Orthorexia Nervosa: differences between clinical and non-clinical samples

Abstract

Background Orthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups. Methods The sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups. Results Analyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON. Conclusion Individuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.

The role of dieting, psychopathological characteristics and maladaptive personality traits in Orthorexia Nervosa

“…These results are consistent with the literature that suggests diet as a possible risk factor for Orthorexia Nervosa [ 11 , 41 ]. Nevertheless, groups of people with high orthorexic tendencies -both on diet and not on diet- show differences in orthorexic features, personality traits, eating-disorders characteristics, and in other aspects; as a consequence, diet alone can not explain the tendencies described above [ 26 ].…”

“…ON symptomatology is related to non-adaptive perfectionism [ 14 , 15 ], and it concerns high personal standards and rigid organization that could explain the strict adherence to healthy eating. Moreover, people on a diet could be more likely to expose themselves to rigorous dietary rules and perfectionism could impact on orthorexic tendencies in this group [ 11 ]. Furthermore, the HIGH-D group showed higher levels of depression than the LOW-D group; the excessive focus on healthy food could compromise social functioning and lead to a deflection of mood [ 17 ].…”

“…The sample of this study is part of a larger one whose results were previously published [ 11 , 13 ]. The study was conducted among 133 adults belonging to three different groups: High Orthorexic Tendencies (HIGH) group, High Orthorexic Tendencies on Diet (HIGH-D) group, and Low Orthorexic Tendencies on Diet (LOW-D) group.…”

“…Anonymity and confidentiality of the collected data were guaranteed. Some of these data were used in previous research [ 11 , 13 ] with different aims.…”

“…Although ON is not formally present as a nosological category of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; [ 5 ]) or in other major classification of disorders, many publications have contributed to hypothesize diagnostic criteria [ 2 , 3 , 6 , 7 ] in order to consider ON a new psychopathological disorder. Literature highlights important overlaps between ON and the symptomatology of Eating Disorders (ED) [ 8 – 11 ]. There are moderate relationships between ON and obsessive–compulsive features [ 12 , 13 ].…”