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Kalika E, Hussain M, Egan H, Mantzios M. Exploration of the Mediating Role of Self-Compassion and Mindfulness on Orthorexia Nervosa and Perfectionism. Psychol Rep 2024:332941241256886. [PMID: 38835133 DOI: 10.1177/00332941241256886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Orthorexia Nervosa (ON) is characterized by an excessive preoccupation with healthy eating, accompanied by increasingly restrictive dietary practices over time. In light of the increased attention to ON, it is noteworthy that the existing body of research, specifically with regard to mindfulness and self-compassion remains constrained in scope and depth. A total of 151 participants over the age of 18 completed scales measuring Orthorexia, Self-Compassion, Mindfulness, and Perfectionism. The findings revealed that individuals exhibiting high levels of ON tended to have low levels of self-compassion and mindfulness, along with high levels of perfectionism. Furthermore, the results indicated that self-compassion and mindfulness acted as mediators in the relationship between perfectionism and orthorexia nervosa. These findings deepen our comprehension of orthorexia and underscore the role of self-compassion and mindfulness, or their absence, as mediating factors in this context. The implications of these results and potential future directions are discussed.
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Affiliation(s)
- Eliza Kalika
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Misba Hussain
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Helen Egan
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Michail Mantzios
- Department of Psychology, Birmingham City University, Birmingham, UK
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Bozkurt O, Kocaadam‐Bozkurt B. Evaluation of factors related to organic food consumption and orthorexia nervosa tendencies. Food Sci Nutr 2024; 12:3585-3592. [PMID: 38726398 PMCID: PMC11077188 DOI: 10.1002/fsn3.4029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 05/12/2024] Open
Abstract
The relationship between organic food consumption, awareness of reducing ecological footprint, and orthorexia nervosa (ON) tendencies has yet to be explored in detail. This study aimed to determine factors related to organic food consumption and ON tendencies in young adults. Also, the relationship between organic food consumption, awareness of reducing ecological footprint, and ON tendencies was investigated. This study was conducted with 887 young adults (58.4% female, 41.6% male, aged 18-25 years, mean age 20.8 ± 2.55 years). Study data were obtained with a web-based questionnaire. The questionnaire included socio-demographic characteristics, anthropometric measurements, the Organic Food Consumption Scale (OFC), ORTO-11, and the Awareness Scale for Reducing Ecological Footprint (ASREF). While 17.2% were overweight or obese, 74.9% had a normal body weight. There were no differences by sex in terms of ORTO-11, OFC, and ASREF total scores (p > .05). Significant positive correlations were found between ASREF and OFC (p < .001), while negative correlations were found for ORTO-11 and OFC (p < .001). A higher ASREF and increased ON tendencies predicted increased organic food consumption (p < .05). Furthermore, higher organic food consumption behaviors and awareness of reducing ecological footprint predicted increased ON tendencies (p < .05). Findings from this study will contribute to a deeper understanding of the factors associated with organic food consumption and ON tendencies among individuals. By shedding light on the interplay between ecological awareness, organic food consumption, and orthorexic tendencies, policymakers and health professionals can develop targeted interventions to promote sustainable and healthy food consumption.
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Affiliation(s)
- Osman Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health SciencesErzurum Technical UniversityErzurumTurkey
| | - Betul Kocaadam‐Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health SciencesErzurum Technical UniversityErzurumTurkey
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Intra- and Interpersonal Dimensions of Orthorexia: Preliminary Development and Validation of an Intra- and Interpersonal Effects Scale for Orthorexia. Nutrients 2024; 16:1010. [PMID: 38613043 PMCID: PMC11013874 DOI: 10.3390/nu16071010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
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.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-059 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
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Boutin C, Maïano C, Aimé A. Relation between orthorexia nervosa and healthy orthorexia: A latent profile analysis. Appetite 2024; 194:107165. [PMID: 38103792 DOI: 10.1016/j.appet.2023.107165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Orthorexic eating behaviors can be conceptualized as a bidimensional construct encompassing an orthorexia nervosa dimension (ON) and a healthy orthorexia dimension (HO). Although variable-centered studies showed that ON and HO are distinguishable orthorexic eating behaviors, the evidence of whether they can co-occur or be distinct in subgroups of individuals is still limited. The present study aimed to address previous person-centered studies' limitations by examining profiles of ON and HO among a convenience sample of 251 French-speaking Canadian adults (85.7% women; Mage = 33.56). Profile membership was examined as function of participants characteristics such as age, gender, body mass index, frequency of physical activity and sports and vegetarianism. The relation between profile membership, intuitive eating and disordered eating attitudes and behaviors was also assessed. Latent profile analysis (LPA) were used to estimate profiles of ON and HO. Results from LPA did not provide support for the distinguishability of ON and HO. Indeed, they revealed the presence of two profiles showing co-occurring levels of ON and HO that only differed quantitatively: low (68.9% of the sample; low levels of ON and HO) or moderate orthorexic eating behaviors (31.1%; moderate levels of ON and HO). Participants who declared being vegetarian and being more frequently involved in physical activities and sports were more likely to belong to the moderate orthorexic eating behaviors' profile. Finally, participants from the moderate orthorexic eating behaviors' profile showed higher levels of disordered eating attitudes and behaviors, whereas those from the low orthorexic eating behaviors' profile showed higher levels of intuitive eating. Findings from the present study question the distinguishability of ON and HO dimensions. They also suggest that, similarly to ON, HO is also related to higher eating and lifestyle preoccupations.
