Orthorexia nervosa (ON) is characterized by the pursuit of extreme dietary purity due to an exaggerated focus on food quality that could ultimately lead to a new kind of eating disorder. Even though researchers have tried to reach a univocal description of ON, to this date, there is no consensus on its diagnostic criteria, making it considerably more difficult to develop a valid questionnaire for assessing the symptoms of ON and to assess its actual prevalence. The aim of this review was to evaluate and gather scientific evidence about the prevalence of ON in both clinical and non-clinical adult populations, using the main validated scale for ON evaluation.

Electronic databases (PubMed, Scopus, and Web of Science) were reviewed to identify studies in accordance with PRISMA guidelines; at the end of the selection process, 62 studies were included.

Prevalence rates of ON vary greatly due to the differences in psychometric qualities of the tools used and the socio-cultural norms of the countries, with the lowest being obtained with the Dusseldorf orthorexic scale (DOS) (2.6% up to 36.7% in cancer survivor women) and the BOS-T (12.8% up to 34.7%), the greatest variability concerning the two thresholds of the ORTO-15 (14.6% with the >35 threshold and up to 86% with the >40 threshold) and the higher score being reported with the ORTO-11 in post-partum women (87.7%).

Additional research is necessary to support the development of a thorough, sensitive, and valid questionnaire for assessing the symptoms of ON.

Orthorexia has been widely studied, but recently, a new conceptualisation was proposed to distinguish its healthy characteristics from its pathological ones. The objective of this study was to differentiate healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) by exploring their sociodemographic, psychological, health and dietary characteristics using comparative and correlational statistical methods.

Cross-sectional analysis. Participants completed an online, self-administered questionnaire assessing their sociodemographic characteristics, orthorexia, exercise dependence, personality, health anxiety, food choice motives, emotional competences and eating disorders (ED).

Data were collected between May 2021 and September 2022.

1515 French females (meanage = 37·67). Responses from men were excluded.

While OrNe was mainly associated with weight control motives in food choices (r = 0·42), HeOr was more strongly correlated with natural content (r = 0·60) and health motives (r = 0·49). In relation to exercising, OrNe showed its highest association with weight control (r = 0·41). Health anxiety was more strongly associated with OrNe than with HeOr. Both OrNe and HeOr were related to diet adherence and regular exercise, but the association was stronger for the latter. Orthorexia scores, mainly OrNe, were higher in participants at the risk of ED. Participants who were afraid to gain weight showed higher OrNe scores.

HeOr seems to be part of a healthy lifestyle in general. In contrast, OrNe falls into the category of an ED and is associated with more problematic psychological functioning. Particular attention should be given to individuals who are beginning to control and reduce their food intake to prevent them from developing OrNe.

In some individuals, interest in healthy attitudes and behaviours towards food may show obsessive signs. Preoccupation with ‘healthful’ eating may contribute to orthorexia nervosa (ON) – a strong preoccupation with “healthy eating” manifested by the avoidance of all foods considered by the individual to be “unhealthy”.

The objective of the present study was to determine whether disordered eating behaviour, physical activity and self-esteem are predictors of ON in young adults.

Five hundred fifty-four Polish and Italian university students participated in the present study. Participants were asked to answer the Eating Habits Questionnaire, the Eating Attitudes Test, the International Physical Activity Questionnaire and the Rosenberg Self-Esteem Scale.

Our findings found that higher levels of concern about dieting and moderate-intensity physical activity were related to ON. Particularly, higher levels of concern about dieting, bulimic behaviour and thoughts about food and moderate-intensity physical activity predicted problems associated with healthy eating. Higher levels of concern about dieting, self-esteem as well as self-control of eating and perceived pressure from others to gain weight were associated with knowledge of healthy eating. Whereas, higher levels of concern about dieting with country factor (Poland) predicted feeling positively about healthy eating.

In ON treatment, reduction in symptoms and concerns characteristic of eating disorders and adequate levels of physical activity should be taken into consideration.

No significant relationships.

The term Orthorexia derives from the Greek “ortho – correct” and “orexis – appetite”; Orthorexia Nervosa is a pathological fixation with healthy eating that, starting with the idea to obtain a maximum health with a proper diet, leads to malnourishment and other medical sequelae, loss of relationships, loss of self-esteem, poor quality of life in general. Orthorexia, despite receiving broad empirical evidence, is not currently included in any psychiatric diagnostic manual.

The main aim of this study is to investigate its presence in a sample of patients already diagnosed with a canonical eating disorder and also to understand eventual overlaps with other clinical disorders in order to optimize treatment and follow up.

The ORTO-15 questionnaire, developed by an Italian team of researchers in 2005, was used to achieve the above aims: it is a tool comprehensive of 15 questions that assesses eating habits perceived as healthy. Really interesting and fascinating is to comprehend if people with a diagnosis of eating disorder present orthorectic behaviour and how this emerging reality fits in the Irish society with its peculiarities and uniqueness.

The Point Prevalence obtained is 17.9%. The expected rates of Orthorexia Nervosa in the general population are between 6.9% and 57.6%, with a peak of 81.8% in specific populations, fact that places our examined sample in the lower side of the prevalence previously considered in other studies.

It is significant the absence of correlation found between OCD and ON and that ON is more linked to Bulimia Nervosa rather than Anorexia Nervosa.

There has been increasing interest in identifying individuals with pathological healthy eating behaviours, or orthorexia nervosa (ON). This study aimed to investigate the validity (construct- and criterion-related) and reliability (internal consistency) of the Eating Habits Questionnaire (EHQ) as a measure of ON. A secondary aim was to examine how the EHQ would predict a distinct feature of ON, adequate dietary intake.

Cross-sectional online questionnaire incorporating existing measures of ON and dietary intake.

Participants were recruited online via social media and a university’s research webpage.

Women (n 286) ranging in age from 17 to 73 years.

Exploratory factor analysis established that the EHQ represented four ON dimensions (Healthy Eating Cognitions, Dietary Restriction, Diet Superiority and Social Impairment), inconsistent with the scale’s original three dimensions (Problems, Knowledge and Feelings). Cronbach’s α coefficients ranged from 0·72 to 0·80 for the four subscales and was 0·89 for the total EHQ scale. Criterion-related validity revealed a significant moderate to strong correlation (r = −0·54, P < 0·001) between the EHQ and ORTO-10 (a ten-item version of ORTO-15). The EHQ, particularly the EHQ–Diet superiority subscale, was found to be predictive of better, as opposed to, poorer dietary adequacy.

Findings suggest that improvements still need to be made to the EHQ for it to be a valid and reliable measure of ON. Ideally, new assessment tools based on established diagnostic criteria are needed to advance our understanding of ON.