Conceptualisations of health in orthorexia nervosa: a mixed-methods study.
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ABSTRACT: Purpose
Limited research has explored conceptualisations of health and healthy eating in orthorexia nervosa (ON). This mixed-methods study aimed to investigate how 'health' and 'healthy eating' are conceptualised by individuals at risk for ON. This study examined the potential relationships between health anxiety, beliefs about health controllability and orthorexic symptomatology in our broader sample.Methods
A total of 362 participants took a survey on health anxiety (measured with the HAQ), beliefs about the controllability of one's own health (IMHLC) and ON symptomatology (E-DOS and EHQ). Participants 'at risk' for ON (n = 141), also completed an online qualitative survey about conceptualisations of health and healthy eating. Qualitative data were analysed using thematic analysis (part A). The PROCESS macro for SPSS was used for the quantitative analysis (part B).Results
Conceptualisations of health and healthy eating were complex. Four themes were generated from our qualitative data: 'health is more than thin ideals', 'healthy food equals healthy mind', 'a body that works for you' and 'taking control of your body'. Our quantitative analysis revealed that health anxiety and beliefs in health controllability independently predicted ON symptomatology.Conclusion
A richer understanding of what health means in the context of ON is important, given the centrality of this concept to the proposed classification of this disordered eating style. Our findings highlight that both health anxiety and health controllability are important targets for future investigation, given their potential relevance to the aetiology and treatment of ON.Level of evidence
Level V, based on a descriptive study.
SUBMITTER: Greville-Harris M
PROVIDER: S-EPMC9301897 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND AND AIMS:Numerous studies have provided evidence for orthorexia nervosa (ON), an eating pattern characterized by an almost manic obsession for and fixation on healthy eating, to be of epidemiological relevance. However, there is scientific debate on whether it is merely a behavioral or lifestyle phenomenon as compared to a mental disorder. Aim of this cross-sectional study was to explore whether ON is of epidemiological and clinical relevance, and whether ON can be distinguished from other mental health disorders and healthy lifestyle features. METHODS:An online survey including a measure of orthorexic behaviors [Duesseldorf Orthorexia Scale (DOS)], well-being and distress, eating behaviors, pathological eating, anxiety and depression, addictive behaviors, obsessive-compulsive symptoms, personality, and health behaviors was completed by 713 subjects (79.8% women, 18-75 years, median age: 25 years). RESULTS:Twenty-seven subjects (3.8%, 21 women) showed significant orthorexic eating (DOS???30). ON cases reported lower well-being, lower satisfaction with life, and higher current stress levels than non-ON cases. The highest percentage of variation in ON was explained by pathological eating (R2?=?.380), followed by eating style, Mediterranean diet, compulsive symptoms, and subjective social status. Importantly, ON provided hardly any additional predictive value for well-being when also considering pathological eating. DISCUSSION AND CONCLUSIONS:Our data confirmed the epidemiological and clinical relevance of orthorexic behaviors, but the strong conceptual overlap with other mental health problems and pathological eating raise initial doubts as to whether ON is a distinct mental health disorder category. This co-occurrence, unique symptoms, and underlying processes need further exploration by comparing ON cases with patients with other mental disorders.
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