Orthorexia Nervosa, Eating Disorders, and Obsessive-Compulsive Disorder: A Selective Review of the Last Seven Years
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Selection Procedure, Data Extraction, and Data Management
3. Results
3.1. Clinical significance of Orthorexia Nervosa
3.2. Orthorexia Nervosa and DSM-5 Eating Disorders
3.3. Orthorexia Nervosa and Obsessive-Compulsive Disorder
Study | Sample | Method(s) | Measures | Results |
---|---|---|---|---|
Barnes and Catalbiano [50] | Sample: 220 adults (180 university psychology students, 40 recruited from Facebook; 46 male, 154 female; age range: 17–62 years [M = 23.81, SD = 8.40]) | Experimental study | ORTO-15; MPS; MBSRQ-AS; RSQ; RSES | History of an ED was the strongest predictor of ON; ORTO-15 scores were significantly correlated with perfectionism and fearful and dismissing attachment styles, but not with self-esteem |
Novara et al. [51] | Sample: 302 university students in northern Italy. Total sample divided into two groups: “High EHQ” (n = 43; 22 male, 21 female, age range: 18–31 years [M = 20.60, SD = 2.44]) and “Low EHQ” (n = 259; 41.5% male, 58.5% female; age range: 18–49 years [M = 20.83, SD = 3.33]) | Experimental study | EHQ-21; EDI-3; OCI-R; WDQ; PSWQ; MPS; BAI; BDI-II | Association between ON and perfectionism, anxious and depressive symptoms, and ED symptoms |
Brytek-Matera et al. [49] | Sample: 52 women diagnosed with an ED (Mage = 22.81, SD = 3.80) | Experimental study | ORTO-15; MBSRQ; EAT-26 | Lower level of eating pathology associated with more frequent orthorexic behaviors; higher level of eating pathology associated with less frequent orthorexic behaviors; ON negatively predicted by eating pathology, weight concern, health orientation, and appearance orientation |
Barthels et al. [48] | Sample: 42 female anorexic patients with orthorexic eating behaviors (Mage = 21.17, SD = 6.88; MBMI = 15.97, SD = 1.52 kg/m2) Control group: 30 females (Mage = 22.10, SD = 7.43 years; MBMI = 21.83, SD = 2.75 kg/m2) | Experimental study | DOS; EDI-2; DKB-35; BPNS-E; MIHT | Orthorexic eating behaviors might represent coping mechanisms for patients with anorexic eating behaviors, and healthier ways of controlling food intake than focusing on low-calorie foods |
Rania et al. [54] | Sample: 4 women with a prior psychiatric disorder (Mage = 35) | Case report | ORTO-15; SCID-5-CV | Some psychiatric conditions, across a diagnostic continuum, may lead to ON |
Łucka et al. [47] | Sample: 864 adolescents and young adults from the general population (265 male, 599 female; age range: 13–30 years) | Experimental study | ORTO-15; EAT-26; MOCI | Significant association between EDs (EAT-26) and ON (ORTO-15); no significant relationship between the severity of obsessive-compulsive symptoms (MOCI) and orthorexia (ORTO-15) |
Vaccari et al. [52] | OCD group: 50 patients Control group 1: 42 patients with a diagnosed anxiety or depressive disorder Control group 2:236 subjects from the general population | Multi-center, observational, controlled study | ORTO-15; ORTO-R; OCI-R | More ON symptoms among widowers relative to subjects with a partner and separated/divorced subjects; ON symptoms more prevalent in less educated subjects and those engaging in high-frequency physical activity; ORTO-R variation associated with a positive OCI-R score |