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Affiliation(s)
- Camille Boutin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | - Christophe Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada; Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérôme, Canada.
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults. Nutrients 2024; 16:638. [PMID: 38474767 DOI: 10.3390/nu16050638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Measuring orthorexia nervosa is challenging due to the use of various existing tools and problems with sample representativeness. Another challenge for the Polish population is the adaptation of existing research tools and the evaluation of their relevance and research reliability. Our research aimed to adapt the TOS to the Polish language and measure pathological and nonpathological orthorexic behavior among the Polish population. The adaptation of the PL-TOS has high psychometric value and allows us to assess healthy and nervous orthorexia levels. This scale can be used not only for further research but also for diagnostic purposes in the daily work of clinicians and psychologists. Our results obtained in the present study indicate a correlation between TOS and both the use of supplements and diet. Higher TOS, ORTO_R and KZZJ_Diet Restrictions scores were obtained for individuals using dietary supplements than for those not using dietary supplements. In the future, it is worth conducting research aimed at various risk groups of individuals with orthorexia to confirm the psychometric properties of this adaptation of the TOS.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-093 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
| | - Emilia Samardakiewicz-Kirol
- Simulation Laboratory for Patient Safety, Department of Medical Education, Medical University of Lublin, 20-093 Lublin, Poland
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Eltink E, Bröer C. Healthism online: 'What I eat in a day' vlogs before and during COVID-19 restrictions. Heliyon 2024; 10:e23623. [PMID: 38187283 PMCID: PMC10770541 DOI: 10.1016/j.heliyon.2023.e23623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Objective and setting The COVID-19 pandemic and its restrictions coincide with an increase in body weight and changes in health-related habits worldwide. This study focusses on the way health-related habits are portrayed online in digital food cultures. The study aims to investigate if and how the content of high-profile Dutch 'What I eat in a day' vlogs has changed during the first period of COVID-19 restrictions. We approach changes in digital food culture through the concept of 'healthism' and see vloggers as cultural intermediaries. Design and participants We collected the most watched vlogs of almost all high-profile Dutch influencers pre-post corona and analyzed these in a mixed method approach by using summative and thematic content analysis. Results Pre-COVID vlogs highlight an explicit consciousness of energy balance-related behavior, focusing on calorie counting, avoidance of unhealthy food and the use of tracking apps. In vlogs uploaded in 2020, these themes are less present. Instead, intuitive eating and listening to one's body are more central themes within the vlogs. Conclusions We consider the shift towards intuitive eating as another variant of "wellness diets" rather than a shift away from dieting, furthered by COVID-19 restrictions. The core values of health and self-regulation are upheld within the shift towards intuitive eating. Yet, we nuance the broad claims of healthism in biopolitics and point to relevant cultural changes within foodscapes.
