Orthorexia nervosa is a term that may not be as widely recognized as anorexia or bulimia, yet it describes a potentially debilitating condition that has been gaining attention in the field of eating disorders. A new study published in the Journal of Eating Disorders provides evidence that individuals grappling with lower self-esteem and heightened obsessive perfectionism are more susceptible to orthorexia nervosa tendencies, which represent a pathological fixation on healthy food.
Orthorexia nervosa is characterized by an excessive preoccupation with eating food that one considers healthy. It involves rigid, self-imposed rules around diet that go beyond simply eating a healthy meal. Individuals with orthorexia nervosa are obsessed with the quality and purity of their food, often leading to significant dietary restrictions, nutritional deficiencies, and even social isolation due to their stringent eating habits.
A team of researchers from Singapore, Poland, Lebanon, and Italy sought to better understand this relatively new condition. Despite increasing recognition, orthorexia nervosa lacks formal diagnostic criteria, making it a challenging disorder to study and treat. The researchers aimed to uncover the psychological underpinnings of the condition to identify those at risk and develop effective interventions.
The study included 977 participants from Italy, Lebanon, and Poland, with an average age of 22 and an average body mass index of 22 (normal weight). A majority of the participants (77.1%) were women.
The participants completed a series of psychological assessments, including the Eating Habits Questionnaire (EHQ), which assesses cognitions, behaviors, and feelings related to an extreme focus on healthy eating; the Obsessive-Compulsive Inventory-Revised (OCI-R), measuring symptoms of OCD; the Obsessive Beliefs Questionnaire-44 (OBQ-44), evaluating domains associated with OCD; the Multidimensional Perfectionism Scale (MPS), assessing different aspects of perfectionism; and the Rosenberg Self-Esteem Scale (RSES), a measure of self-worth.
The researchers identified three distinct clusters of participants based on their psychological characteristics: High Self-Mastery, Moderate Self-Mastery, and Low Self-Mastery.
- The High Self-Mastery cluster, constituting 37.0% of the sample, exhibited low levels of obsession-compulsion and high self-esteem.
- The Moderate Self-Mastery cluster, constituting 39.5% of participants, displayed moderate levels of both obsessive-compulsive tendencies and self-esteem.
- The Low Self-Mastery cluster, constituting 23.6% of the sample, was characterized by high levels of obsession-compulsion and perfectionism, alongside low self-esteem.
The analysis further revealed that individuals in the Low Self-Mastery cluster were significantly more prone to exhibit orthorexia nervosa tendencies than those in the High Self-Mastery cluster. This suggests that high obsessive perfectionism and low self-esteem may predispose individuals to orthorexia nervosa tendencies.
Geographical differences also emerged as a notable aspect of the study’s findings. Participants from Lebanon exhibited higher orthorexia nervosa tendencies compared to those from Poland and Italy. This variation points to the potential influence of cultural factors on the manifestation of orthorexia nervosa, although the study calls for further research to fully understand these dynamics.
The study, like all research, includes some limitations. For example, its cross-sectional nature hinders causal inference. Future research could benefit from incorporating a wider array of psychological and cultural factors, employing more diverse and representative sampling techniques, and exploring the condition through longitudinal studies to better understand its development over time.
“The study highlights the importance of assessing self-esteem, obsessive–compulsive symptoms, and perfectionism in individuals with ON tendencies. These factors seem closely associated with the development and severity of ON. Therefore, interventions aimed at building self-esteem and reducing obsessive–compulsive and perfectionism symptoms may benefit those in the Low Self-Mastery cluster.”
The study, “Profiling orthorexia nervosa in young adults: the role of obsessive behaviour, perfectionism, and self-esteem,” was authored by Daniella Mahfoud, Susanna Pardini, Magdalena Mróz, Souheil Hallit, Sahar Obeid, Marwan Akel, Caterina Novara, and Anna Brytek-Matera.
