Psychological Correlates of Excessive Healthy and Orthorexic Eating: Emotion Regulation, Attachment, and Anxious-Depressive-Stress Symptomatology

Abstract

Orthorexia nervosa, the pathological obsession with eating healthy, shares risks and significant comorbidity with other mental disorders. Based on a behavioral conceptualization of the overlap, emotion regulation, attachment style, and anxious-depressive-stress symptomatology are prominent but insufficiently researched endophenotypes for orthorexia nervosa. This study aimed at identifying ways in which difficulties in emotion regulation and attachment-related anxiety and avoidance become apparent in orthorexia nervosa and healthy orthorexia. Additionally, the moderating role of anxious, depressive, and stress symptoms was explored. A convenience sample of 399 adults (266 women) completed questionnaires to measure orthorexia nervosa and healthy orthorexia, difficulties in emotion regulation, partnership-related bond, and anxious-depressive-stress symptomatology. The healthy orthorexia subscale was negatively associated with lack of emotional awareness but no other subscale of difficulties in emotion regulation or attachment-related anxiety and avoidance. Orthorexia nervosa scores were positively linked to difficulties in emotion regulation as well as attachment-related anxiety and avoidance. Multiple linear regression indicated non-acceptance of emotional responses and impulse control difficulties to be the strongest predictors for orthorexia nervosa. Both subscales also mediated the effects of attachment style on orthorexia nervosa with anxious-depressive-stress symptomatology moderating some of these effects. Individuals with higher orthorexia nervosa tendencies showed difficulties in emotion regulation, a common feature also of affective and eating disorders. Improvement in understanding the psychological features of orthorexia nervosa can enable a better differentiation from other disorders, advances in the development of treatment approaches and treatment planning, and outlines directions for future research on mechanisms.

Exploring the Link between Mindful Eating, Instagram Engagement, and Eating Disorders: A Focus on Orthorexia Nervosa

“…This aligns with existing literature highlighting the multifaceted nature of eating disorders and their co-occurrence with psychological challenges [44]. The stringent dietary regulations seen in orthorexia nervosa contribute to heightened levels of depression, anxiety, and stress [45].…”

Orthorexia Nervosa as a Disorder of Less Intuition and Emotion Dysregulation

“…The current findings are also consistent with our previous observations that ERD predicted ON. Accordingly, previous studies have highlighted the importance of emotion regulation problems in AN, BN ( Harrison et al 2010, Brockmeyer et al 2012, and ON (Vuillier et al 2020b, Obeid et al 2021b, Strahler et al 2022). Acceptance of negative emotions and problems with impulse control has been identified as the main contributor to the ERD in AN and BN (Fischer et al 2008, Brockmeyer et al 2014, Rowsell et al 2016).…”

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case–Control Study

“…Nevertheless, psychiatric comorbidities seem to be frequent in ON. Recent studies have attested that depression and anxiety positively correlate with ON [13] as well as stress [14] and that all these factors can play the role of moderators on specific predictors (i.e., attachment) of ON [15]. In summary, several studies agree on the fact that when a healthy diet turns into ON, it leads to significant impairments and stress [16].…”