Use of online and paper-and-pencil questionnaires to assess the distribution of orthorexia nervosa, muscle dysmorphia and eating disorders among university students: can different approaches lead to different results?

Abstract Purpose Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey—WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey—PBS), gives different results. Methods During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS. Results The WBS response rate was 6.7% (N = 137), and the PBS response rate was 86.5% (N = 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%). Conclusion The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results. Level of evidence Level V, descriptive cross-sectional survey.

Download Full-text

Contributions of disordered eating behaviours and mindful eating to obesity among young female adults

10.21203/rs.3.rs-962963/v1 ◽

2021 ◽

Author(s):

Seliz Bagcilar ◽

Ceren Gezer

Keyword(s):

Body Composition ◽

Disordered Eating ◽

Statistical Significance ◽

Negative Relationship ◽

Young Female ◽

Eating Attitudes ◽

Mindful Eating ◽

Eating Behaviours ◽

Level Of Evidence ◽

Eat 26

Abstract Purpose The aim of the current study was to investigate the relationship between disordered eating behaviours, level of mindful eating and obesity amongst young female adults. Methods Two hundred and twenty-seven female young adults aged 19-35 living in Famagusta in North Cyprus participated in this current study. Mindful Eating Questionnaire (MEQ) and Eating Attitudes Test (EAT)-26 were used for data collecting through face-to-face interviews. Weight and body composition were obtained by body composition analyser and height were obtained by stadiometer. The measurements of neck circumference (NC), waist circumference (WC), hip circumference (HC) were measured by using a non-stretching tape according to standard techniques. Body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Results The majority of participants (66.5%) had less than 20 points on the EAT-26. Overall, the participants with BMI below 18.5 kg/m2 had the highest MEQ scores, while the participants with BMI above 30.0 kg/m2 had the lowest MEQ scores (p < 0.05). Similarly, statistical significance was found between the MEQ scores of obese and normal weighted participants (p < 0.05). A significant negative correlation was found between MEQ scores and BMI, fat mass, WHR, WHtR, NC and WC (r=-0.216, p < 0.01; r=-0.234, p < 0.01; r=-172, p < 0.01 and r=-0.244, p < 0.01, r=-0.145, p < 0.05; r=-0.238, p < 0.05, respectively). Conclusion Our findings suggest that there is a negative relationship between the level of mindful eating and BMI. The evidence from this study also suggests a positive relationship between the risk of eating disorders and BMI. Level of Evidence Level V, cross-sectional descriptive study

Download Full-text

FOOD FOR THOUGHT: EATING DISORDERS AND THE COVID-19 LOCKDOWN- A QUESTIONNAIRE BASED SURVEY

10.36106/ijar/5801392 ◽

2021 ◽

pp. 35-38

Author(s):

Rose Mary Jacob Vatakencherry ◽

R Bhadra ◽

Niharika B ◽

Vishal Marwaha ◽

Anusree M

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Young People ◽

Diagnostic Criteria ◽

South India ◽

Eating Behaviours ◽

Healthcare Students ◽

Unhealthy Eating ◽

Eat 26

BACKGROUND: Anyone whose eating behaviours tend to cause disruptions and inconveniences in their day-to-day life could possibly have an eating disorder (ED). The coronavirus pandemic and the ensuing lockdown resulted in young people being conned to their homes for months on end. This may have led to the adoption of unhealthy eating behaviours and the consequent development of eating disorders. The objective of this study is to assess the prevalence of eating disorders among healthcare students of South India during the COVID-19 pandemic lockdown. METHODS This study was conducted for a period of two weeks among healthcare students of South India during the COVID-19 lockdown. The study tools were two pretested and self-administered questionnaires. Analysis was done using IBM Statistics 25 and SPSS. RESULTS The total number of respondents whose SCOFF score was greater than or equal to 2 is 367 (38.3%), which indicates possible cases of anorexia or bulimia. The total number of respondents whose EAT-26 score is higher than 20 in this study are 153 (14.3%), which indicates that they must be referred to a qualied professional to determine if they meet the diagnostic criteria for an eating disorder. This indicates that there was an increased prevalence of eating disorders in the students during the pandemic lockdown. CONCLUSIONS As expected, there was denitely an increased prevalence of eating disorders among the students during the COVID-19 lockdown. Awareness about these disorders must be created via seminars, webinars and workshops.

