Is orthorexia nervosa a feature of obsessive-compulsive disorder? A multicentric, controlled study.
Diagnostic criteria
Eating disorders
ORTO-15
ORTO-R
Obsessive–compulsive disorder
Orthorexia nervosa
Psychopathology
Journal
Eating and weight disorders : EWD
ISSN: 1590-1262
Titre abrégé: Eat Weight Disord
Pays: Germany
ID NLM: 9707113
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
03
09
2020
accepted:
13
01
2021
pubmed:
6
2
2021
medline:
23
11
2021
entrez:
5
2
2021
Statut:
ppublish
Résumé
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). 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. 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. 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.
Identifiants
pubmed: 33544361
doi: 10.1007/s40519-021-01114-7
pii: 10.1007/s40519-021-01114-7
doi:
Types de publication
Controlled Clinical Trial
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2531-2544Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.
Références
Bratman S, Knight D (2000) Health food junkies. Orthorexia nervosa: overcoming the obsession with healthful eating. Broadway Books, New York
Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2004) Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord 9:151–157
pubmed: 15330084
Mathieu J (2005) What is orthorexia? J Am Diet Assoc 105:1510–1512
pubmed: 16183346
Moroze RM, Dunn TM, 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 56:397–403
pubmed: 25016349
Koven NS, Abry AW (2015) The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat 11:385–394
pubmed: 25733839
pmcid: 4340368
Łucka I, Janikowska-Hołoweńko D, Domarecki P, Plenikowska-Ślusarz T, Domarecka M (2019) Orthorexia nervosa—a separate clinical entity, a part of eating disorder spectrum or another manifestation of obsessive-compulsive disorder? Psychiatr Pol 53:371–382
pubmed: 31317964
Cena H, Barthels F, Cuzzolaro M, Bratman S, Brytek-Matera A, Dunn T, Varga M, Missbach B, Donini LM (2019) Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord 24:209–246
pubmed: 30414078
Barthels F, Meyer F, Pietrowsky R (2015) Orthorexic eating behavior. Ernahrungs. Umschau 62:156–161
Vandereycken W (2011) Media hype, diagnostic fad or genuine disorder? Professionals’ opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eat Disord 19:145–155
pubmed: 21360365
Varga M, Dukay-Szabó S, Túry F, van Furth EF (2013) Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord 18:103–111
pubmed: 23760837
Dunn TM, Bratman S (2016) On orthorexia nervosa: review of the literature and proposed diagnostic criteria. Eat Behav 21:11–17
pubmed: 26724459
Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2005) Orthorexia nervosa: validation of a diagnosis questionnaire. Eat Weight Disord 10:28–32
Valente M, Syurina EV, Donini LM (2019) Shedding light upon various tools to assess orthorexia nervosa: a critical literature review with a systematic search. Eat Weight Disord 24(4):671–682
pubmed: 31228168
pmcid: 6647444
Arusoğlu G, Kabakçi E, Köksal G, Merdol TK (2008) Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turk J Psychiatr 19:283–291
Brytek-Matera A, Krupa M, Poggiogalle E, Donini LM (2014) Adaptation of the ORTHO-15 test to Polish women and men. Eat Weight Disord 19:69–76
pubmed: 24448996
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
pubmed: 26280449
pmcid: 4539204
Varga M, Thege BK, Dukay-Szabó S, Túry F, van Furth EF (2014) When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry 14:59–70
pubmed: 24581288
pmcid: 3943279
Rogoza R, Donini LM (2020) Introducing ORTO-R: a revision of ORTO-15. Based on the re-assessment of original data. Eat Weight Disord. https://doi.org/10.1007/s40519-020-00924-5
doi: 10.1007/s40519-020-00924-5
pubmed: 32436165
pmcid: 8004519
Kinzl JF, Hauer K, Traweger C, Kiefer I (2006) Orthorexia nervosa in dieticians. Psychother Psychosom 75(6):395–396
pubmed: 17053342
De Souza QJOV, Rodrigues AM (2014) Risk behavior for orthorexia nervosa in nutrition students. Revista Chilena de Nutricion 63:200–204
Dunn TM, Gibbs J, Whitney N, Starosta A (2017) Prevalence of orthorexia nervosa is less than 1%: data from a US sample. Eat Weight Disord 22:185–192
