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Is orthorexia nervosa a feature of obsessive–compulsive disorder? A multicentric, controlled study

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive–Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population).

Methods

We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R.

Results

In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p = .0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study.

Conclusions

ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.

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Availability of data and material

Data and material used in the present study are available upon request to the corresponding author, prof. Silvia Ferrari.

Code availability

Not pertinent.

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Funding

The present research was conducted without receiving any support or funding.

Author information

Authors and Affiliations

  1. School of Specialization in Geriatrics, Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy

    G. Vaccari

  2. School of Specialization in Psychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy

    A. Cutino, F. Luisi, S. Navab Daneshmand & M. Pinelli

  3. Private Hospital Casa Di Cura Villa Rosa, Modena, Italy

    N. Giambalvo

  4. Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy

    G. Maina

  5. Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy

    G. Maina & S. Ferrari

  6. Section of Clinical Neurosciences, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124, Modena, Italy

    G. M. Galeazzi

  7. Department of Surgical, Medical, Dental and Morphological Sciences With Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy

    S. Kaleci

  8. Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy

    U. Albert

  9. Department of Mental Health, UCO Clinica Psichiatrica, ASUGI-Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy

    U. Albert

  10. Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy

    A. R. Atti

Authors
  1. G. Vaccari
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  2. A. Cutino
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  3. F. Luisi
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  8. G. M. Galeazzi
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  9. S. Kaleci
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  12. S. Ferrari
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by all the authors. The first draft of the manuscript was written by Anna Cutino, Silvia Ferrari, Filippa Luisi & Margherita Pinelli, and all the other authors subsequently included comments and improvements. All authors read and approved the final manuscript and its subsequent revised version.

Corresponding author

Correspondence to S. Ferrari.

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Conflict of interest

No one of the authors has any conflicts to declare.

Ethical approval

The study was conducted according to the Good Clinical Practice principles, the Helsinki Declaration’s statements and the current legislation regarding observational studies. The study was approved by the local ethics committee (Comitato Etico AVEN, Regione Emilia Romagna, Italy, Cod. 146/16, date of approval 9.9.2016).

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This was collected in the written form from all participants to the study.

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Vaccari, G., Cutino, A., Luisi, F. et al. Is orthorexia nervosa a feature of obsessive–compulsive disorder? A multicentric, controlled study. Eat Weight Disord 26, 2531–2544 (2021). https://doi.org/10.1007/s40519-021-01114-7

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  • DOI: https://doi.org/10.1007/s40519-021-01114-7

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