Orthorexia Nervosa: over concern or obsession about healthy food?

Eat Weight Disord. 2021 Dec;26(8):2577-2588. doi: 10.1007/s40519-021-01110-x. Epub 2021 Feb 10.

Abstract

Purpose: Orthorexia Nervosa is characterized by specific behaviors frequently related to other psychopathological conditions, such as Obsessive-Compulsive Disorder (OCD) and Eating Disorders (EDs). Whereas ON can mainly be described as an excessive concern regarding healthy food, the study's principal aim was to investigate if ON could be considered a condition related and differentiated from worry, other than OCD, EDs, perfectionism, anxiety, and depression.

Method: To achieve these aims, 302 individuals from the general population were enrolled and were divided into two groups named "High EHQ" and "Low EHQ", based on their Eating Habits Questionnaire's score (EHQ-21).

Results: Correlations of ON with EDs and non-adaptive perfectionism constructs emerged independently from Obsessive-Compulsive (OC) symptoms, and the same pattern was observed when comparing the High and the Low EHQ groups. The two groups also differ in the worry anxiety and depression constructs and are not affected by OC symptoms removal.

Discussion: Our results confirm a relationship between ON with the typical ED, perfectionistic, anxious, and depressive symptomatology, mainly when the OC features are controlled; moreover, worry constructs could be considered characteristic of the ON phenomenology. This study does not entirely exclude the relationship with obsessive and compulsive characteristics, which could be associated with or serve as a mediator of the orthorexic behavior. Future research could explore the potential mediating or collateral role of OC symptoms.

Level of evidence: Level III, evidence obtained from well-designed cohort or case-control analytic studies.

Keywords: Dieting; Eating features; Obsessive–compulsive features; Orthorexia Nervosa; Worry.

MeSH terms

  • Anxiety Disorders
  • Feeding Behavior
  • Feeding and Eating Disorders*
  • Humans
  • Obsessive Behavior
  • Perfectionism*