Prevalence and determinants of orthorexia nervosa among Turkish adolescents

Given the prevalence and diversity of eating issues among adolescents, understanding the epidemiological aspects of orthorexia nervosa (ON) in this demographic, along with identifying associated clinical factors, sociodemographic traits, eating habits and parental attitudes, holds paramount importance both clinically and scientifically. This study aimed to ascertain the prevalence of ON among Turkish high school adolescents aged 14-18 and explore potential correlates of this clinical condition.

In the initial phase, 1784 adolescents completed the Data Form, Orthorexia Nervosa Inventory (ONI) and Parent Style Scale (PSS), while their parents filled out the the parental version of the revised Child Anxiety and Depression Scale (RCADS). Subsequently, clinical interview and The Kiddie-Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version (KD-SADS-PL) were conducted with 9 adolescents with high risk for ON to assess comorbidities.

The study revealed ON prevalence of 0.5%, with 0.3% in boys and 0.6% in girls. Rural residency, dietary supplement use, and pet ownership correlated with higher ONI scores (p = 0.022, p = 0.002, p = 0.042 respectively). OCD and panic disorder symptoms (B = 0.307, p < 0.001 and B = 0.165, p = 0.018 respectively), increased BMI, and anxiety scores were associated with elevated ONI scores. Authoritarian parenting was significantly related to ONI total scores (B = 1.69, p = 0.018).

This study significantly contributes to the literature by delineating the prevalence of ON in adolescents, identifying associated risk factors, elucidating psychopathological associations of orthorexic symptoms, and identifying the relationship between parenting styles and ON. Such insights into the factors influencing ON can aid in demystifying its nature.