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Evidence and gaps in the literature on orthorexia nervosa

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

An Erratum to this article was published on 07 May 2013

Abstract

Aim

To review the literature on the prevalence, risk groups and risk factors of the alleged eating disorder orthorexia nervosa.

Methods

We searched Medline and Pubmed using several key terms relating to orthorexia nervosa (ON) and checked the reference list of the articles that we found. Attention was given to methodological problems in these studies, such as the use of non-validated assessment instruments, small sample size and sample characteristics, which make generalization of the results impossible.

Results

Eleven studies were found. The average prevalence rate for orthorexia was 6.9 % for the general population and 35–57.8 % for high-risk groups (healthcare professionals, artists). Dieticians and other healthcare professionals are at high risk of ON. Risk factors include obsessive–compulsive features, eating-related disturbances and higher socioeconomic status. Relevant clinical experience, published literature and research data have increased in the last few years.

Discussion

The definition and diagnostic criteria of ON remain unclear. Further studies are needed to clarify appropriate diagnostic methods and the place of ON among psychopathological categories.

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References

  1. Russell G (1979) Bulimia nervosa: an ominous variant of anorexia nervosa. Psychol Med 9:429–448

    Article  PubMed  CAS  Google Scholar 

  2. Keel PK, Heatherton TF, Dorer DJ, Joiner TE, Zalta AK (2006) Point prevalence of bulimia nervosa in 1982, 1992, and 2002. Psychol Med 36:119–127

    Article  PubMed  Google Scholar 

  3. Spitzer RL, Devlin M, Walsh BT, Hasin D, Wing R, Marcus M, Stunkard A, Wadden T, Yanovski S, Agras S, Mitchell J, Nonas C (1992) Binge eating disorder: a multisite field trial of the diagnostic criteria. Int J Eat Disord 11(3):191–203

    Article  Google Scholar 

  4. Bratman S (1997) Orthorexia nervosa. Yoga J. http://www.orthorexia.com/index.php?page=essay

  5. Bratman S, Knight D (2000) Health food junkies: overcoming the obsession with healthful eating. Broadway Books, New York

    Google Scholar 

  6. Swain PI (2005) Trends in eating disorders research. Nova Publishers, Hauppauge

    Google Scholar 

  7. Mathieu J (2005) What is orthorexia? J Am Diet Assoc 105(10):1510–1512

    Article  PubMed  Google Scholar 

  8. Rössner S (2004) Orthorexia nervosa—a new disease? Lakartidningen 101(37):2835

    PubMed  Google Scholar 

  9. Dudás K, Túry F (2008) Orthorexia nervosa: az egészségesétel-függőség, mint a legújabb evészavarok egyike. Mentálhigiéné és Pszichoszomatika 9:125–137

    Article  Google Scholar 

  10. Bartrina JA (2007) Orthorexia or when a healthy diet becomes an obsession. Arch Latinoam Nutr 57(4):313–315

    PubMed  Google Scholar 

  11. Varga M, Dudás K, Túry F (2010) Az orthorexia nervosa—egészségesétel-függőség. In: Kun B (ed) Demetrovics Zs. Budapest, Az addiktológiai alapjai IV. Viselkedési függőségek. ELTE Eötvös Kiadó, pp 447–458

    Google Scholar 

  12. Cartwright MM (2004) Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient. Crit Care Nurs Clin N Am 16(4):515–530

    Google Scholar 

  13. Catalina Zamora ML, Bote Bonaechea B, García Sánchez F, Ríos Rial B (2005) Orthorexia nervosa. A new eating behavior disorder? Actas Esp Psiquiatr 33(1):66–8

  14. Paraschakis A (2007) Psychiatric disorders of the developed world: the case of orthorexia nervosa. Encepha-los 44:46–49

    Google Scholar 

  15. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2004) Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord 9(2):151–157

    PubMed  CAS  Google Scholar 

  16. Kinzl JF, Hauer, K, Traweger, Ch, Kiefer I. Orthorexia nervosa: Eine häufige Essstörung bei Diätassistentinnen? Ernährungs-Umschau 2005; 52(11)

  17. Kinzl JF, Hauer K, Traweger CH, Kiefer I (2006) Orthorexia nervosa in dieticians. Psychother Psychosom 75:395–396

    Article  PubMed  Google Scholar 

  18. Bağci Bosi AT, Camur D, Güler C (2007) Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey). Appetite 49(3):661–666

    Article  PubMed  Google Scholar 

  19. Eriksson L, Baigi A, Marklund B, Lindgren EC (2008) Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants. Scand J Med Sci Sports 18(3):389–394

    Article  PubMed  CAS  Google Scholar 

  20. Arusoğlu G, Kabakçi E, Köksal G, Merdol TK (2008) Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turk Psikiyatri Derg 19(3):283–291

    PubMed  Google Scholar 

  21. Aksoydan E, Camci N (2009) Prevalence of orthorexia nervosa among Turkish performance artists. Eat Weight Disord 14(1):33–37

    PubMed  CAS  Google Scholar 

  22. Korinth A, Schiess S, Westenhoefer J (2010) Eating behaviour and eating disorders in students of nutrition sciences. Public Health Nutr 13(1):32–37

    Article  PubMed  Google Scholar 

  23. Fidan T, Ertekin V, Işikay S, Kirpinar I (2010) Prevalence of orthorexia among medical students in Erzurum, Turkey. Compr Psychiatry 51(1):49–54

    Article  PubMed  Google Scholar 

  24. Ramacciotti CE, Perrone P, Burgalassi A, Conversano C, Massimetti G, Dell’Osso L (2011) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15). Eating Weight Disord 16:127–130

    Google Scholar 

  25. Varga M, Máté G (2010) Eating disturbances in orthorexia nervosa. XIII. Annual meeting of the European Association for Consultation-Liason Psychiatry and psychosomatics EACLPP) XVIII. European Conference of Psychosomatic Research (ECPR): a selection of the best abstracts submitted. J Psychosom Res 68:672–673

    Google Scholar 

  26. Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C (2005) Orthorexia nervosa: validation of a diagnosis questionnaire. Eat Weight Disord 10(2):28–32

    Google Scholar 

  27. Vandereycken W (2011) Media hype, diagnostic fad or genuine disorder? Professionals’ opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eat Disord 19(2):145–155

    Article  PubMed  Google Scholar 

  28. Molina Alén E (2006) “Perspectiva antropológica de un caso de ortorexia nerviosa”. Cultura de los cuidados. Año 10(20):109–116

  29. Shelton NJ (2007) What not to eat: inequalities in healthy eating behaviour, evidence from the 1998 Scottish Health Survey. J Public Health 27(1):36–44

    Google Scholar 

  30. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC

    Google Scholar 

  31. Golan M, Crow S (2004) Parents are key players in the prevention and treatment of weight-related problems. Nutrition Rev 62(1):39–50

    Article  Google Scholar 

  32. Berghöfer A, Pischon T, Reinhold Th, Apovian CM, Sharma AM, Willich SN (2008) Obesity prevalence from European perspective: a systematic review. BMC Public Health 8:200

    Article  PubMed  Google Scholar 

  33. Fairburn Ch, Cooper Z (2011) Eating disorders, DSM-5 and clinical reality. Brit J Psychiatry 198:8–10

    Article  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Márta Varga.

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Varga, M., Dukay-Szabó, S., Túry, F. et al. Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord 18, 103–111 (2013). https://doi.org/10.1007/s40519-013-0026-y

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  • DOI: https://doi.org/10.1007/s40519-013-0026-y

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