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Affiliation(s)
- Elisa Eltink
- Communication, Health and Life Sciences, Wageningen University, PO Box 8130, 6700 EW, Wageningen, the Netherlands
| | - Christian Bröer
- Department of Sociology, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, the Netherlands
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Foyster M, Sultan N, Tonkovic M, Govus A, Burton-Murray H, Tuck CJ, Biesiekierski JR. Assessing the presence and motivations of orthorexia nervosa among athletes and adults with eating disorders: a cross-sectional study. Eat Weight Disord 2023; 28:101. [PMID: 38070009 PMCID: PMC10710386 DOI: 10.1007/s40519-023-01631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Orthorexia nervosa involves restricting diet based on quality rather than quantity. Although orthorexia is well reported in many at-risk populations, limited data addresses its presence in individuals with eating disorder history (EDs) or athletes. We aimed to identify the presence and potential drivers of orthorexia in adults with EDs and endurance athletes, compared to control subjects. METHODS Participants ≥ 18y included: people with a diagnosed eating disorder (ED as per DSM-5); endurance athletes (training/competing ≥ 5 h/week); or control subjects. Participants (n = 197) completed an online survey assessing orthorexia (eating habits questionnaire, EHQ), eating motivations (TEMS-B) and compulsive exercise (CET). RESULTS ED had the highest orthorexia symptom severity (92.0 ± 3.02, n = 32), followed by athletes (76.2 ± 2.74, n = 54) and controls (71.0 ± 1.80, n = 111) (F (2) = 18.2, p < 0.001). A strong positive correlation existed between weight control motives and higher orthorexia symptom severity (r = 0.54, 95% CI [1.35, 2.36], p < 0.001), while a weak negative association existed between Hunger and Pleasure motives and higher orthorexia symptom severity (r = 0.23, 95% CI [- 2.24, - 0.34], p = 0.008; r = 0.26, 95% CI [- 2.11, - 0.47], p = 0.002, respectively). A moderate positive relationship was found between CET and orthorexia symptom severity (95% CI [1.52, 3.12], p < 0.001). CONCLUSION Adults with ED history and endurance athletes have greater orthorexia symptom severity compared to control. Clinicians working with at-risk populations should screen patients and be aware of red-flags of orthorexic traits, desire to control weight, and compulsive exercise behavior. LEVEL OF EVIDENCE III: Evidence obtained from cohort studies.
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Affiliation(s)
- Mandy Foyster
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Nessmah Sultan
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Matilda Tonkovic
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Andrew Govus
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Helen Burton-Murray
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline J Tuck
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nursing and Allied Health, Swinburne University, Hawthorn, VIC, Australia
| | - Jessica R Biesiekierski
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.
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Jelicich R, Braun V. "Your Diet Defines Who You Are, Especially as a Man": Masculinity in Online Media Focused on Healthy Eating for Men. Am J Mens Health 2023; 17:15579883231213588. [PMID: 38130065 DOI: 10.1177/15579883231213588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
In contexts marked by neoliberal ideology and a claimed "crisis" in men's health, men are responsibilized to be/come healthy. Eating has long been a gendered practice in Western cultures, and recent cultural shifts have produced ways of eating that are both masculinized and (claimed) healthy. Online healthy eating advice, which encourages and supports men to eat healthily, is an important information source. However, such information draws on, reproduces, and/or disrupts existing meanings about men and eating. To understand contemporary representations of men and healthy eating, we examined 30 online media articles oriented specifically to this topic. Using reflexive thematic analysis from a social constructionist position, we developed two themes: A lad's looks and lifestyle and Mind over matter: The masculine mindset. These themes together told an overarching story that healthy eating is effectively sold to men by drawing on traditional or hegemonic ideals of masculinity and effectively evoking access to an enhanced masculinity through healthy eating. While these representational practices may sell healthy eating to men, with likely positive health benefits, they also reinforce hegemonic ideals of masculinity which can be problematic from a health perspective.
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Affiliation(s)
- Ruby Jelicich
- School of Psychology, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
| | - Virginia Braun
- School of Psychology, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
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Dziewa M, Bańka B, Herbet M, Piątkowska-Chmiel I. Eating Disorders and Diabetes: Facing the Dual Challenge. Nutrients 2023; 15:3955. [PMID: 37764739 PMCID: PMC10538145 DOI: 10.3390/nu15183955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Eating disorders and diabetes mellitus are distinct yet closely linked health conditions, presenting distinct challenges in terms of care and management. Eating disorders encompass a spectrum of mental health disorders characterized by abnormal eating behaviors and disruptions in weight regulation. Research indicates that individuals with diabetes might be at an elevated risk of developing eating disorders. The necessity to adhere to specific dietary guidelines, monitor blood sugar levels vigilantly, and manage drug administration can collectively contribute to the emergence of detrimental attitudes toward food and body image. On the other hand, incorrect eating behaviors such as binge eating and purging can disrupt blood sugar control, significantly impacting the development and management of diabetes. This intricate relationship emphasizes the crucial necessity for a comprehensive understanding and specialized care to effectively address the dual challenges faced by individuals dealing with both diabetes and eating disorders. This paper represents the inaugural comprehensive review delving into the intricate connection between eating disorders and diabetes, thereby illuminating previously under-researched areas. The insights gleaned from this review may contribute to developing integrated interventions that aim to improve the overall well-being and quality of life for individuals grappling with the complexities of eating disorders and diabetes.
