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Validation of the Teruel Orthorexia Scale and relationship to health anxiety in a U.S. sample

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Abstract

Background

Scholarly investigation into orthorexia nervosa is relatively new, leading several scholars to develop new measures to adequately assess the concerns thought to underlie this condition. A promising new measure of orthorexia, the Teruel Orthorexia Scale (TOS), was developed using a Spanish sample.

Purpose

This study was the first to investigate the psychometric properties of the English version of the TOS in a U.S. sample. This study also examined the long-hypothesized relationship between orthorexia and health anxiety.

Methods

We used exploratory factor analysis (EFA) to evaluate the factor structure of the TOS. We also used correlational methods to test theorized relationships with related concerns.

Results

ESEM supported a 16-item, 2-factor model. Correlations between the modified TOS (i.e., TOS-16) subscales and measures of obsessive–compulsive and eating disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS-16. There was a moderate positive correlation between orthorexia nervosa and health anxiety and, together, pursuit of healthy eating and preoccupation with healthy eating accounted for a significant amount of variance in health anxiety after controlling for eating disorder symptoms.

Conclusion

Overall, this research suggests that the TOS-16 demonstrates psychometric properties as good as or better than other measures commonly used to assess the construct in a U.S. sample. In addition, findings support the consideration of health anxiety as a possible feature of orthorexia nervosa.

Level of evidence

Level V, descriptive research.

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Data are available from the corresponding author upon request.

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Authors and Affiliations

  1. Auburn University, Auburn, AL, USA

    Samantha Chace

  2. University of Mississippi, Oxford, MS, USA

    Annette S. Kluck

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  1. Samantha Chace
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Contributions

SC (lead author) had primary responsibility for conceptualization, methodology, analysis, interpretation of the data, and writing. AK supervised the research and supported the conceptualization, design, analysis, interpretation of data, and review and editing of the manuscript. Both authors read and approved the final manuscript.

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Correspondence to Samantha Chace.

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The study was approved by the Institutional Review Board (IRB) at Auburn University prior to initiation of participant recruitment or data collection. Participants provided informed consent and the authors followed the protocol as approved by the IRB.

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Chace, S., Kluck, A.S. Validation of the Teruel Orthorexia Scale and relationship to health anxiety in a U.S. sample. Eat Weight Disord 27, 1437–1447 (2022). https://doi.org/10.1007/s40519-021-01272-8

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