Download Full-text

Orthorexia nervosa and dieting in a non-clinical sample: a prospective study

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-021-01353-8 ◽

2022 ◽

Author(s):

Caterina Novara ◽

Susanna Pardini ◽

Francesco Visioli ◽

Nicola Meda

Keyword(s):

Eating Disorders ◽

Body Dissatisfaction ◽

Clinical Sample ◽

Critical Factor ◽

Orthorexia Nervosa ◽

Multiple Time ◽

Level Of Evidence ◽

Dietary Regimen ◽

Previous Diagnosis ◽

A Prospective Study

Abstract Purpose Orthorexia Nervosa (ON) is characterised by excessive attention to a dietary regimen perceived as healthy. A critical factor in the distinction between ON and other eating disorders (EDs) is the dichotomy of quality-versus-quantity of food intake. We investigated whether specific types of diet or dieting frequency are associated with orthorexic features, explored the overlap between ON and EDs symptoms, and examined which constructs are predictive of ON after 6 months. Methods A total of 1075 students (75.1% female, mean age 20.9) completed a set of questionnaires assessing Orthorexia, Eating Disorders, Obsessions and Compulsions, Anxiety and Depression; 358 individuals (79.9 female, mean age 20.9) agreed to participate in the study and completed the same questionnaires after 6 months. Different regression models were defined to investigate our hypothesis. Results Findings suggest that ON is associated with the number and type of diets followed over a lifetime. Moreover, participants with EDs, body dissatisfaction, or a dysfunctional idea of thinness are more likely to report a greater degree of ON features. After 6 months, the best predictors of ON characteristics are the same ON characteristics assessed at the first administration, with a significant role in the ideal of thinness. Conclusions ON is more frequent in individuals with a previous diagnosis of EDs and in individuals who followed a restrictive diet or a vegan/vegetarian one; the number of lifetime diets, beliefs, and behaviors related to the ideals of thinness or body dissatisfaction is common features of ON. Moreover, considering that having ON features in the past is the best ON predictor in the present, we can presume that ON is a construct stable over time. Level of evidence Level IV: Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).

Download Full-text

High risk of eating disorders in adults shows the need for more nutritional education actions

International Journal for Innovation Education and Research ◽

10.31686/ijier.vol6.iss3.995 ◽

2018 ◽

Vol 6 (3) ◽

pp. 103-108

Author(s):

ALINE DO CARMO FRANÇA-BOTELHO ◽

Aline Daniele Santana Silva ◽

Juliana Luzia França Mesquita

Keyword(s):

Eating Disorders ◽

High Risk ◽

Great Majority ◽

Eating Attitudes ◽

High Rate ◽

Eating Behaviours ◽

Populations At Risk ◽

The World ◽

Abnormal Eating ◽

Eat 26

Eating disorders, particularly, anorexia nervosa and bulimia nervosa have been highlighted for clinicians and researchers. They are heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity. Considering that early detection of predisposition to eating disorders is very important, the present study aimed to detect the risks of adults over 18 years. This choice was due to the fact that the great majority of the published researches were in samples of adolescents and young adults, not having many data in higher age. The research was carried out in 2017, in Brazil, with 142 adults participants, 107 women and 35 men. To assess the risk of eating disorders was used Eating Attitudes Test (EAT-26). According to the results of the EAT-26 the prevalence of high risk for eating disorders was 49.9%, a very alarming finding, is well above the world average. Through the detection of populations at risk it is possible to implement and intensify educational actions focused on the nutrition.