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Affiliation(s)
| | | | | | - Iwona Piątkowska-Chmiel
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland
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Sanzari CM, Hormes JM. U.S. health professionals' perspectives on orthorexia nervosa: clinical utility, measurement and diagnosis, and perceived influence of sociocultural factors. Eat Weight Disord 2023; 28:31. [PMID: 36947321 PMCID: PMC10033613 DOI: 10.1007/s40519-023-01551-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/09/2023] [Indexed: 03/23/2023] Open
Abstract
PURPOSE This study examined U.S. health professionals' perspectives on the clinical utility, measurement, and etiology of orthorexia nervosa (ON). METHODS Participants (n = 100) were U.S. health professionals with experience working clinically with eating disorders, including trainees, Ph.D. psychologists, social workers/mental health counselors, and medical health professionals. After reviewing the proposed ON criteria, participants responded to questions regarding the clinical utility, diagnosis, and measurement of ON, and sociocultural influence on the emergence of ON. Views of ON as a useful diagnostic category were examined as a function of participants' current involvement in clinical versus research activities. RESULTS Participants mostly (71.9%) agreed that ON should be a distinct clinical diagnosis. Participants who endorsed ON as a valid diagnosis spent more time on clinical work and less time engaged in research compared to participants who disagreed (both ps < 0.05). Approximately 27% of participants believed additional components should be added to the proposed ON diagnostic criteria. Participants indicated that sociocultural factors have considerable influence on the development of ON, namely the diet and weight loss industry, and the perceptions that biological/organic/vegan and low fat/low carb/gluten free food are the healthiest. CONCLUSION Professionals who spent more time working clinically with eating disorders were more likely to endorse ON as a unique disorder, and professionals who spent more time on research were more likely to disagree. To the extent that professionals who spend more time on research may shape the narrative around ON more visibly, this study underscores the importance of listening to practitioners' experiences in applied settings. LEVEL OF EVIDENCE Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Christina M Sanzari
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA.
| | - Julia M Hormes
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA
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Kamarli Altun H, Özyildirim C, Koç Ş, Aksoy HN, Sağir B, Bozkurt MS, Karasu H. The factors associated with orthorexia nervosa in type 2 diabetes and their effect on diabetes self-management scores. Eat Weight Disord 2023; 28:22. [PMID: 36809582 PMCID: PMC9944002 DOI: 10.1007/s40519-023-01552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/10/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE This study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management. METHODS The study included 373 individuals with type 2 diabetes between the ages of 18-65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R. RESULTS The linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management. CONCLUSION It should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
- Hülya Kamarli Altun
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Caner Özyildirim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye.
| | - Şeyma Koç
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hatice Nur Aksoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Beyza Sağir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Merve Sefa Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
| | - Hakan Karasu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Türkiye
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Muacevic A, Adler JR. A Case of Eating Disorder Diagnosed As Orthorexia Nervosa. Cureus 2023; 15:e33801. [PMID: 36819398 PMCID: PMC9928574 DOI: 10.7759/cureus.33801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2023] [Indexed: 02/24/2023] Open
Abstract
A 13-year-old girl presented to our hospital with chief complaints of rapid weight loss, fatigue, discomfort, chills in the extremities, and alopecia. We initially suspected anorexia nervosa (AN). However, she did not express fear of gaining weight or have a distorted perception of her weight or body shape; thus, her presentation was not typical of AN. We also suspected avoidant/restrictive food intake disorder (ARFID), but she did not exhibit any food-avoidance behaviors. However, she was obsessed with nutrition control, so we diagnosed her with orthorexia nervosa (ON). She was hospitalized, given education on proper nutrition, and her eating behavior subsequently improved. After discharge, we administered the ORTO-15, which assesses the propensity for ON, and her score met the diagnostic criteria for ON. The incidence of ON has increased during the COVID-19 pandemic. In this case, her obsession was brought about by information she read in magazines and on social media that promoted an unbalanced diet centered almost exclusively on vegetables. Pediatricians should raise awareness of misinformation regarding children's health to ensure healthy growth.
