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Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students

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Abstract

Introduction

The present study aimed to investigate the relationship between ORTO-15 score and obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among female and male university students and to examine the predictive model of ORTO-15 in both groups.

Methods

One hundred and twenty students participated in the present study (mean age 22.74 years, SD 7.31). The ORTO-15 test, the Maudsley Obsessive-Compulsive Questionnaire, the Eating Attitudes Test-26 and the Body Uneasiness Test were used for the present study.

Results

Our results revealed no gender differences in ORTO-15 score. Our results show, rather unexpectedly, that in female students lower scores, corresponding to greater severity, were related to less pathological body image discomfort and obsessive-compulsive signs, while in male students, lower ORTO-15 scores were related to less pathological eating patterns, as behaviors and symptoms.

Conclusion

Further studies regarding the relationship between ON and anorexia nervosa, as well as obsessive-compulsive symptoms, are needed to better understand the causality.

Level of Evidence Level V, descriptive study.

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References

  1. Brytek-Matera A (2012) Orthorexia nervosa—an eating disorder, obsessive-compulsive disorder or disturbed eating habit? Arch Psychiatr Psychother 14(1):55–60

    Google Scholar 

  2. Chaki B, Pal S, Bandyopadhyay A (2013) Exploring scientific legitimacy of orthorexia nervosa: a newly emerging eating disorder. J Hum Sport Exerc 8(4):1045–1053. doi:10.4100/jhse.2013.84.14

    Article  Google Scholar 

  3. World Health Organization (2002) Global strategy on diet, physical activity and health. World Health Organization, Geneva

    Google Scholar 

  4. Bratman S (1997) Health food junkie. Yoga J 136:42–50

    Google Scholar 

  5. Bratman S, Knight D (2000) Health food junkies. Orthorexia nervosa: overcoming the obsession with healthful eating. Broadway Books, New York

    Google Scholar 

  6. Catalina Zamora ML, Bote Bonaechea B, García Sánchez F, Ríos Rial B (2005) Ortorexia nerviosa. ¿Un nuevo trastorno de la conducta alimentaria? Actas Esp Psiquiatr 33(1):66–68

    CAS  PubMed  Google Scholar 

  7. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington

    Book  Google Scholar 

  8. World Health Organization (2010) International statistical classification of diseases and related health problems, tenth revision. World Health Organization, Geneva

    Google Scholar 

  9. Barthels F, Meyer F, Pietrowsky R (2015) Orthorexic eating behavior. A new type of disordered eating. Ernährungs Umschau 62:156–161

    Google Scholar 

  10. Koven NS, Abry AW (2015) The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat 11:385–394. doi:10.2147/NDT.S61665

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bartrina JA (2007) Ortorexia o la obsesión por la dieta saludable. Arch Latinoam Nutr 57(4):313–315

    PubMed  Google Scholar 

  12. Fidan T, Ertekin V, Işikay S, Kirpinar I (2010) Prevalence of orthorexia among medical students in Erzurum, Turkey. Compr Psychiatry 51(1):49–54. doi:10.1016/j.comppsych.2009.03.001

    Article  PubMed  Google Scholar 

  13. Kummer A, Dias FM, Teixeira AL (2008) On the concept of orthorexia nervosa. Scand J Med Sci Sports 18(3):395–396. doi:10.1111/j.1600-0838.2008.00809.x

    Article  CAS  PubMed  Google Scholar 

  14. Arusoğlu G, Kabakçi E, Köksal G, Merdol TK (2008) Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turk Psikiyatri Derg 19(3):283–291

    PubMed  Google Scholar 

  15. Bağci Bosi AT, Camur D, Güler C (2007) Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey). Appetite 49(3):661–766. doi:10.1016/j.appet.2007.04.007

    Article  PubMed  Google Scholar 

  16. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2004) Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord 9(2):151–157

    Article  CAS  PubMed  Google Scholar 

  17. Mathieu J (2005) What is orthorexia? J Am Diet Assoc 105(10):1510–1512. doi:10.1016/j.jada2005.08.021

    Article  PubMed  Google Scholar 

  18. McInerney-Ernst EM (2011) Orthorexia nervosa: real construct or newest social trend? Dissertation, University of Missouri-Kansas City

  19. Kinzl JF, Hauer K, Traweger C, Kiefer I (2006) Orthorexia nervosa in dieticians. Psychother Psychosom 75(6):395–396. doi:10.1159/000095447

    Article  PubMed  Google Scholar 

  20. Koven NS, Senbonmatsu N (2013) A neuropsychological evaluation of orthorexia nervosa. Open J Psychiatr 3:214–222. doi:10.4236/ojpsych.2013.32019

    Article  Google Scholar 

  21. Segura-Garcia C, Ramacciotti C, Rania M, Aloi M, Caroleo M, Bruni A, Gazzarrini D, Sinopoli F, De Fazio P (2015) The prevalence of orthorexia nervosa among eating disorder patients after treatment. Eat Weight Disord 20(2):161–166. doi:10.1007/s40519-014-0171-y

