Too healthy for their own good: Orthorexia nervosa and compulsive exercise in the community

Abstract

Background The similarities and differences between the orthorexia nervosa symptoms (ONs) and the symptoms and correlates of eating disorders listed in the DSM-5 need to be elucidated. ONs were examined in a volunteer community sample in conjunction with compulsive exercise, disordered eating, as well as emotional and behavioral correlates of eating disorders. Methods Participants were 561 adult volunteers (93 men, 17.09%) aged 19–72 (M = 32.7 ± 11), recruited via social media networks. Participants self-reported online on the following measures: Düsseldorf Orthorexia Scale, Compulsive Exercise Test, Retrospective Child Feeding Questionnaire, Experiences in Close Relationships, Difficulties in Emotional Regulation Scale, Toronto Alexithymia Scale, and Eating Disorder Examination Questionnaire 13. Data was downloaded and analyzed in SPSS26 and Amos26. Results A theoretical model of the connections between the study variables was tested via SEM and confirmed. The profiles of participants with high, average and low levels of ONs were compared. Participants with the highest levels also scored highest for compulsive exercise, insecure attachment, alexithymia, emotion regulation difficulties, weight and shape concerns, body dissatisfaction, restriction, bingeing, purging and recollections of their parents being concerned about their overweight, and restricting and monitoring their intake of calorie-rich foods as children. Discussion High levels of ONs are related to disordered eating attitudes and behaviors, as well as to emotional and behavioral correlates of eating disorders. It is unclear to what extent these ONs are distinguishable from symptoms of other eating disorders listed in the DSM-5. Longitudinal studies may help to elucidate distinct trajectories and risk factors of ON. Level of evidence Level III, case–control analytic study.

A Correlational Study of Orthorexia and Positive Body Experiences

“…The protective role of positive body experiences in this study was observed both indirectly as well as directly, as some variance was also accounted for by the positive body experiences down-moderating the in uence of compulsive exercise on ONs. Since ONs and compulsive exercise seem to be synergic [10], it is possible that positive body experiences dampen this positive feedback loop.…”

“…Although this study identi ed some positive body experiences as being protective against ON, it must be noted that their contribution is considerably weaker than that of known risk factors. Risk factors, such as compulsive exercise, disordered eating, emotion dysregulation, insecure attachment and parental feeding practices account for even more of the variance in ONs [10]. The relative weakness of protective vs risk factors for orthorexia is disappointing since targeting protective factors is an effective strategy in prevention programs [31].…”

“…Often a ritualized interdependence between food consumption and exercise develops, with a combination of speci c eating or restricting behaviours and exercise practices [9]. Zohar et al [10] showed a strong correlation between ONs and compulsive exercise.…”

“…As described in Zohar et al [10], 561 adult community volunteers ranging in age between 19 and 72 years of age (M=32.7+11) were recruited via social media networks. Ninety-three (17.09%) of the participants were male.…”

“…Barthels et al, [11] found that individuals in the community who reported more severe ONs also reported more frequent bingeing and purging. Zohar et al [10] found that the individuals whose scored above the clinical cut-off point for ON, reported signi cantly more restriction, bingeing and purging than those below the cut-off point [10]. This suggests that ONs go beyond extreme restriction and may swing between extremes of restriction, bingeing, and even purging, as a way of compensating for the loss of control over eating.…”