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Hanras E, Dorard G, Boujut E. Une ou plusieurs orthorexies ? Conceptualisation, évaluation et enjeux sociétaux : une revue critique de la littérature. PSYCHOLOGIE FRANCAISE 2022. [DOI: 10.1016/j.psfr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Costanzo G, Marchetti D, Manna G, Verrocchio MC, Falgares G. The role of eating disorders features, psychopathology, and defense mechanisms in the comprehension of orthorexic tendencies. Eat Weight Disord 2022; 27:2713-2724. [PMID: 35648315 PMCID: PMC9556392 DOI: 10.1007/s40519-022-01417-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/07/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Recent studies pointed out the importance to distinguish orthorexia nervosa (ON) from non-problematic forms of interest with healthy eating. This distinction needs to be further explored since it may favor a better comprehension of the relationship between orthorexic behaviors and psychopathology and lead to an improved understanding of the psychological processes implicated in ON. Therefore, the aim of the current study was to investigate the associations between ON and the core features of eating disorders (EDs), psychopathological symptoms and defense mechanisms, by differentiating three groups of individuals: an ON symptoms group, a healthy-eating control group, and a normal-eating control group. METHODS College students (n = 270, Mage = 21.57, SD = 2.16) were recruited from Palermo's University, in the south of Italy, and were assigned to three groups: 52 in the ON symptoms group, 157 in the healthy-eating control group and 61 in the normal-eating control group. Participants completed four questionnaires assessing ON (EHQ-21), eating psychopathology (EDI-3), psychopathological symptoms (BSI) and defense mechanisms (DSQ-40). RESULTS Compared to the control groups, the ON symptoms group reported greater EDs' features, higher psychopathological symptoms and greater employment of different neurotic and immature defense mechanisms. No differences were found between groups with regard to obsessive-compulsive symptoms. CONCLUSION Our findings support the notion that ON behaviors should be carefully distinguished from non-problematic forms of interest with healthy eating. Indeed, results suggest that ON individuals are characterized by similar clinical features and defensive functioning as those observed in traditional EDs, indicating the importance of deepening our understanding of the relationship between these conditions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Giulia Costanzo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Giovanna Manna
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy.
| | - Giorgio Falgares
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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15
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Hofmann B. Managing the moral expansion of medicine. BMC Med Ethics 2022; 23:97. [PMID: 36138414 PMCID: PMC9502962 DOI: 10.1186/s12910-022-00836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns. While these challenges have been studied from a wide range of perspectives, the problems prevail. This article adds value to previous analyses by identifying how the moral imperative of medicine has expanded in three ways: (1) from targeting experienced phenomena, such as pain and suffering, to non-experienced phenomena (paraclinical signs and indicators); (2) from addressing present pain to potential future suffering; and (3) from reducing negative wellbeing (pain and suffering) to promoting positive wellbeing. These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship. In order to find ways to manage the moral expansion of medicine, four traditional ways of setting limits are analyzed and dismissed. However, basic asymmetries in ethics suggest that it is more justified to address people’s negative wellbeing (pain and suffering) than their positive wellbeing. Moreover, differences in epistemology, indicate that it is less uncertain to address present pain and suffering than future wellbeing and happiness. Based on these insights the article concludes that the moral imperative of medicine has a gradient from pain and suffering to wellbeing and happiness, and from the present to the future. Hence, in general present pain and suffering have normative priority over future positive wellbeing.
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Affiliation(s)
- Bjørn Hofmann
- Institute for the Health Sciences, The Norwegian University of Science and Technology (NTNU), PO Box 191, 2802, Gjøvik, Norway. .,Centre of Medical Ethics, University of Oslo, PO Box 1130, N-0318, Oslo, Norway.
