Skip to main content
SpringerLink
Log in

Structural validation of the ORTO-12-FR questionnaire among a French sample as a first attempt to assess orthorexia nervosa in France

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

To the best of our knowledge, no scientific publications on orthorexia nervosa have been based on a French population. The goal of our study was to confirm the factor structure of the French version of the ORTO-15 questionnaire.

Methods

An online survey (N = 768) was conducted asking participants (84.77% were women) to answer several questions about their dietary habits and to assess orthorexia nervosa using the ORTO-15 scale. Confirmatory factor analysis (CFA) was used for the validation.

Results

Given our results, we deemed it necessary to adapt the French version of the ORTO-15 questionnaire by omitting three items. The CFA supported the ORTO-12-FR (composed of 12 items and addressing three domains: rational, emotional, and behavioral) as the better-fitting model, with an internal consistency of 0.73. The Comparative Fit Index value was 0.93, the Tucker–Lewis Index was 0.90, and the Root Mean-Square Error of Approximation was 0.05.

Conclusions

Our results provide evidence for the reliability of ORTO-12-FR with a French population.

Level of evidence

V, descriptive cross-sectional study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bratman S The health food eating disorder. http://www.orthorexia.com/original-orthorexia-essay

  2. Bratman S, Knight D (2000) Health food junkies: orthorexia nervosa. Overcoming the obsession with healthful eating. Broadway Books, New York

    Google Scholar 

  3. Strahler J, Hermann A, Walter B, Stark R (2018) Orthorexia nervosa: a behavioral complex or a psychological condition? J Behav Addict 7(4):1143–1156. https://doi.org/10.1556/2006.7.2018.129

    Article  PubMed  PubMed Central  Google Scholar 

  4. Missbach B, Dunn T, König J (2016) We need new tools to assess orthorexia nervosa. A commentary on “prevalence of orthorexia nervosa among college students based on Bratman’s test and associated tendencies”. Appetite. https://doi.org/10.1016/j.appet.2016.07.010

    Article  PubMed  Google Scholar 

  5. Dell’Osso L, Carpita B, Muti B (2017) Prevalence and characteristics of orthorexia nervosa in a sample of university students in Italy. Eat Weight Disord 23:55–66. https://doi.org/10.1007/s40519-017-0460-3

    Article  PubMed  Google Scholar 

  6. Zickgraf H, Ellis J, Essayli J (2019) Disentangling orthorexia nervosa from healthy eating and other eating disorder symptoms: relationships with clinical impairment, comorbidity, and self-reported food choices. Appetite 134:40–49. https://doi.org/10.1016/j.appet.2018.12.006

    Article  PubMed  Google Scholar 

  7. Brytek-Matera A, Fonte ML, Poggiogalle E, Donini LM, Cena H (2017) Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disorderd eating patterns and body uneasiness among Italian University students. Eat Weight Disord 4:609–617. https://doi.org/10.1007/s40519-017-0427-4

    Article  Google Scholar 

  8. Cena H, Barthels F, Cuzzolaro M, Bratman S, Brytek-Matera A, Dunn T, Varga M, Missbach B, Donini LM (2018) Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord 24(2):209–246. https://doi.org/10.1007/s40519-018-0606-y

    Article  PubMed  Google Scholar 

  9. Chard C, Hilzendegen C, Barthels F (2018) Psychometric evaluation of the English version of the Düsseldorf Orthorexie Scale (DOS) and the prevalence of orthorexia nervosa among as US student sample. Eat Weight Disord 24(2):275–281. https://doi.org/10.1007/s40519-018-0570-6

    Article  PubMed  Google Scholar 

  10. Varga M, Dukay-Szabo S, Tury F, Van Furth E (2013) Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord 18:103–111. https://doi.org/10.1007/s40519-013-0026-y

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  12. Moroze R, Dunn T, Craig Holland J, 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. https://doi.org/10.1016/j.psym.2014.03.003

    Article  PubMed  Google Scholar 

  13. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington

    Book  Google Scholar 

  14. World Health Organization (2018) International statistical classification of diseases and related health problems (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en

  15. Łucka I, Janikowska-Hołoweńko D, Domarecki P, Plenikowska-Ślusarz T, Domarecka M (2018) Orthorexia nervosa—a separate clinical entity, a part of eating disorder spectrum or another manifestation of obsessive-compulsive disorder? Psychiatr Pol 53:1–12. https://doi.org/10.12740/PP/OnlineFirst/85729

    Article  Google Scholar 

  16. 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. https://doi.org/10.2147/NDT.S108912

    Article  PubMed  PubMed Central  Google Scholar 

  17. Missbach B, Barthels F (2017) Orthorexia Nervosa: moving forward in the field. Eat Weight Disord. https://doi.org/10.1007/s40519-017-0365-1

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Segura-Garcia C, Ramacciotti C, Rania M, Aloi M, Caroleo M, Bruni A, Gazzarrini D, Sinopoli F, De Fazio P (2014) The prevalence of orthorexia nervosa among eating disorder patients after treatment. Eat Weight Disord 2:161–166. https://doi.org/10.1007/s40519-014-0171-y

    Article  Google Scholar 

  20. Luck-Sikorski C, Jung F, Schlosser K, Riedel-Heller S (2018) Is orthorexic behavior common in the general public? A large representative study in Germany. Eat Weight Dis Stud Anorex Bulim Obes. https://doi.org/10.1007/s40519-018-0502-5

