Correlates of orthorexia nervosa among a representative sample of the Lebanese population

  • Chadia Haddad
  • Sahar Obeid
  • Marwan Akel
  • Karl Honein
  • Maria Akiki
  • Jocelyne Azar
  • Souheil HallitEmail author
Original Article
Part of the following topical collections:
  1. Orthorexia Nervosa



Orthorexia nervosa (ON), or the pathological preoccupation and “fixation on healthy food” has been emerging as a new eating disorder. A limited amount of literature exists today on the prevalence of ON. The objective of the current study was to assess factors associated with ON tendencies and behaviors among a representative sample of the Lebanese population.


This was a cross-sectional study, conducted between January and May 2018, which enrolled 811 participants from all Lebanese governorates. The ORTHO-15 scale was used to evaluate ON tendencies and behaviors among participants. Scores below 40 indicate the presence of ON.


The results showed that 589 (75.2%) participants had ON tendencies and behaviors. The results of the multivariable analysis taking the ORTHO-15 score as the dependent variable, showed that female gender (Beta = − 0.739), starving to lose weight (Beta = − 0.859), convincing others to follow a diet (Beta = − 0.971), thinking that eating out is unhealthy (Beta = − 0.931) and increased EAT (eating attitudes test) scores (Beta = − 0.087) were associated with higher level of orthorexia tendencies and behaviors (lower ORTHO-15 scores).


A highly unexpected prevalence of ON tendencies and behaviors was found in our sample. The Lebanese population might have high preoccupation behavior towards healthy and proper nutrition. Social awareness and behavioral intervention programs are warranted to follow a healthy diet and lifestyle behaviors, and consequently overcome ON.

Level of evidence

Level 5, cross-sectional descriptive study.


Orthorexia nervosa Healthy food Body image Eating habits Lifestyle habits 




Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

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. The Psychiatric Hospital of the Cross Ethics and Research Committee, in compliance with the Hospital’s Regulatory Research Protocol, approved this study protocol (HPC-020-2018).

Informed consent

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


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Psychiatric Hospital of the CrossJal EddibLebanon
  2. 2.Faculty of Philosophy and Human SciencesHoly Spirit University (USEK)JouniehLebanon
  3. 3.Faculty of PedagogyLebanese UniversityBeirutLebanon
  4. 4.School of PharmacyLebanese International UniversityBeirutLebanon
  5. 5.INSPECT-LBInstitut National de Sante Publique, Epidemiologie Clinique et ToxicologieBeirutLebanon
  6. 6.Faculty of Medicine and Medical SciencesHoly Spirit University of Kaslik (USEK)JouniehLebanon
  7. 7.Faculty of MedicineLebanese American UniversityByblosLebanon
  8. 8.BiakoutLebanon

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