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16
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Valente M, Cesuroglu T, Labrie N, Syurina EV. " When Are We Going to Hold Orthorexia to the Same Standard as Anorexia and Bulimia?" Exploring the Medicalization Process of Orthorexia Nervosa on Twitter. HEALTH COMMUNICATION 2022; 37:872-879. [PMID: 33475011 DOI: 10.1080/10410236.2021.1875558] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study contributes to understanding medicalization on social media, by using Conrad's concept of medicalization as a theoretical framework to explore the conversation about Orthorexia Nervosa (ON) on Twitter. The aim of this mixed-methods study was twofold: the quantitative component aimed to provide descriptive information on the type of tweets and users, as well as on the network structure of the ON-related conversation on Twitter, while the qualitative component aimed to explore how the medicalization of ON unfolds on Twitter by performing a thematic analysis of original tweets about ON. Quantitative descriptive findings show that the most popular hashtags associated with orthorexia include #rdchat, #psychology and #doctors, which hints to a link between discourses around ON and the medical profession. Among the most active, prominent and visible users are news accounts, a registered dietitian, a researcher, a professor and an editor. Qualitative thematic analysis shed light on the discursive process of medicalization. Some users bring about medicalization by approaching ON as a medical entity; in contrast, other users resist medicalization by describing ON as a social phenomenon. A discursive struggle emerges, where certain individuals feel confused around what constitutes ON. This leads to stigmatization of non-traditional diets like veganism, which in turn triggers complaints regarding over-medicalization. As the first Twitter investigation on ON, this study serves the purpose of providing insights into how an emerging disorder develops in society in a time of social media.
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Affiliation(s)
- Martina Valente
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Tomris Cesuroglu
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Nanon Labrie
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
| | - Elena V Syurina
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam
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17
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Gkiouras K, Grammatikopoulou MG, Tsaliki T, Ntwali L, Nigdelis MP, Gerontidis A, Taousani E, Tzimos C, Rogoza R, Bogdanos DP, Donini LM, Goulis DG. Orthorexia nervosa: replication and validation of the ORTO questionnaires translated into Greek in a survey of 848 Greek individuals. Hormones (Athens) 2022; 21:251-260. [PMID: 35092606 PMCID: PMC8799960 DOI: 10.1007/s42000-022-00351-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. METHODS The tool was translated into the Greek language (ORTO-15-GR) using the forward-backward-forward method. A total of 848 adults participated in the validation study by filling in the questionnaires and providing general characteristics (age, gender, educational level, body weight, and height). The internal consistency of the tool was assessed by the omega (ω) coefficient, and confirmatory factor analyses (CFA) examined its factorial structure. Using the original six items of the ORTO-15 tool, a separate CFA model examined the factorial structure of the proposed ORTO-R tool. Furthermore, regression models tested the association of ORTO-R with study variables. RESULTS For ORTO-15-GR, the omega coefficient was 0.70 and for the ORTO-R 0.65. For the latter, the CFA revealed acceptable goodness-of-fit (standardized factor loadings from 0.36 to 0.64); however, all ORTO-15 models were characterized by a poor fit. In addition, there was a negative association between ORTO-R score and female gender, body mass index (BMI), and having a nutrition-related health problem. CONCLUSION The replication of ORTO-R indicates that it is a reliable tool in the field of ON. Therefore, the use of a 6-item questionnaire for ON assessment appears promising in research and clinical settings.
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Affiliation(s)
- Konstantinos Gkiouras
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Tsampika Tsaliki
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Laurette Ntwali
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Gerontidis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftheria Taousani
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Midwifery, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Christos Tzimos
- Northern Greece Statistics Directorate, Hellenic Statistical Authority, Thessaloniki, Greece
| | - Radosław Rogoza
- Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Lorenzo M Donini
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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18
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Zemlyanskaya Y, Valente M, Syurina EV. Orthorexia nervosa and Instagram: exploring the Russian-speaking conversation around #opтopeкcия. Eat Weight Disord 2022; 27:1011-1020. [PMID: 34125430 PMCID: PMC8964642 DOI: 10.1007/s40519-021-01230-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/28/2021] [Indexed: 11/27/2022] Open
Abstract
This mixed-methods study explored the conversation around orthorexia nervosa (ON) on Instagram from a Russian-speaking perspective. Two quantitative data sources were implemented; a comparative content analysis of posts tagged with #opтopeкcия (n = 234) and #orthorexia (n = 243), and an online questionnaire completed by Russian-speakers (n = 96) sharing ON-related content on Instagram. Additionally, five questionnaire participants were interviewed, four of which identified with having (had) ON. Russian-speakers who share ON-related content on Instagram are primarily female, around their late-twenties, and prefer Instagram over other platforms. They describe people with ON as obsessed with correct eating, rather than healthy or clean eating. Instagram appears to have a dual effect; it has the potential to both trigger the onset of ON and encourage recovery. Positive content encourages a healthy relationship with food, promotes intuitive eating, and spread recovery advice. Harmful content, in turn, emphasizes specific diet and beauty ideals. Russian-speaking users mainly post pictures of food, followed by largely informative text that explains what ON is, and what recovery may look like. Their reasons for posting ON-related content are to share personal experiences, support others in recovery, and raise awareness about ON. Two main target audiences were people unaware of ON and people seeking recovery support. The relationship between ON and social media is not strictly limited to the global north. Thus, it may be valuable to further investigate non-English-speaking populations currently underrepresented in ON research.Level of evidence: Level V, descriptive study.