Download Full-text

Examining Eating Attitudes and Behaviors in Collegiate Athletes, the Association Between Orthorexia Nervosa and Eating Disorders

Frontiers in Nutrition ◽

10.3389/fnut.2021.763838 ◽

2021 ◽

Vol 8 ◽

Author(s):

Nancy A. Uriegas ◽

Zachary K. Winkelmann ◽

Kelly Pritchett ◽

Toni M. Torres-McGehee

Keyword(s):

Eating Disorders ◽

Healthy Eating ◽

Student Athletes ◽

Collegiate Athletes ◽

Threshold Value ◽

Eating Attitudes ◽

Orthorexia Nervosa ◽

Eating Attitude ◽

Sport Type ◽

Eat 26

Purpose: Orthorexia nervosa (Orthorexia) is an eating attitude and behavior associated with a fixation on healthy eating, while eating disorders (EDs) are clinically diagnosed psychiatric disorders associated with marked disturbances in eating that may cause impairment to psychosocial and physical health. The purpose of this study was to examine risk for Orthorexia and EDs in student-athletes across sex and sport type and determine the association between the two.Methods: Student-athletes (n = 1,090; age: 19.6 ± 1.4 years; females = 756; males = 334) completed a survey including demographics, the ORTO-15 test (<40 and <35 threshold values), the Eating Attitudes Test-26 (EAT-26; >20 score), and additional questions about pathogenic behaviors to screen for EDs.Results: Using a <40 threshold value for the ORTO-15, 67.9% were at risk for Orthorexia, a more restrictive threshold value of <35 determined 17.7% prevalence across student-athletes with significant differences across sex [ <40: χ(1,1,090)2 = 4.914, p = 0.027; <35: χ(1,1,090)2 = 5.923, p = 0.015). Overall, ED risk (EAT-26 and/or pathogenic behavior use) resulted in a 20.9% prevalence, with significant differences across sex (χ2 = 11.360, p < 0.001) and sport-type category (χ2 = 10.312, p = 0.035). Multiple logistic regressions indicated a significant association between EAT-26 subscales scores and Orthorexia, and between Orthorexia positivity, ORTO-15 scores, and risk for EDs.Conclusions: Risk for Orthorexia and ED is present in collegiate student-athletes. While healthy and balanced eating is important, obsessive healthy eating fixations may increase the risk for EDs in athletes. More education and awareness are warranted to minimize the risk for Orthorexia and EDs in student-athletes.

Download Full-text

Selective attentional bias to food-related stimuli in healthy individuals with characteristics towards orthorexia nervosa

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-019-00755-z ◽

2019 ◽

Vol 25 (5) ◽

pp. 1225-1233 ◽

Cited By ~ 1

Author(s):

Ian P. Albery ◽

Monika Michalska ◽

Antony C. Moss ◽

Marcantonio Spada

Keyword(s):

Attentional Bias ◽

Healthy Food ◽

Orthorexia Nervosa ◽

Healthy Individuals ◽

Eating Behaviours ◽

Level Of Evidence ◽

Unique Type ◽

Modified Stroop ◽

Level I ◽

The Individual

Abstract Purpose It has been argued that orthorexia nervosa (ON) is a unique type of disordered eating of food considered by the individual to be healthy. Given that in other eating disorder populations attentional preference for food-related cues influences eating behaviours, is it also likely that these biases may be a characteristic of ON tendency. Methods Eighty healthy individuals completed the ORTO-15 questionnaire (ON tendency), a modified Stroop task containing words related to healthy and unhealthy foods and perceived hunger levels pre- and post-testing. The ORTO-15 was used to identify participants within this sample who demonstrated more or less of the characteristics of ON. Results Results suggest that the presence of attentional bias to healthy, but not for unhealthy food-related stimuli independently predict increased ON tendency. Increased attentional bias towards healthy food-related stimuli is associated with increased scores on the ORTO-15. Conclusion Attentional bias, as a deficit in information processing, towards healthy food-related stimuli accounts for variability in ON characteristics. Level of evidence Level I, experimental study.

