Profiling orthorexia nervosa in young adults: the role of obsessive behaviour, perfectionism, and self-esteem

Daniella Mahfoud; Susanna Pardini; Magdalena Mróz; Souheil Hallit; Sahar Obeid; Marwan Akel; Caterina Novara; Anna Brytek-Matera

doi:10.1186/s40337-023-00915-8

Profiling orthorexia nervosa in young adults: the role of obsessive behaviour, perfectionism, and self-esteem

J Eat Disord. 2023 Oct 19;11(1):188. doi: 10.1186/s40337-023-00915-8.

Authors

Daniella Mahfoud¹, Susanna Pardini², Magdalena Mróz³, Souheil Hallit^{4

5

6}, Sahar Obeid⁷, Marwan Akel⁸, Caterina Novara², Anna Brytek-Matera⁹

Affiliations

¹ Eye N' Brain Research Group, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
² Department of General Psychology, University of Padova, 35131, Padua, Italy.
³ Eating Behavior Laboratory (EAT Lab), Institute of Psychology, University of Wrocław, 50-527, Wrocław, Poland.
⁴ School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
⁵ Applied Science Research Center, Applied Science Private University, Amman, 11931, Jordan.
⁶ Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
⁷ School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, 4504, Lebanon.
⁸ School of Pharmacy, Lebanese International University, Beirut, Lebanon.
⁹ Eating Behavior Laboratory (EAT Lab), Institute of Psychology, University of Wrocław, 50-527, Wrocław, Poland. anna.brytek-matera@uwr.edu.pl.

Abstract

Background: Orthorexia nervosa (ON) is a relatively new potential eating disorder characterized by an intense fixation on one's eating habits and the imposition of rigid and inflexible rules on oneself. Psychological factors such as obsessive-compulsive tendencies, perfectionism and self-esteem may interact in complex ways and contribute to the development and maintenance of ON.

Methods: This cross-sectional study included 977 participants from Italy, Lebanon, and Poland. Participants completed a questionnaire consisting of socio-demographic information, the Eating Habits Questionnaire, Obsessive-Compulsive Inventory, Obsessive Beliefs Questionnaire-44, Multidimensional Perfectionism Scale, and Rosenberg Self-Esteem Scale. Cluster analysis was used to identify subgroups of individuals with common psychological characteristics associated with ON.

Results: Three distinct clusters were identified based on their levels of obsession-compulsive beliefs, perfectionism, and self-esteem. The first group, labeled "High Self-Mastery," consisted of 37.0% of participants and exhibited low levels of obsession-compulsion, obsessive beliefs, and perfectionism, but high self-esteem. The second group, "Moderate Self-Mastery," comprised 39.5% of participants and had moderate levels of these traits. The third group, "Low Self-Mastery," consisted of 23.6% of participants and exhibited the highest levels of obsession-compulsion, obsessive beliefs, and perfectionism, but the lowest self-esteem. Additionally, a multivariable analysis revealed that being Lebanese (Beta = 3.39) and belonging to the last cluster (Beta = 4.53) were significantly associated with higher ON tendencies.

Conclusion: Our findings show that individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies. This study emphasizes the need to have a comprehensive understanding of how cultural and psychological factors interact in the development of eating disorders.

Keywords: Cluster analysis; Obsessive–compulsive beliefs; Orthorexia nervosa; Perfectionism; Self-esteem; Self-mastery.

Plain language summary

Orthorexia nervosa (ON) is a relatively new eating disorder that involves an intense focus on eating habits and strict rules about food. This study aimed to identify factors that may predict the development of ON. A questionnaire was given to 977 participants from Italy, Lebanon, and Poland to assess their psychological characteristics such as obsessive–compulsive tendencies, perfectionism, and self-esteem. Cluster analysis was performed to identify subgroups of individuals with common psychological characteristics associated with ON. The study found that participants from Lebanon, and individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies and were particularly vulnerable to the disorder.