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Affiliation(s)
- Yana Zemlyanskaya
- Amsterdam University College, Science Park 113, 1098 XG Amsterdam, Netherlands
| | - Martina Valente
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
| | - Elena V. Syurina
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
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19
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Valente M, Renckens S, Bunders-Aelen J, Syurina EV. The #orthorexia community on Instagram. Eat Weight Disord 2022; 27:473-482. [PMID: 33835422 PMCID: PMC8933345 DOI: 10.1007/s40519-021-01157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/18/2021] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This mixed-methods study delved into the relationship between orthorexia nervosa (ON) and Instagram. METHODS Two quantitative data sources were used: content analysis of pictures using #orthorexia (n = 3027), and an online questionnaire investigating the experience of ON and the use of Instagram of people sharing ON-related content on Instagram (n = 185). Following, interviews (n = 9) were conducted with people posting ON-related content on Instagram and self-identifying as having (had) ON. RESULTS People who share ON-related content on Instagram were found to be primarily young women (questionnaire = 95.2% females, mean age 26.2 years; interviews = 100% females, mean age 28.4 years), who were found to be heavy social media users and favor Instagram over other platforms. Questionnaire respondents agreed in defining ON as an obsession with a diet considered healthy, with bio-psycho-social negative consequences, though those who self-identified as having (had) ON were more likely to point out the negative impairments of ON. Interviewees deemed Instagram partially responsible for the development of ON. Instead, they agreed that Instagram encourages problem realization. Content analysis showed that ON is encoded in pictures of 'food', 'people', 'text' and 'other.' Interviewees revealed that they started posting to recover, share information, help others, and they felt inspired to post by other accounts. A sense of belonging to the #orthorexia community emerged, where people share values and ideals, and seek validation from others. CONCLUSION Conversations around #orthorexia on Instagram generate supportive communities aiding recovery. Individuals use Instagram for helping others and themselves recovering from ON. Understanding how people help each other, manage their health, cope with symptoms, and undertake recovery can inform the implementation of therapeutic interventions for ON. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Martina Valente
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Sophie Renckens
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Joske Bunders-Aelen
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Elena V Syurina
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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20
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Grammatikopoulou MG, Gkiouras K, Polychronidou G, Kaparounaki C, Gkouskou KK, Magkos F, Donini LM, Eliopoulos AG, Goulis DG. Obsessed with Healthy Eating: A Systematic Review of Observational Studies Assessing Orthorexia Nervosa in Patients with Diabetes Mellitus. Nutrients 2021; 13:nu13113823. [PMID: 34836080 PMCID: PMC8622186 DOI: 10.3390/nu13113823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/20/2021] [Accepted: 10/24/2021] [Indexed: 12/12/2022] Open
Abstract
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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Affiliation(s)
- Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, GR-57400 Thessaloniki, Greece;
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Georgia Polychronidou
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Chrysi Kaparounaki
- Medical School, Faculty of Health Sciences, University Campus, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; (K.G.); (G.P.); (C.K.)
| | - Kalliopi K. Gkouskou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece; (K.K.G.); (A.G.E.)
- Embiodiagnostics Biology Research Company, GR-71305 Heraklion, Greece
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, 1958 Frederiksberg, Denmark;
| | - Lorenzo Maria Donini
- Department of Experimental Medicine-Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy;
| | - Aristides G. Eliopoulos
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece; (K.K.G.); (A.G.E.)
