Purpose Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. Methods 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A–Definition, Clinical Aspects, Duration; B–Consequences; C–Onset; D–Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. Results 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. Conclusions This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. Level of evidence Level V: opinions of expert committees

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Purpose The present study aimed to understand how quarantine associated with COVID-19 was experienced by women from different BMI groups (underweight, normal weight, pre-obesity, and obesity), by exploring the changes introduced in eating and exercise routines and the differences between BMI groups regarding shape concern, weight concern, and binge eating behaviours reported during this time. Methods This study comprised 580 women aged between 18 and 65 years old, who completed self-report measures, during the mandatory confinement in Portugal due to COVID-19. The total sample was divided into four groups, according to their BMI. Results Results revealed that overall, there were no significant differences between the groups regarding the eating and exercise routine changes introduced during quarantine. However, significant differences between the four groups were found in the reported body and eating-related difficulties (shape concern, weight concern, and binge eating behaviours), with the pre-obesity and obesity groups presenting significant higher levels. Conclusions Our study suggests that, even though the changes introduced to the eating and exercise routine are independent of BMI, the pre-obesity and obesity group represent a major vulnerability group for the development of eating disorders. We hope this study allows professionals to understand the need to develop different guidelines and strategies for the pre-obesity and obesity female population during the deconfinement period. Level of evidence Level V-Descriptive study. Keywords COVID-19 • Eating routine changes • Exercise routine changes • Shape and weight concern • Binge eating • BMI

Resumo O objetivo do estudo foi avaliar o estado nutricional e o consumo alimentar, e caracterizar aspectos do estilo de vida de idosos hipertensos que freqüentam centros de convivência na cidade de Teresina-PI. O estudo, do tipo transversal, envolveu 125 idosos, de ambos os sexos (17 homens e 108 mulheres), avaliados por meio de questionário previamente testado para a caracterização da casuística. As variáveis nutricionais foram investigadas por antropometria, medidas de circunferência e pelo levantamento do consumo alimentar nas últimas 24 horas. Encontraram-se índices elevados de sobrepeso (45,6%) e baixo-peso (36,0%), a pressão arterial diastólica (PAD) associando-se positivamente com o sobrepeso (índice de massa corporal 27kg/m2). A distribuição da gordura central apresentou elevada prevalência (88%), indicando risco para doenças cardiovasculares. Os alimentos mais consumidos foram: feijão, leite, pães, cereais, arroz, massas e carnes. Não se observou grande adesão às medidas terapêuticas não-farmacológicas no grupo de idosos hipertensos, o que mostra a necessidade de rever as orientações propostas no Programa de Controle da Pressão Arterial para o Idoso.