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Orthorexic eating behavior in patients with somatoform disorders

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Abstract

Purpose

Although anecdotal reports suggest a relation between orthorexic eating behavior and symptoms of somatoform disorders, this issue has not yet been investigated. The aim of this study was to compare orthorexic eating behavior and other characteristics of disordered eating behavior in patients with somatoform disorders to a sample of healthy controls.

Methods

31 patients with somatoform disorders and 30 matched controls completed eight questionnaires, i.a., the Düsseldorf Orthorexia Scale, three scales of the Eating Disorder Inventory-2, Eating Attitudes Test-26, Multidimensional Inventory of Hypochondriacal Traits, Attitudes Towards Body and Health Questionnaire, and Screening for Somatoform Disorders.

Results

The patients displayed higher levels of orthorexic eating behavior, drive for thinness, body dissatisfaction, bulimia, and dieting than the control group. In both groups, orthorexic eating behavior was associated with higher levels of somatization in eating and health habits. The control group showed an association of orthorexic eating behavior with catastrophizing cognitions and the perceptual component of health anxiety.

Conclusion

The results support the hypothesis of a connection between orthorexic eating behavior and somatoform disorders. However, patients with somatoform disorders do not seem to be at particular risk for orthorexia. Future studies should investigate causes for the relationship between orthorexic eating behavior and characteristics of somatoform disorders in samples of healthy individuals.

Level of evidence

Level V, descriptive study with matched control group.

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Notes

  1. Please note that we refer to ICD-10 throughout this manuscript. This is because in Germany, ICD is used as the classification system in the health system. Since collection of the data took place in 2016, ICD-10 was the current manual.

  2. Please note that we use the term “orthorexic eating behavior” to describe the spectrum of an obsession with healthy eating ranging from 10 to 30 points on the DOS. Hence, we do not imply a potential pathological condition in these cases.

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Acknowledgements

The authors thank Jana Esders, Sina Lavendel, Saskia Poerschke, and Anna Wiecha for their help in collecting the data of the control group. The authors also wish to thank Hannah Kiesow-Berger for her valuable assistance with language revision and Laura Schall for technical support.

Funding

This study did not receive any funding.

Author information

Authors and Affiliations

  1. Department of Clinical Psychology, Institute of Experimental Psychology, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225, Düsseldorf, Germany

    Friederike Barthels, Romina Müller & Reinhard Pietrowsky

  2. Clinic of Psychosomatic Medicine and Psychotherapy, LVR Hospital Düsseldorf, Düsseldorf, Germany

    Tobias Schüth

  3. Center of Psychosocial Medicine, Clinic of Internal Medicine and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany

    Hans-Christoph Friederich

Authors
  1. Friederike Barthels
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  2. Romina Müller
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  3. Tobias Schüth
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  4. Hans-Christoph Friederich
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  5. Reinhard Pietrowsky
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Contributions

Conceptualization: FB and RM; methodology: FB; formal analysis, investigation and data collection: FB and TS; writing—original draft preparation: FB; writing—review and editing: RP and RM; resources: TS, HCF, and RP; supervision: RP and HCF.

Corresponding author

Correspondence to Friederike Barthels.

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Conflict of interest

The authors declare that they do not have a conflict of interest.

Ethical approval

The study was approved by the local ethics committee of the Heinrich-Heine-University, Düsseldorf, Germany (no reference number assigned), and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

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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Barthels, F., Müller, R., Schüth, T. et al. Orthorexic eating behavior in patients with somatoform disorders. Eat Weight Disord 26, 135–143 (2021). https://doi.org/10.1007/s40519-019-00829-y

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  • DOI: https://doi.org/10.1007/s40519-019-00829-y

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