From health to harm: Cross-sectional analysis of factors associated with orthorexia nervosa

The present study systematically examined factors associated with orthorexic tendencies, to provide a clearer understanding of this phenomenon. In a cross-sectional setting, data were collected using an online questionnaire including validated instruments for assessing orthorexic tendencies and related variables. Therefore, correlation measures and difference tests were used. Hierarchical multiple linear regression was performed to identify variables independently associated with orthorexic tendencies. A total of n = 1049 participants were included in data analyses. Individuals with a current or past mental disorder had significantly higher DOS scores than those without such a history (Hedges' g = 0.55, p < .001). Physically active participants had significantly higher orthorexic tendencies (g = 0.29, p = .01). Significant correlations between DOS scores and BMI, r = -0.11, p = .002, training days, r = 0.2, p < .001, engagement with health and fitness content, r = 0.35, p < .001, eating disorder symptomatology, r = 0.62, p < .001, perfectionism, r = 0.43, p < .001, and self-esteem, r = -0.41, p < .001, were observed. In the multivariate regression model, eating disorder symptoms showed the strongest independent association with orthorexic tendencies. The overall model explained 57.7 % of the variance in orthorexic tendencies. In the present sample, orthorexic tendencies showed substantial overlap with eating disorder symptomatology, which emerged as the dominant correlate in the multivariate model. Overall, the findings support interpreting orthorexic tendencies primarily in relation to broader eating disorder psychopathology.