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Article

Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS)

by
María Manzanares-Cabrera
1,
María Dolores Onieva-Zafra
2,3,
Alberto Bermejo-Cantarero
2,3,4,*,
Raúl Expósito-González
2,3,
Daniel Lerma-García
5 and
María Laura Parra-Fernández
2,3
1
Hospital Quiron Health Ciudad Real, 13002 Ciudad Real, Spain
2
Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
3
Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Castilla-La Mancha, 45004 Toledo, Spain
4
Centro de Estudios Sociosanitarios (CESS), University of Castilla-La Mancha, 13071 Cuenca, Spain
5
Department of Nursing, University of Illes Balears, Ibiza, Baleares, 07800 Ibiza, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(24), 3814; https://doi.org/10.3390/nu17243814
Submission received: 31 October 2025 / Revised: 2 December 2025 / Accepted: 3 December 2025 / Published: 5 December 2025
(This article belongs to the Section Sports Nutrition)

Abstract

Background: Orthorexia nervosa (OrNe) and healthy orthorexia (HeOr) are two distinct but related dimensions of interest in eating behavior research. Evidence regarding their associations with sociodemographic, dietary, and sport-related variables in physically active young adults remains limited. Methods: A cross-sectional study was conducted in 190 physically active young adults (53.2% women; mean age = 23.16 ± 5.13 years). Participants practiced a variety of sports including fitness (25.3%), soccer (13.7%), handball (10.5%), athletics, martial arts, cycling, and other individual or team sports. Although all participants belonged to organized sports teams or structured training groups, 38.9% were not actively competing at the time of data collection. Participants completed validated instruments assessing OrNe, HeOr, and eating-related cognitions, alongside questionnaires on sociodemographic data, dietary habits, sport discipline, training frequency, and supplement use. Hierarchical and K-means clustering were applied using the standardized scores of HeOr, OrNe, and the EHQ total score. Group differences were assessed using t-tests and ANOVA with effect sizes (η²p) reported. Results: Age correlated positively with OrNe, HeOr, and eating-related cognitions, indicating greater consolidation of rigid eating patterns in young adulthood. BMI was associated with OrNe only among men. Vegetarian participants showed higher nutritional knowledge but lower overall orthorexia scores. Supplement users in fitness-related sports reported higher OrNe, whereas participants in collective sports reported lower scores. Three distinct orthorexia profiles were identified, characterized by lower, slightly above-average, and higher scores on orthorexia-related variables. Participants in the higher-scoring profile showed significantly higher EHQ total, OrNe, and HeOr scores compared with the other groups (η²p range = 0.11–0.19). Correlations among orthorexia dimensions were positive and moderate to large. Differences between clusters in sport modality, training frequency, and supplement use underscored the influence of the sporting context. Conclusions: Orthorexia in young physically active adults reflects heterogeneous patterns shaped by the interplay of individual (age, sex, BMI), dietary, and sport-related factors. The identification of differentiated profiles reinforces the multidimensional nature of orthorexia and underscores the relevance of considering specific sport environments when interpreting orthorexic tendencies. Longitudinal research is warranted to examine the stability or variability of these patterns over time and to enable the use of more robust multivariate approaches that further clarify the characterization of orthorexia.
Keywords: orthorexia nervosa; healthy orthorexia; young adults; sports; dietary patterns; supplements; cluster analysis orthorexia nervosa; healthy orthorexia; young adults; sports; dietary patterns; supplements; cluster analysis

Share and Cite

MDPI and ACS Style

Manzanares-Cabrera, M.; Onieva-Zafra, M.D.; Bermejo-Cantarero, A.; Expósito-González, R.; Lerma-García, D.; Parra-Fernández, M.L. Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS). Nutrients 2025, 17, 3814. https://doi.org/10.3390/nu17243814

AMA Style

Manzanares-Cabrera M, Onieva-Zafra MD, Bermejo-Cantarero A, Expósito-González R, Lerma-García D, Parra-Fernández ML. Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS). Nutrients. 2025; 17(24):3814. https://doi.org/10.3390/nu17243814

Chicago/Turabian Style

Manzanares-Cabrera, María, María Dolores Onieva-Zafra, Alberto Bermejo-Cantarero, Raúl Expósito-González, Daniel Lerma-García, and María Laura Parra-Fernández. 2025. "Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS)" Nutrients 17, no. 24: 3814. https://doi.org/10.3390/nu17243814

APA Style

Manzanares-Cabrera, M., Onieva-Zafra, M. D., Bermejo-Cantarero, A., Expósito-González, R., Lerma-García, D., & Parra-Fernández, M. L. (2025). Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS). Nutrients, 17(24), 3814. https://doi.org/10.3390/nu17243814

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