- Biomedical Research Foundation of the Academy of Athens, GR-11527 Athens, Greece
- Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, GR-56429 Thessaloniki, Greece
- Correspondence:
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21
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Nunn TA. Meghan Markle's healthy lifestyle in the media: Multiracial exceptionalism and the cult of slimness. WOMENS STUDIES INTERNATIONAL FORUM 2021. [DOI: 10.1016/j.wsif.2021.102459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Brytek-Matera A, Plasonja N, Décamps G. Assessing Orthorexia Nervosa: Validation of the Polish Version of the Eating Habits Questionnaire in a General Population Sample. Nutrients 2020; 12:nu12123820. [PMID: 33327518 PMCID: PMC7764984 DOI: 10.3390/nu12123820] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
Extreme focus on healthy eating, called orthorexia nervosa (ON), was assessed using a 21-item Eating Habits Questionnaire (EHQ). The present study aimed to validate the Polish version of the EHQ in a general population sample. Nine hundred sixty-seven women (59%) and men participated in the present study. Data was obtained from an internet-administered survey. Exploratory factor analysis with the first split sample (n = 502) produced a three-factor solution accounting for 47% of the variance. In confirmatory factor analysis with the second split sample (n = 465), the three-factor structure showed satisfactory goodness-of-fit (comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.008). Reliability analysis for the Polish version of the EHQ across the whole questionnaire showed strong internal consistency (α = 0.88, intraclass correlation coefficient (ICC) = 0.86). The internal consistency, measured by Cronbach's alpha coefficients, for the EHQ subscales were 0.85 (knowledge), 0.81 (problems), and 0.81 (feelings and behaviors). Total EHQ score was positively correlated with its three subscales, cognitive restraint, uncontrolled eating, and emotional eating, and was negatively correlated with body mass index (BMI). The Polish version of the EHQ is a reliable questionnaire that can be used with confidence to better assess ON in a general population sample.
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Affiliation(s)
- Anna Brytek-Matera
- Faculty of Psychology in Katowice, SWPS University of Social Sciences and Humanities, 40-326 Katowice, Poland
- Correspondence: or
| | - Natalija Plasonja
- LabPsy, University of Bordeaux, F-33000 Bordeaux, France; (N.P.); (G.D.)
| | - Greg Décamps
- LabPsy, University of Bordeaux, F-33000 Bordeaux, France; (N.P.); (G.D.)
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23
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Strahler J, Haddad C, Salameh P, Sacre H, Obeid S, Hallit S. Cross-cultural differences in orthorexic eating behaviors: Associations with personality traits. Nutrition 2020; 77:110811. [PMID: 32447071 DOI: 10.1016/j.nut.2020.110811] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/10/2020] [Accepted: 03/01/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Sociocultural factors and personality traits play key roles in determining dietary behaviors. Orthorexia nervosa (ON), the pathologic obsession with healthy eating, is increasingly receiving scientific attention. However, mechanisms and risk factors are not completely understood. The aims of this study were to compare the prevalence of orthorexic eating attitudes among adults in Germany and Lebanon, and to examine the relationship with primary facets of personality and maladaptive personality traits. METHODS The German sample comprised 391 adults, of which 314 were women (80.3%) and the mean age was 27 y. The Lebanese sample comprised 519 adults, of which 283 were women (56%) and the mean age was 36 y. In addition to sociodemographic data, participants completed the Dusseldorf Orthorexia Scale (DOS), the Teruel Orthorexia Scale (TOS), the Big Five Inventory, and the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. RESULTS Generally higher levels of healthy orthorexia among women and higher levels of ON according to the TOS-ON and DOS scores were found in Lebanon. In the Lebanese sample, 8.4% presented a high risk for ON, whereas this was true for only 4.9% of the German sample. Some associations between DOS/TOS scores and personality traits appeared but coefficients were generally low. Hierarchical multiple regression showed that the negative association between ON and the traits agreeableness and negative affectivity was clearly evident in the Lebanese sample but less so in the German sample. Age, body mass index, marital status, and subjective social status were not relevant moderators of effects. Comparison by country indicated higher prevalence of pathologic healthful eating and ON in the Lebanese sample compared with the German group. Personality traits, but not sociodemographic variables, partly contributed to this difference. CONCLUSION The present results suggested the importance of sociocultural factors in the development of eating pathologies and proposed specific personality traits as important associated factors.
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Affiliation(s)
- Jana Strahler
- Department of Health Psychology and Applied Diagnostics, Faculty of Human-Social Sciences, University of Wuppertal, Wuppertal, Germany; Department of Psychotherapy and Systems Neuroscience, Faculty of Psychology and Sport Science, University of Giessen, Giessen, Germany.
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, Limoges, France; CH Esquirol, Department of Psychiatry, Limoges, France
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon; Faculty of Pharmacy, Lebanese University, Hadat, Lebanon; Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Hala Sacre
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon; Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Sahar Obeid
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon; Department of Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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