Yilmaz et al. [53] | Sample: 189 individuals (79 outpatients with OCD, 68 healthy controls who regularly engaged in exercise, 69 healthy controls who did not regularly engage in exercise; age range: 18–65 years) | Experimental study | SCID-5/CV Y-BOCS; EAT-40; ORTO-11; HAS | Orthorexic symptoms increased in the E + HC group as eating attitude deteriorated; orthorexic tendencies were higher in subjects with order-symmetry obsessions than in those with no such obsessions |
Bartel et al. [12] | Sample: 512 individuals recruited through social media, an undergraduate psychology pool, and the general student body of a university in Western Canada (89 male, 423 female; Mage = 24.5 years) | Experimental study | EDE-Q; rBOT; ORTO-15; OCI-R; FMPS; FCQ | Strong correlation between ON and EDE-Q (r = 0.63); correlation between ON and OCI-R total scales (r = 0.27); controlling for EDE-Q scores, only a small or no association between ON and OC symptoms (r = 0.08) |
Strahler et al. [46] | Sample: 713 subjects recruited through public advertisements in local shops and mailing lists from universities in the broader Giessen/Marburg area (20.2% male, 79.8% female; age range: 18–75 years [M = 25]) | Cross-sectional study | DOS; WHO-5; PSS-10; RS-13; WREQ; EDE-Q8; PHQ-9; HADS; AUDIT; Y-BOCS; GPPAQ | Strong correlation between ON and other mental disorders; ON no more prevalent than other forms of restrictive dieting and not associated with physical activity levels within a healthy lifestyle |
4. Discussion
4.1. Clinical Significance of Orthorexia Nervosa
4.2. Orthorexia Nervosa and DSM-5 Eating Disorders
4.3. Orthorexia Nervosa and Obsessive-Compulsive Disorder
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Reason for Exclusion | Study Name |
---|---|
Article format (e.g., review) | Bhattacharya, A. et al. [3]; |
Brytek-Matera, A. [22]; | |
Costa, C.B. et al. [23]; | |
Dell’Osso et al. [24]; | |
Dukay-Szabó, S. et al. [25]; | |
Dunn, T.M. et al. [26]; | |
Gortat, M. et al. [27]; | |
Goutaudier, N. et al. [28]; | |
Håman, L. et al. [29]; | |
Hyrnik, J. et al. [30]; | |
Kalra, S. et al. [31]; | |
McComb, S.E. et al. [32]; | |
Michalska, A. et al. [33]; | |
Niedzielski, A. et al. [34]; | |
Opitz, M.C. et al. [35]; | |
Strahler, J. [36]; | |
Strahler, J. et al. [37]; | |
Valente, M. et al. [38]; | |
Zagaria, A. et al. [39] | |
Sample characteristics: only specific population included | Bobonis Babilonia, M. et al. [40]; |
Bóna, E. et al. [41]; | |
Domingues, R.B. et al. [42]; | |
Kinzl, J.F. et al. [43]; | |
Taştekin Ouyaba, A. et al. [44]; | |
Tremeling et al. [45] |
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Pontillo, M.; Zanna, V.; Demaria, F.; Averna, R.; Di Vincenzo, C.; De Biase, M.; Di Luzio, M.; Foti, B.; Tata, M.C.; Vicari, S. Orthorexia Nervosa, Eating Disorders, and Obsessive-Compulsive Disorder: A Selective Review of the Last Seven Years. J. Clin. Med. 2022, 11, 6134. https://doi.org/10.3390/jcm11206134
Pontillo M, Zanna V, Demaria F, Averna R, Di Vincenzo C, De Biase M, Di Luzio M, Foti B, Tata MC, Vicari S. Orthorexia Nervosa, Eating Disorders, and Obsessive-Compulsive Disorder: A Selective Review of the Last Seven Years. Journal of Clinical Medicine. 2022; 11(20):6134. https://doi.org/10.3390/jcm11206134
Chicago/Turabian StylePontillo, Maria, Valeria Zanna, Francesco Demaria, Roberto Averna, Cristina Di Vincenzo, Margherita De Biase, Michelangelo Di Luzio, Benedetta Foti, Maria Cristina Tata, and Stefano Vicari. 2022. "Orthorexia Nervosa, Eating Disorders, and Obsessive-Compulsive Disorder: A Selective Review of the Last Seven Years" Journal of Clinical Medicine 11, no. 20: 6134. https://doi.org/10.3390/jcm11206134