Download Full-text

Orthorexia Nervosa and Substance Use for the Purposes of Weight Control, Conformity, and Emotional Coping

10.21203/rs.3.rs-283732/v1 ◽

2021 ◽

Author(s):

Crystal D. Oberle ◽

Haley S. Marcell ◽

Natalie A. Noebel

Keyword(s):

Eating Disorders ◽

Weight Control ◽

Online Survey ◽

Illicit Drugs ◽

Cross Sectional Study ◽

Orthorexia Nervosa ◽

Level Of Evidence ◽

Cross Sectional ◽

Emotional Coping ◽

And Coping

Abstract Purpose: Orthorexia nervosa (ON), characterized by extreme behaviors driven by the goal of eating only healthy and pure foods, could plausibly be associated with avoidance of nicotine, alcohol, and illicit drugs. However, findings from the limited research on these relationships are mixed, and other eating disorders are associated with greater substance abuse. Method: An online survey was completed by 471 participants (86% women, mean age = 20) recruited from undergraduate courses and through an Instagram advertisement. The questionnaires assessed ON symptomatology; frequency of smoking, alcohol consumption, and illicit drug use; abuse of these substances; and motivations for using these substances. Results: ON scores were not significantly related to the level of use or abuse of nicotine, alcohol, or most illicit drugs. Yet, ON scores were positively correlated with frequency of using illicit depressant drugs. Further, among substance users, ON scores were positively associated with smoking or vaping for the purpose of weight control, and with consuming alcohol and using illicit drugs for the purposes of conformity and coping with such negative emotions as anxiety and depression. Conclusion: Although people who are high in ON symptomatology may be at least partly driven by a strong desire to be as healthy as possible, they are not less likely to use potentially harmful drugs. Instead, many of them may even turn to certain drugs for the same weight-control and emotional-coping motives that guide the behaviors of individuals with other eating disorders.Level of evidence: Level V, descriptive cross-sectional study

Download Full-text

Is Mindful Eating Higher in Individuals With Orthorexia Nervosa ?: A Cross-Sectional Study

10.21203/rs.3.rs-809815/v1 ◽

2021 ◽

Author(s):

Büşra Demirer ◽

Hülya Yardımcı

Keyword(s):

Diagnostic Criteria ◽

Emotional Eating ◽

Cross Sectional Study ◽

Eating Attitudes ◽

Orthorexia Nervosa ◽

Mindful Eating ◽

Sectional Study ◽

Level Of Evidence ◽

Cross Sectional ◽

Eat 26

Abstract Purpose The present study aimed to investigate the relationship between mindful eating and Orthorexia Nervosa (ON) among adults and contribute to establishing ON diagnostic criteria. Methods In the current cross-sectional study, 105 females, 92 males (aged 19–64 years), were enrolled whose scores on the Orthorexia Nervosa Questionnaire-15 (ORTO-15) and the Eating Attitudes Test-26 (EAT-26) and SCOFF scales indicated a prevalence of ON and eating disorder risk. In addition, Mindful Eating Questionnaire (MEQ) was applied to participants to determine mindful eating. Results In participants with ON, the scores of emotional eating and conscious eating scores, which are MEQ sub-factors, and the total score of MEQ are higher than those who do not have ON (p < 0.05). There was a negative correlation between MEQ and ORTO-15 scores (r = -0.269; p < 0.01). In addition, the one-point increase in the ORTO-15 scores of the participants led to 0.094 decrease in MEQ scores (B = -0.094; SE = 0.021; p < 0.001) and 0.175 decrease in EAT-26 scores (B = -0.175; SE = 0.033; p < 0.001). Conclusions The data obtained from our study show that mindful eating of individuals with ON is higher than those who do not have ON and this is important in determining the diagnostic criteria of ON. Level of evidence: V, Cross-sectional descriptive study.

