Mindfulness as a Protective Factor Against Orthorexia: The Mediating Role of Body Image Anxiety

Mindfulness and body image anxiety are psychological factors associated with disordered eating and may contribute to orthorexia nervosa, yet their combined effects remain underexplored. In this cross-sectional online survey, 382 adults in Greece completed the Mindful Attention Awareness Scale (MAAS-15), the Orthorexia scale (ORTO-6), the Social Physique Anxiety Scale (SPAS-12), and measures of body mass index (BMI) and physical activity (PAVS). Descriptive statistics, correlations, regression analyses, and mediation analysis were conducted to examine the associations among mindfulness, body image anxiety, and orthorexia. Mindfulness correlated negatively with orthorexia and body image anxiety, whereas body image anxiety correlated positively with orthorexia. In multinomial logistic regression, higher body image anxiety increased the odds of low (OR = 1.194, 95% CI 1.114-1.280) and moderate mindfulness (OR = 1.125, 95% CI 1.068-1.185); orthorexia also increased the odds of low (OR = 1.146, 95% CI 1.040-1.264) and moderate mindfulness (OR = 1.099, 95% CI 1.026-1.176). Overall, psychological factors (mindfulness, body image anxiety) appeared more influential than anthropometric or lifestyle factors (BMI, physical activity) in relation to orthorexia. These findings indicate that mindfulness was inversely associated with orthorexia tendencies, while body image anxiety was positively associated with orthorexia and was statistically linked to this association in the mediation analysis.