Are the Motives for Food Choices Different in Orthorexia Nervosa and Healthy Orthorexia?

Nutrients. 2019;11(3)
Full text from:

Plain language summary

More than 20 years ago the term “orthorexia nervosa” (OrNe) was coined for people whose intention to eat healthily becomes an unhealthy obsession. OrNe is not recognized in the Diagnostic and Statistical Manual and no official diagnostic criteria exists. Research has been limited by the use of different questionnaires used to establish OrNe. The newly developed Teruel Orthorexia Scale (TOS) also distinguishes between “healthy orthorexia” (HeOr) and OrNe, whereby HeOr is seen as a healthy interest with diet, healthy behaviour with regard to diet, and eating healthily as part of one’s identity, and is not associated with disordered eating, perfectionism, and obsessive-compulsive behaviour. OrNe and HeOr are not thought to be a continuum from people who do not care at all about eating healthily, followed by people who eat healthily (HeOr), and, finally, those who care excessively (OrNe), confirmed by the fact that there is only a low association between HeOr and OrNe. The aim of this study was to find further evidence for this hypothesis, and to evaluate the motives associated with the two types of orthorexia. 460 Spanish students participated in the study, 82% female, 18% male, with a mean age of 21. Participants completed two online questionnaires, the TOS and the Food Choice Questionnaire (FCQ) which assessed the following food choice motives: Weight Control; Sensorial Appeal; Convenience, Health Content; Price; Affect Regulation (e.g. “helps me relax”; Socio-political (e.g. country of food origin). The authors found that HeOr was positively related to Health Content and negatively related to Sensory Appeal and Price. OrNe, on the other hand, was positively related to Weight Control and Affect Regulation, and negatively related to Sensory Appeal and age.

Abstract

Recent research points to the bidimensional nature of orthorexia, with one dimension related to interest in healthy eating (healthy orthorexia) and another dimension related to a pathological preoccupation with eating healthily (orthorexia nervosa). Research was needed to provide further support for this differentiation. We examined the food-choice motives related to both aspects of orthorexia. Participants were 460 students from a Spanish university who completed the Teruel Orthorexia Scale and the Food Choice Questionnaire. By means of structural equation modeling, we analyzed the relationship between orthorexia, food-choice motives, gender, body mass index, and age. The motives predicting food choices in orthorexia nervosa and healthy orthorexia were quite different. In the case of orthorexia nervosa, the main motive was weight control, with sensorial appeal and affect regulation also showing significant associations. For healthy orthorexia, the main motive was health content, with sensorial appeal and price also showing significant associations. This supports the hypothesis that orthorexia nervosa is associated with maladaptive eating behavior motived more by weight control than by health concerns.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Mediators/Eating behaviour
Environmental Inputs : Psychosocial influences
Personal Lifestyle Factors : Nutrition ; Psychological
Functional Laboratory Testing : Not applicable

Methodological quality

Allocation concealment : Not applicable
Publication Type : Journal Article

Metadata