Orthorexia nervosa is associated with positive body image and life satisfaction in Chinese elderly: Evidence for a positive psychology perspective

Abstract

Objective Obsessive attention to healthy eating might paradoxically lead to physical and psychosocial impairments, a potential eating disorder termed orthorexia nervosa (ON). An ongoing debate concerns whether ON should be categorized as an eating disorder, an obsessive–compulsive disorder, or a mental disorder at all. A missing voice in this debate is ON in the elderly, which remains unknown, despite health being a more central issue in everyday life during old age. Similarly missing is ON in East Asia, which remains largely unexplored. Method The current study investigated ON in 313 Chinese elderly (M = 67.90, SD = 7.94) using the Chinese version of the Düsseldorf Orthorexia Scale (C‐DOS). Questionnaires were used to measure traditional eating disorder symptomatology, body image (body dissatisfaction, body appreciation, and functionality appreciation), lifestyle behaviors (fruit and vegetable consumption and time spent on physical activity), and indexes of well‐being (psychological distress, food‐related quality of life, and life satisfaction). Results ON symptoms were positively related to physical activity, fruit and vegetable (F&V) consumption, body appreciation, functionality appreciation, and life satisfaction, but negatively related to body dissatisfaction. Compared with those without ON, the elderly with ON scored higher on positive psychological/lifestyle measures but lower on negative psychological measures. Discussion Contrary to the dominant characterization of ON as a variant of disordered eating, in Chinese elderly ON was associated with several positive lifestyle and psychological measures. Thus, ON in the elderly might not be viewed as a form of disordered eating but can be protective and beneficial.

Development and Validation of the General Dietary Behavior Inventory (GDBI) in Scope of International Nutrition Guidelines

“…In contrast to other self-report questionnaires measuring dietary behavior, which do not correlate negatively with BMI [ 36 ], the GDBI has methodological strengths and has advantages over other dietary behavior questionnaires. The association of dietary behavior and life satisfaction has already been identified in several studies supporting our findings [ 69 , 70 , 71 ]. However, the GDBI did not capture actual food intake in contrast to typical food frequency questionnaires [ 12 , 13 ].…”

Introduction to a special issue on eating disorders in Asia

“…Lastly, the two final papers of the special issue focus on an understudied presentation of disordered eating characterized by an unhealthy obsession with healthy eating: orthorexia nervosa. Specifically, He, Zhao, Zhang, and Lin (2021) described the characteristics of orthorexia nervosa among older adults in China and suggested that orthorexia symptoms in this population may actually be associated with positive health outcomes, providing initial evidence for a positive psychological perspective of orthorexia, at least in China. In response, Hay (2021) provided an interesting commentary on whether or not orthorexia nervosa is an ED.…”

Orthorexia Nervosa—It Is Time to Think About Abandoning the Concept of a Distinct Diagnosis

“…Although features of eating disorders such as drive for thinness, body dissatisfaction, and sex differences are not part of ON conceptually, the independence of orthorexic symptomatology from these features could not be demonstrated empirically. To put our results into perspective, however, we also need to mention that DOS scores were unrelated to features of disordered eating in two studies from China (15,26), indicating that there might be cultural differences in orthorexic symptomatology or in its measurement. Cultural differencesbetween China and Western countries in particular-have been previously noted in self-report measures of eating behavior and their correlates with the reasons for these differences remaining elusive (27,28).…”