (ON) in university students in Spain and Poland, (2) assess differences in ON and eating disorder (ED) pathology in both samples and (3) examine the relationship between ON and ED symptoms among Spanish and Polish university students. Eight hundred and sixty university students participated in the present study (Mage = 21.17 ± 3.38; MBMI = 22.57 ± 3.76). The Spanish and Polish samples comprised 485 and 375 students, respectively. The Düsseldorf Orthorexia Scale and the Eating Disorder Inventory were used in the present study. ON prevalence rates of 2.3% and 2.9%, respectively, are found in the Spanish and Polish samples. Compared to Polish students, Spanish university students reported increased drive for thinness and lower body dissatisfaction, lower level of ineffectiveness and lower level of interpersonal distrust. ON was positively related to drive for thinness, bulimia, body dissatisfaction, perfectionism interoceptive awareness (in both Spanish and Polish students) and ineffectiveness (in Spanish students). Our findings suggest that ON significantly overlaps with ED symptoms, which is in line with recent studies. Longitudinal studies are needed to assess how ON develops in a sample of young adults and whether it develops in isolation of or in parallel with ED pathology.

Development and Validation of the Test of Orthorexia Nervosa (TON-17)

“…However, further studies are needed to verify the accuracy of the threshold in terms of sensitivity and specificity. The prevalence of ON found in this study is consistent with recent studies using DOS which showed the prevalence rates between 2.3% and 7.8% in various studies [ 23 , 24 , 25 , 26 , 27 ].…”

“…Varga et al [ 6 ] showed in the review study that the average prevalence rate for ON was 6.9% for the general population. Some recent studies, conducted in various countries, indicate prevalence rate 21% or less using cut-off score for ORTO-15 ≤ 35 [ 20 , 21 , 22 ], and prevalence between 2.3% and 7.8%, using cut-off score for Düseldorf Orthorexia Scale (DOS) ≥ 30 [ 23 , 24 , 25 , 26 , 27 ].…”

Validation and Polish Adaptation of the Authorized Bratman Orthorexia Self-Test (ABOST): Comparison of Dichotomous and Continuous Likert-Type Response Scales

“… 19 , 58 These previous prevalence rates may have been overestimated, as suggested Dunn et al 28 The prevalence of high risk of ON found in this study (5.3%) was similar to the results of recent research using the Dusseldorf Orthorexia Scale (DOS; prevalence between 2.3% and 7.8%), which seems more realistic. 59–63 According to the recommendation of Valente et al, 57 the ABOST is based on current knowledge and the re-conceptualization of ON. Summarizing the results of this study, the ABOST is a fully suitable and brief six-item instrument to measure orthorexia nervosa, with high validity and good reliability.…”

Orthorexia Nervosa—It Is Time to Think About Abandoning the Concept of a Distinct Diagnosis

“…However, most studies that used the DOS could not demonstrate that orthorexic symptoms are independent from features of disordered eating behavior. For example, positive correlations between DOS scores and eating disorder symptoms such as drive for thinness and body dissatisfaction have been found in both non-clinical and clinical samples [e.g., ( 18 – 20 )] and orthorexic symptomatology tends to be higher in females than males [e.g., ( 21 )].…”