pubmed: 26902744
Ramacciotti CE, Perrone P, Coli E, Burgalassi A, Conversano C, Massimetti G, Dell’Osso L (2011) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15). Eat Weight Disord 16:e127-130
pubmed: 21989097
Dell’Osso L, Carpita B, Muti D, Cremone IM, Massimetti G, Diadema E, Gesi C, Carmassi C (2018) Prevalence and characteristics of orthorexia nervosa in a sample of university students in Italy. Eat Weight Disord 23:55–65
pubmed: 29134507
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
pubmed: 30556782
pmcid: 6376377
McKenna PJ (1984) Disorders with overvalued ideas. Br J Psychiatry 145:579–585
pubmed: 6391600
Segura-Garcia C, Ramacciotti C, Rania M, Aloi M, Caroleo M, Bruni A, Gazzarrini D, Sinopoli F, De Fazio P (2015) The prevalence of orthorexia nervosa among eating disorder patients after treatment. Eat Weight Disord 20(2):161–166
pubmed: 25543324
Brytek-Matera A, Fonte ML, Poggiogalle E, Donini LM, Cena H (2017) Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students. Eat Weight Disord 22(4):609–617
pubmed: 28840493
Yakın E, Raynal P, Chabrol H (2020) Distinguishing orthorexic behaviors from eating disordered and obsessive–compulsive behaviors: a typological study. Eat Weight Disord 11(11):385–394
Barthels F, Meyer F, Huber T, Pietrowsky R (2017) Analyse des orthorektischen Ernährungsverhaltens von Patienten mit Essstörungen und mit Zwangsstörungen. Zeitschrift für Klinische Psychologie und Psychotherapie 46(1):32–41
Bosi ATB, Çamur D, Güler Ç (2007) Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey). Appetite 49:661–666
Roncero M, Barrada JR, Perpiñá C (2017) Measuring orthorexia nervosa: psychometric limitations of the ORTO-15. Span J Psychol 20:E41
pubmed: 28929989
Sica C, Ghisi M, Altoè G, Chiri LR, Franceschini S, Codareschi D, Melli G (2009) The Italian version of the obsessive compulsive inventory: its psychometric properties on community and clinical samples. J Anxiety Disord 23(2):204–211
pubmed: 18701254
Marchetti I, Chiri LR, Ghisi M, Sica C (2010) Obsessive-compulsive inventory-revised (OCI-R): presentazione e indicazioni di utilizzo nel contesto Italiano. Psicoterapia Cogn Comportam 16(1):69–84
Wootton BM, Diefenbach GJ, Bragdon LB, Steketee G, Frost RO, Tolin DF (2015) A contemporary psychometric evaluation of the obsessive compulsive inventory-revised (OCI-R). Psychol Assess 27(3):874–882
pubmed: 25664634
pmcid: 4530108
Abramowitz JS, Tolin DF, Diefenbach GJ (2005) Measuring change in OCD: sensitivity of the obsessive-compulsive inventory-revised. J Psychopathol Behav Assess 27(4):317–325
Fidan T, Ertekin V, Işikay S, Kirpinar I (2010) Prevalence of orthorexia among medical students in Erzurum. Turkey Compr Psychiatry 51(1):49–54
pubmed: 19932826
Eriksson L, Baigi A, Marklund B, Lindgren EC (2008) Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants. Scand J Med Sci Sports 18:389–394
pubmed: 18067519
Aksoydan E, Camci N (2009) Prevalence of orthorexia nervosa among Turkish performance artists. Eat Weight Disord 14:33–37
pubmed: 19367138
Alvarenga MS, Martins MCT, Sato KSCJ, Vargas SVA, Philippi ST, Scagliusi FB (2012) Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15. Eat Weight Disord 17(1):e29-35
pubmed: 22751269
Almeida C, Vieira Borba V, Santos L (2018) Orthorexia nervosa in a sample of Portuguese fitness participants. Eat Weight Disord 23(4):443–451
pubmed: 29808255
Fendrich M, Mackesy-Amiti ME, Johnson TP, Hubbell A, Wislar JS (2005) Tobacco-reporting validity in an epidemiological drug-use survey. Addict Behav 30(1):175–181
pubmed: 15561458
Falk,P. (1994). The consuming body, Bologna, Il Mulino.
Bokor G, Anderson PD (2014) Obsessive-compulsive disorder J Pharm Pract 27(2):116–130
pubmed: 24576790
Shadish WR, Cook TD, Campbell DT (2002) Experimental and quasi-experimental designs for generalized causal inference. Houghton Mifflin Company, Boston, MA
Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, Fulton J, Hebert JR (2005) The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol 161(4):389–398
pubmed: 15692083