The risk of believing that emotions are bad and uncontrollable: association with orthorexia nervosa

What role do orthorectic beliefs play in orthorexia nervosa and healthy orthorexia? Development and validation of the Orthorexia Beliefs Scale (OBS)

Cognitive models of obsessive-compulsive disorder (OCD) postulate that dysfunctional beliefs and appraisals are key elements in the development and maintenance of obsessions. Given the relationship between the orthorexia nervosa (OrNe), OCD, and eating disorders, it is not surprising that some dysfunctional beliefs are present in OrNe. The aim of this research was to determine the relevance of dysfunctional beliefs in OrNe. To do so, we developed and validated an instrument that assesses these beliefs -the Orthorexia Beliefs Scale (OBS)- and, subsequently, analyzed the association between orthorexia, food restriction, obsessive-compulsive symptoms, and negative/positive affect, along with the beliefs evaluated with the OBS. Participants (n = 418) were given a set of questionnaires. We expected the obtained instrument to be able to assess dysfunctional beliefs related to orthorexia and establish positive associations between pathological dimensions and OrNe. The results revealed that the scale evaluated three factors: Overvaluation of Healthy Eating, Moral Meaning, and Need to Control. OrNe was significantly associated with all three of these factors and the most relevant association was with the Need to Control factor. An association between the non-pathological variable of orthorexia (HeOr) and the Overvaluation of Healthy Eating factor was also found. The results seem to indicate that the dysfunctionality of orthorexia is highly marked by the need to control, as also occurs in eating disorders.

Orthorexia in obsessive-compulsive personality disorder: the impact of perfectionism and metacognition

BACKGROUND

Obsessive‒compulsive personality disorder (OCPD) is characterized by a rigid need for control, orderliness, and perfectionism, often impairing functionality. Traits such as striving for an "ideal" figure can lead to orthorexic tendencies, characterized by an obsessive focus on healthy eating, which can result in significant social, psychological, and physical complications. This study investigates the presence of orthorexic tendencies in individuals with OCPD and examines whether these tendencies are predicted by metacognition and perfectionism, with a focus on the mediating role of metacognition.

METHODS

The study included 73 patients diagnosed with OCPD through the DSM-5 Structured Clinical Interview (SCID-5-PD) and 73 healthy controls matched by age, sex, and education level. Perfectionism, orthorexia, and metacognition were assessed via the Frost Multidimensional Perfectionism Scale (FMPS), Meta-Cognition Questionnaire-30 (MCQ-30), and ORTO-11 scale. Pearson correlation, linear regression, and mediation analyses were conducted to explore these relationships.

RESULTS

OCPD patients had lower BMIs and higher scores for perfectionism, orthorexia, and metacognitive activity than did the control group. A negative correlation was found between the FMPS and ORTO-11 scores. MCQ scores were positively correlated with FMPS scores and negatively correlated with ORTO-11 scores. In the mediation analysis, metacognition was found to have a partial mediating effect on the relationship between perfectionism and orthorexia.

CONCLUSION

Perfectionism and dysfunctional metacognition significantly contribute to orthorexic tendencies in individuals with OCPD. These findings suggest that metacognitive therapy may effectively address and reduce orthorexic behaviors in this population.