    Article  PubMed  Google Scholar 

  22. Moroze RM, Dunn TM, Holland JC, Yager J, Weintraub P (2015) Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near-fatal “orthorexia nervosa” and proposed diagnostic criteria. Psychosomatics 56(4):397–403. doi:10.1016/j.psym.2014.03.003

    Article  PubMed  Google Scholar 

  23. Dunn TD, Bratman S (2016) On orthorexia nervosa: a review of the literature and proposed diagnostic criteria. Eat Behav 21:11–17. doi:10.1016/j.eatbeh.2015.12.006

    Article  PubMed  Google Scholar 

  24. Cuzzolaro M, Vetrone G, Marano G, Garfinkel PE (2006) The Body Uneasiness Test (BUT): development and validation of a new body image assessment scale. Eat Weight Disord 11(1):1–13

    Article  CAS  PubMed  Google Scholar 

  25. Varga M, Máté G (2009) Eating disturbances in orthorexia nervosa. XIII annual meeting of the European Association for Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) XXVIII European Conference on Psychosomatic Research (ECPR): a selection of the best abstracts submitted. J Psychosom Res 68:672–673

  26. Brytek-Matera A, Donini LM, Krupa M, Poggiogalle E, Hay P (2016) Erratum to: Orthorexia nervosa and self-attitudinal aspects of body image in female and male university students. J Eat Disord 4:16. doi:10.1186/s40337-016-0105-3

    Article  PubMed  PubMed Central  Google Scholar 

  27. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2005) Orthorexia nervosa: validation of a diagnosis questionnaire. Eat Weight Disord 10:e28–e32

    Article  CAS  PubMed  Google Scholar 

  28. Brytek-Matera A, Krupa M, Poggiogalle E, Donini LM (2014) Adaptation of the ORTHO-15 test to Polish women and men. Eat Weight Disord 19(1):69–76. doi:10.1007/s40519-014-0100-0

    Article  PubMed  Google Scholar 

  29. Tremelling K, Sandon L, Vega GL, McAdams CJ (2017) Orthorexia nervosa and eating disorder symptoms in registered dietitian nutritionists in the United States. J Acad Nutr Diet S2212–2672(17):30448–30453. doi:10.1016/j.jand.2017.05.001

    Article  Google Scholar 

  30. Ramacciotti CE, Perrone P, Coli E, Burgalassi A, Conversano C, Massimetti G, Dell’Osso L (2011) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15). Eat Weight Disord 16(2):e127–e130. doi:10.1007/BF03325318

    Article  CAS  PubMed  Google Scholar 

  31. Dell’Osso L, Abelli M, Carpita B, Pini S, Castellini G, Carmassi C, Ricca V (2016) Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive–compulsive spectrum. Neuropsychiatr Dis Treat 12:1651–1660. doi:10.2147/NDT.S108912

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sanavio E, Vidotto G (1985) The components of the Maudsley Obsessional-Compulsive Questionnaire. Behav Res Ther 23(6):659–662. doi:10.1016/0005-7967(85)90061-0

    Article  CAS  PubMed  Google Scholar 

  33. Bertolotti G, Zotti AM, Michielin P, Vidotto G, Sanavio E (1990) A computerized approach to cognitive behavioral assessment: an introduction to CBA-2.0 primary scales. J Behav Ther Exp Psychiatry 21(1):21–27. doi:10.1016/0005-7916(90)90045-M

    Article  CAS  PubMed  Google Scholar 

  34. Hodgson RJ, Rachman S (1977) Obsessional-compulsive complaints. Behav Res Ther 15(5):389–395. doi:10.1016/0005-7967(77)90042-0

    Article  CAS  PubMed  Google Scholar 

  35. Einstein D, Menzies R (2006) Magical thinking in obsessive-compulsive disorder, panic disorder and the general community. Behav Cogn Psychother 34(3):351–357. doi:10.1017/S1352465806002864

    Article  Google Scholar 

  36. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med 12(4):871–878

    Article  CAS  PubMed  Google Scholar 

  37. Dotti A, Lazzari R (1998) Validation and reliability of the Italian EAT-26. Eat Weight Disord 3(4):188–194

    Article  CAS  PubMed  Google Scholar 

  38. Rose N (1999) Powers of freedom: reframing political thought. Cambridge University Press, Cambridge

    Book  Google Scholar 

  39. Runfola CD, Von Holle A, Trace SE, Brownley KA, Hofmeier SM, Gagne DA, Bulik CM (2013) Body dissatisfaction in women across the lifespan: results of the UNC-SELF and Gender and Body Image (GABI) studies. Eur Eat Disord Rev 21(1):52–59. doi:10.1002/erv.2201

    Article  PubMed  Google Scholar 

  40. Carvalheira A, Godinho L, Costa P (2017) The impact of body dissatisfaction on distressing sexual difficulties among men and women: the mediator role of cognitive distraction. J Sex Res 54(3):331–340. doi:10.1080/00224499.2016.1168771

    Article  PubMed  Google Scholar 

  41. Karazsia BT, Murnen SK, Tylka TL (2017) Is body dissatisfaction changing across time? A cross-temporal meta-analysis. Psychol Bull 143(3):293–320. doi:10.1037/bul0000081

