Prevalence of Orthorexia Nervosa and Its Diagnostic Tools—A Literature Review

Niedzielski, Antoni; Kaźmierczak-Wojtaś, Natalia

doi:10.3390/ijerph18105488

Cited by 74 publications

(88 citation statements)

References 118 publications

(176 reference statements)

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“…A characteristic of ON is a gradual intensification of dietary restrictions, often paired with obsessive thoughts and deviations from the imposed norms, leading to intense feelings of guilt, fear, shame, and additional dietary restrictions [41,65]. In the studies included herein, ON tendencies were associated with an increased fiber intake and a lower energy consumption.…”

Section: Characteristics Of Patients With Dm and On Tendenciesmentioning

confidence: 87%

“…Despite the plethora of tools used to identify ON [41], most studies relied on the ORTO-15 or its adaptations, as seen in research on the general population [42]. Specifically, one study used the ORTO-15 [36]; two studies used the Turkish adaptation of the ORTO-15 (ORTO-11) [35,38]; and Fidan [34] and Anil [37] used the ORTHO-11 and OR-THO-15, respectively-probably misspelt variations of the ORTO-15 tool.…”

Section: Tools Used To Identify On Tendenciesmentioning

confidence: 99%

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Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus

et al. 2021

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Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Τypical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the evidence on the prevalence of ON symptomatology among patients with DM. PubMed, Web of Science, Scopus, and grey literature were searched, and relevant observational studies were screened using the Rayyan software. The quality of the studies was assessed using the appraisal tool for cross-sectional studies (AXIS) and the Newcastle–Ottawa scale (NOS). Out of 4642 studies, 6 fulfilled the predefined criteria and were included in the qualitative synthesis. Most studies relied on the ORTO-15 or its adaptations to identify ON among patients with DM. No apparent sex or age differences exist regarding the prevalence of ON symptoms. None of the studies compared the prevalence of ON in patients with type 1 and type 2 DM. Most of the research was of average to good methodological quality. In conclusion, patients with DM often exhibit ON tendencies, although research is still limited regarding the etiology or mechanistic drivers behind ON and the characteristics of patients with a dual ON–DM diagnosis.

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Section: Characteristics Of Patients With Dm and On Tendenciesmentioning

confidence: 87%

Section: Tools Used To Identify On Tendenciesmentioning

confidence: 99%

Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus

et al. 2021

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“…The prevalence of orthorexia depends on the diagnostic cut-off criteria, the instrument used, or geographic region, and ranges between 1% to 89%, as suggested by review studies [43][44][45]. However, Varga et al [45] found the average prevalence of ON to be 6.9% in the general population, while rates between 1% and 7% were estimated by using Düseldorf Orthorexia Scale (DOS ≥ 30) [46], and 5.5% using Test of Orthorexia Nervosa (TON-17 ≥ 61) [47] in the Polish sample.…”

Section: Orthorexia Nervosamentioning

confidence: 99%

“…The prevalence of ON was previously discussed as challenging to compare with other studies since various measurement tools have different cut-off criteria. Cross-cultural differences may also be important for it [43][44][45]. Di Renzo et al [14] examined the impact of the early stage of the COVID-19 pandemic on eating habits and lifestyle changes among the Italian population.…”

Section: Orthorexia Fear Of Covid-19 and Pa Among University Studentsmentioning

confidence: 99%

The Mediating Role of Orthorexia in the Relationship between Physical Activity and Fear of COVID-19 among University Students in Poland

Kuśnierz

Rogowska

Kwaśnicka

et al. 2021

JCM

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Previous research showed that the COVID-19 pandemic has a significant impact on the wellbeing and lifestyle of populations worldwide, including eating and physical activity (PA) patterns. The present study aims to examine the mediating effect of orthorexia on the relationship between PA and fear of COVID-19. A sample of 473 university students from Poland of a mean age of 22 years (M = 22.04, SD = 2.90, 47% of women) participated in the cross-sectional online survey study. Continuous variables were measured using the Fear of COVID-19 Scale (FCV-19S) and the Test of Orthorexia Nervosa (TON-17), while categorical variables divided participants into the physically active and inactive group regarding WHO criteria (150 min per week). Weak gender differences were found. Active people showed lower fear of COVID-19 and higher orthorexia scores than those inactive. Orthorexia was found as a suppressor variable, which increases the negative predictive value of PA on fear of COVID-19. The model of cooperative suppression explained 7% of FCV-19S. The mechanism of mediation showed that health-related behavior could help reduce fear of COVID-19, but caution is necessary for people with addictive behavior tendencies. Universities should support university students by offering programs focused on increasing healthy lifestyles and improving wellbeing.

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“…To date, advancement in knowledge about OrNe has been, to a certain extent, hindered by the way orthorexia was assessed. Multiple scales have been used to screen for orthorexic tendencies and behaviors among people: 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) [ 22 ]. The most commonly used scale, the ORTO-15 tool [ 2 , 3 ], was created and validated in Italy [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

The relation of orthorexia with lifestyle habits: Arabic versions of the Eating Habits Questionnaire and the Dusseldorf Orthorexia Scale

et al. 2021

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Background Some of the commonly used tools to assess orthorexia nervosa (OrNe) do not allow a meaningful interpretation of the scores or yield mixed results about the dimensions needed to represent orthorexia. Since no advancement in the theoretical knowledge can be made without a thorough examination of the measurement aspects, this study aimed to evaluate the correlation between orthorexia nervosa (OrNe) and lifestyle habits, notably alcohol drinking, cigarette and waterpipe smoking, and physical exercise, and to validate and assess the psychometric properties of the Arabic versions of the Eating Habits Questionnaire (EHQ) and Düsseldorf Orthorexia Scale (DOS). Methods A total of 456 adult participants completed a self-administered questionnaire. Exploratory structural equation models were used to test the internal structure of the instruments. Shorter and more explicit versions were proposed for instruments. Pearson and partial correlations were computed between orthorexia scores and healthy behaviors scores. Results Regarding the internal structure of both EHQ and DOS, evidence favored the bi-dimensional construct of orthorexia. Both tools presented two theoretically clearly interpretable factors (OrNe and Healthy Orthorexia—HeOr—). The two questionnaires presented a high convergent validity, as dimensions with the same interpretation were correlated around 0.80. While OrNe was positively correlated with the use of unhealthy substances (higher alcohol use disorder, cigarette, and waterpipe dependence), HeOr was negatively associated with these behaviors. Conclusion Our results emphasize the idea that further attention should be paid to the multidimensional structure of orthorexia, as OrNe and HeOr present an opposite pattern of associations with healthy behaviors. An OrNe etiopathogenesis common to eating disorders can explain these differences.

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Prevalence of Orthorexia Nervosa and Its Diagnostic Tools—A Literature Review

Cited by 74 publications

References 118 publications

Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus

Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus

The Mediating Role of Orthorexia in the Relationship between Physical Activity and Fear of COVID-19 among University Students in Poland

The relation of orthorexia with lifestyle habits: Arabic versions of the Eating Habits Questionnaire and the Dusseldorf Orthorexia Scale

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