Download Full-text

Do Age and Symptoms of Anxiety, Stress and Depression Predict Risk Behaviors for Eating Disorders in Brazilian Men and Women During the Covid-19 Pandemic?

10.21203/rs.3.rs-100005/v1 ◽

2020 ◽

Author(s):

José Roberto Andrade do Nascimento Junior ◽

Gabriel Lucas Morais Freire ◽

Mariana Pereira Gonçalves ◽

Daniel Vicentini de Oliveira ◽

José Fernando Vila Nova de Moraes ◽

...

Keyword(s):

Eating Disorders ◽

Multiple Regression ◽

Risk Behavior ◽

Eating Attitudes ◽

Positive Contribution ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Men And Women ◽

Symptoms Of Depression ◽

Eat 26

Abstract ObjectiveThis study investigated the predicting role of age and symptoms of depression, anxiety and stress on risk behavior for eating disorders in Brazilian adults during the COVID-19 pandemic.MethodsA web‐based cross‐sectional survey was administered during the COVID‐19 in Brazil. A total of 715 participants were recruited (237 men and 478 women) with a mean age of 29.20 (10.73) years from all regions of Brazil. The instruments used were the depression, anxiety and stress scale (DASS-21) and eating attitudes test-26 (EAT-26). Data analysis was conducted through the independent t-test, Pearson’s correlation and multiple regression Analysis (p<.05). ResultsThe data showed significant differences between men and women for anxiety (p<.001), stress (p<.001), depression (p<.001), total DASS score (p<.001) and eating disorders (p<.001), indicating that women presented more symptoms in all variables. Depression, stress and DASS total score were significantly and positively associated with eating disorders (EDs) (r range= .16 to .21) for men and EDs was significantly and negatively associated with all dimensions of DASS and DASS total score (r range -.19 to -.22) for women. Multiple regression showed that DASS total score made the largest positive contribution to eating disorders for men (β= .17, p <.01) and women (β= .22, p <.001). ConclusionOur findings show that symptoms of depression, anxiety and stress predict risk behavior for eating disorders in Brazilian adults during the COVID-19 pandemic.

Download Full-text

Exploration of the Diagnostic Classification of Orthorexia Nervosa: Distinct Disorder, Anorexia Nervosa or Obsessive-Compulsive Disorder?

10.21203/rs.3.rs-981587/v1 ◽

2021 ◽

Author(s):

Suzanne M Cosh ◽

Jemma Olson ◽

Phillip J. Tully

Keyword(s):

Anorexia Nervosa ◽

Obsessive Compulsive Disorder ◽

Orthorexia Nervosa ◽

Diagnostic Classification ◽

Operating Characteristics ◽

Obsessive Compulsive ◽

Level Of Evidence ◽

Cross Sectional ◽

Compulsive Disorder ◽

Eat 26

Abstract PurposeOrthorexia Nervosa (ON) is characterised as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, its diagnostic classification remains uncertain, with theoretical overlap with Anorexia Nervosa (AN) and Obsessive-Compulsive Disorder (OCD). This study aimed to further understand appropriate diagnostic classification by assessing the ability of ON for detecting the presence/absence of AN and OCD.MethodAn observational survey was completed by 362 participants recruited through eating-disorder, dieting and mental health support groups. Receiver Operating Characteristics (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by ORTO-15 and ORTO-9) for detecting AN (determined by EAT-26 cut-scores and BMI >17.5), and OCD and Obsessional thinking (assessed by the OCI-R).ResultsResults showed both ON measures are able to adequately predict AN, however ON was poor to moderate at detecting OCD and Obsessional thinking. Specificity for detecting AN was poor and ability to discriminate between AN and ON was low.ConclusionThese results suggest that ON, as it is currently measured, may be more closely related to EDs than OCD, and that ON may represent a subtype or subset of AN; although results are limited by the lack of definitive ON diagnostic criteria and limitations of ON measures.Level of evidence – Level V, cross-sectional descriptive study

Download Full-text