    Article  PubMed  Google Scholar 

  42. del Mar Bibiloni M, Coll JLI, Pich J, Pons A, Tur JA (2017) Body image satisfaction and weight concerns among a Mediterranean adult population. BMC Public Health 17(1):39. doi:10.1186/s12889-016-3919-7

    Article  Google Scholar 

  43. Richard A, Rohrmann S, Lohse T, Eichholzer M (2016) Is body weight dissatisfaction a predictor of depression independent of body mass index, sex and age? Results of a cross-sectional study. BMC Public Health 16(1):863. doi:10.1186/s12889-016-3497-8

    Article  PubMed  PubMed Central  Google Scholar 

  44. Rodin J, Silberstein L, Striegel-Moore R (1984) Women and weight: a normative discontent. Neb Symp Motiv 32:267–307

    CAS  Google Scholar 

  45. Griffiths S, Hay P, Mitchison D, Mond JM, McLean SA, Rodgers B, Massey R, Paxton SJ (2016) Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress. Aust N Z J Public Health 40(6):518–522. doi:10.1111/1753-6405.12538

    Article  PubMed  Google Scholar 

  46. Sanlier N, Yassibas E, Bilici S, Sahin G, Celik B (2016) Does the rise in eating disorders lead to increasing risk of orthorexia nervosa? Correlations with gender, education, and body mass index. Ecol Food Nutr 55(3):266–278. doi:10.1080/03670244.2016

    Article  PubMed  Google Scholar 

  47. Herranz Valera J, Acuña Ruiz P, Romero Valdespino B, Visioli F (2014) Prevalence of orthorexia nervosa among ashtanga yoga practitioners: a pilot study. Eat Weight Disord 19:469–472. doi:10.1007/s40519-014-0131-6

    Article  PubMed  Google Scholar 

  48. Brytek-Matera A, Rogoza R, Gramaglia C, Zeppegno P (2015) Predictors of orthorexic behaviours in patients with eating disorders: a preliminary study. BMC Psychiatry 15(1):252. doi:10.1186/s12888-015-0628-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Bundros J, Clifford D, Silliman K, Neyman Morris M (2016) Prevalence of Orthorexia nervosa among college students based on Bratman’s test and associated tendencies. Appetite 101:86–94. doi:10.1016/j.appet.2016.02.144

    Article  PubMed  Google Scholar 

  50. Asil E, Saip Sürücüoğlu M (2015) Orthorexia nervosa in Turkish dietitians. Ecol Food Nutr 54(4):303–313. doi:10.1080/03670244.2014.987920

    Article  PubMed  Google Scholar 

  51. Park SW, Kim JY, Go GJ, Jeon ES, Pyo HJ, Kwon YJ (2011) Orthorexia nervosa with hyponatremia, subcutaneous emphysema, pneumomediastinum, pneumothorax, and pancytopenia. Electrolyte Blood Press 9(1):32–37. doi:10.5049/EBP.2011.9.1.32

    Article  PubMed  PubMed Central  Google Scholar 

  52. Saddichha S, Babu GN, Chandra P (2012) Orthorexia nervosa presenting as prodrome of schizophrenia. Schizophr Res 134(1):110. doi:10.1016/j.schres.2011.10.017

    Article  PubMed  Google Scholar 

  53. Barnes MA, Caltabiano ML (2016) The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eat Weight Disord 22(1):177–184. doi:10.1007/s40519-016-0280-x

    Article  PubMed  Google Scholar 

  54. National Collaborating Centre for Mental Health (2004) Eating disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. NICE Clinical Guidelines, No. 9. British Psychological Society, Leicester

  55. Missbach B, Hinterbuchinger B, Dreiseitl V, Zellhofer S, Kurz C, König J (2015) When eating right, is measured wrong! A validation and critical examination of the ORTO-15 Questionnaire in German. PLoS One 10(8):e0135772. doi:10.1371/journal.pone.0135772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Dunn TM, Gibbs J, Whitney N, Starosta A (2017) Prevalence of orthorexia nervosa is less than 1%: data from a US sample. Eat Weight Disord 22:185–192. doi:10.1007/s40519-016-0258-8

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Katowice Faculty of Psychology, SWPS University of Social Sciences and Humanities, 40-326, Katowice, Poland

    Anna Brytek-Matera

  2. Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy

    Maria Luisa Fonte & Hellas Cena

  3. Experimental Medicine Department, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Rome, Italy

    Eleonora Poggiogalle & Lorenzo Maria Donini

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  1. Anna Brytek-Matera
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  2. Maria Luisa Fonte
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  3. Eleonora Poggiogalle
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  4. Lorenzo Maria Donini
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  5. Hellas Cena
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Correspondence to Anna Brytek-Matera.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Institutional Review Board (IRB) approval was obtained per institutional guidelines. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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This article is part of the topical collection on Orthorexia nervosa.

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Brytek-Matera, A., Fonte, M.L., Poggiogalle, E. et al. Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students. Eat Weight Disord 22, 609–617 (2017). https://doi.org/10.1007/s40519-017-0427-4

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