    Article  Google Scholar 

  21. Bratman S. http://www.orthorexia.com/the-authorized-bratman-orthorexia-self-test/

  22. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2005) Orthorexia Nervosa: validation of a diagnosis questionnaire. Eat Weight Dis 10:28–32

    Article  Google Scholar 

  23. Barthels F, Meyer F, Pietrowsky R (2015) Die Düsseldorfer Orthorexie Skala-Konstruktion und Evaluation eines Fragebogens zur Erfassung ortho-rektischen Ernährungsverhaltens. Z Klin Psychol Psychother 44:97–105 (in German)

    Article  Google Scholar 

  24. Costa C, Hardan-Khalil K, Gibbs K (2017) Orthorexia nervosa: a review of the literature. Issues Ment Health Nurs 38(12):980–988. https://doi.org/10.1080/01612840.2017.1371816

    Article  PubMed  Google Scholar 

  25. Rogoza R (2018) Investigating the structure of ORTO-15: a meta-analytical simulation study. Eating and weight disorders. https://doi.org/10.1007/s40519-018-0621-z

    Article  PubMed  PubMed Central  Google Scholar 

  26. Arusoğlu G, Kabakçi E, Köksal G, Merdol TK (2008) Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turk Psikiyatr Derg 19:283–291. http://www.ncbi.nlm.nih.gov/pubmed/18791881

  27. Varga M, Thege BK, Dukay-Szabó S, Túry F, van Furth EF, Bratman S et al (2014) When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry BioMed Cent 14:59. https://doi.org/10.1186/1471-244X-14-59

    Article  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 Dis 19:69–76. https://doi.org/10.1007/s40519-014-0100-0

    Article  Google Scholar 

  29. 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:e0135772. https://doi.org/10.1371/journal.pone.0135772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Parra-Fernandez ML, Rodríguez-Cano T, Pérez-Haro MJ, Onieva-Zafra M, Fernandez Martinez E, Blanca Notario-Pacheco (2018) Structural validation of ORTO-11-ES for the diagnosis of orthorexia nervosa, Spanish version. Eat Weight Dis Stud Anorex Bulim Obes. https://doi.org/10.1007/s40519-018-0573-3

    Article  Google Scholar 

  31. Goldfield GS, Adamo KB, Rutherford J et al (2008) Stress and the relative reinforcing value of food in female binge eaters. Physiol Behav 93:579–587. https://doi.org/10.1016/j.physbeh.2007.10.022

    Article  CAS  PubMed  Google Scholar 

  32. Macht M, Dettmer D (2006) Everyday mood and emotions after eating a chocolate bar or an apple. Appetite 46(3):332–336. https://doi.org/10.1016/j.appet.2006.01.014

    Article  PubMed  Google Scholar 

  33. Macht M, Gerer J, Ellgring H (2003) Emotions in overweight and normal-weight women immediately after eating foods differing in energy. Physiol Behav 80(2–3):367–374. https://doi.org/10.1016/j.physbeh.2003.08.012

    Article  CAS  PubMed  Google Scholar 

  34. Marzola E, Nasser JA, Hashim SA, Shih PB, Kaye WH (2013) Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment. BMC Psychiatry 13:290. https://doi.org/10.1186/1471-244X-13-290

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ford T, Lee H, Jeon M (2017) The emotional eating and negative food relationship experiences of obese and overweight adults. Soc Work Health Care 56:488–504. https://doi.org/10.1080/00981389.2017.1301620

    Article  PubMed  Google Scholar 

  36. Barthels F, Barrada JR, Roncero M (2019) Orthorexia nervosa and healthy orthorexia as new eating styles. PLoS ONE 14(7):e0219609. https://doi.org/10.1371/journal.pone.0219609

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Kinzl J, Hauer K, Traweger C, Kiefer I (2006) Orthorexia nervosa in dieticians. Psychother Psychosom 75:395–396. https://doi.org/10.1159/000095447

    Article  PubMed  Google Scholar 

  38. Barthels F, Meyer F, Huber T, Pietrowsky R (2016) Orthorexic eating behaviour as a coping strategy in patients with anorexia nervosa. Eat Weight Dis 2:269–276. https://doi.org/10.1007/s40519-016-0329-x

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology EA 7403, ICP Ecole de Psychologues Praticiens, 71 rue Molière, 69003, Lyon, France

    Camille Babeau & Tristan Le Chevanton

  2. EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France

    Sabrina Julien-Sweerts, Aurélie Brochenin & Damien Fouques

  3. Sapienza University, Rome, Italy

    Lorenzo Maria Donini

Authors
  1. Camille Babeau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tristan Le Chevanton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabrina Julien-Sweerts
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aurélie Brochenin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lorenzo Maria Donini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Damien Fouques
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Camille Babeau.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study followed the ethical guidelines of the Declaration of Helsinki and was approved by the local ethics committee of the Ecole de Psychologues Praticiens (Paris, France).

Informed consent

All participants offered their informed consent before starting the survey.

Funding

No funding was obtained for this research.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of topical collection on Orthorexia Nervosa.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Babeau, C., Le Chevanton, T., Julien-Sweerts, S. et al. Structural validation of the ORTO-12-FR questionnaire among a French sample as a first attempt to assess orthorexia nervosa in France. Eat Weight Disord 25, 1771–1778 (2020). https://doi.org/10.1007/s40519-019-00835-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-019-00835-0

Keywords

Search

Navigation