Shedding Light Upon Various Tools to Assess Orthorexia Nervosa: a Critical Literature Review with a Systematic Search

Overview

Journal Eat Weight Disord

Publisher Springer

Date 2019 Jun 23

PMID 31228168

Citations 36

Authors

Martina Valente

Elena V Syurina

Lorenzo Maria Donini

Affiliations

Soon will be listed here.

Abstract

Aim: The aim of this literature review was to identify the tools developed and used to assess orthorexia nervosa (ON).

Methods: A systematic search was executed in PubMed, Biomed Central, and PsycINFO. The final list included 70 articles that were critically analyzed.

Results: A total of six tools were reported to assess ON: the BOT, the ORTO-15, the EHQ, the DOS, the BOS, and the TOS. The tools were based upon different conceptualizations of ON and of its diagnostic criteria. Although they were different, all the conceptualizations derived from the initial definition of ON provided by Bratman in 1997. None of the methodologies adopted for tool construction considered end users or client perspectives and, when carried out, the validations of the tools were fragmented and often based on specific populations.

Conclusion: This study may be a starting point for the construction of a new diagnostic tool for ON. Starting from the methodological weaknesses identified by this review, it was possible to derive some suggestions for future research: (a) developing a modern re-conceptualization of ON, comprehensive of end-user perspectives; (b) adopting qualitative data collection techniques to gain insights into how to diagnose ON; and (c) actively involving diverse stakeholders for constructing a new tool.

Level Of Evidence: Level of Evidence: I, systematic review.

Citing Articles

Food Neophobia and Two Facets of Orthorexia Among Women: Cross-Sectional Study.

Yalcin T, Ciftci S, Ozturk E Behav Sci (Basel). 2025; 15(1).

PMID: 39851874 PMC: 11759857. DOI: 10.3390/bs15010070.

Factors associated with food label use: focus on healthy aspects of orthorexia and orthorexia nervosa.

Bellikci-Koyu E, Karaagac Y, Yuruk A Eat Weight Disord. 2024; 29(1):32.

PMID: 38703233 PMC: 11069476. DOI: 10.1007/s40519-024-01661-9.

Reliability generalization meta-analysis of orthorexia nervosa using the ORTO-11/12/15/R scale in all populations and language versions.

Alshaibani L, Elmasry A, Kazerooni A, Alsaeed J, Alsendy K, Alaamer R J Eat Disord. 2024; 12(1):39.

PMID: 38504366 PMC: 10949742. DOI: 10.1186/s40337-024-00997-y.

Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults.

Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M Nutrients. 2024; 16(5).

PMID: 38474767 PMC: 10935177. DOI: 10.3390/nu16050638.

On Orthorexia Nervosa: A Systematic Review of Reviews.

Ng Q, Lee D, Yau C, Han M, Liew J, Teoh S Psychopathology. 2024; :1-14.

PMID: 38432209 PMC: 11326525. DOI: 10.1159/000536379.

References

Donini L, Marsili D, Graziani M, Imbriale M, Cannella C . Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord. 2004; 9(2):151-7. DOI: 10.1007/BF03325060. View

Donini L, Marsili D, Graziani M, Imbriale M, Cannella C . Orthorexia nervosa: validation of a diagnosis questionnaire. Eat Weight Disord. 2006; 10(2):e28-32. DOI: 10.1007/BF03327537. View

Bosi A, Camur D, Guler C . Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey). Appetite. 2007; 49(3):661-6. DOI: 10.1016/j.appet.2007.04.007. View

Eriksson L, Baigi A, Marklund B, Lindgren E . Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants. Scand J Med Sci Sports. 2007; 18(3):389-94. DOI: 10.1111/j.1600-0838.2007.00723.x. View

Arusoglu G, Kabakci E, Koksal G, Merdol T . [Orthorexia nervosa and adaptation of ORTO-11 into Turkish]. Turk Psikiyatri Derg. 2008; 19(3):283-91. View

Swaans K, Broerse J, Meincke M, Mudhara M, Bunders J . Promoting food security and well-being among poor and HIV/AIDS affected households: lessons from an interactive and integrated approach. Eval Program Plann. 2008; 32(1):31-42. DOI: 10.1016/j.evalprogplan.2008.09.002. View

Aksoydan E, Camci N . Prevalence of orthorexia nervosa among Turkish performance artists. Eat Weight Disord. 2009; 14(1):33-7. DOI: 10.1007/BF03327792. View

Korinth A, Schiess S, Westenhoefer J . Eating behaviour and eating disorders in students of nutrition sciences. Public Health Nutr. 2009; 13(1):32-7. DOI: 10.1017/S1368980009005709. View

Fidan T, Ertekin V, Isikay S, Kirpinar I . Prevalence of orthorexia among medical students in Erzurum, Turkey. Compr Psychiatry. 2009; 51(1):49-54. DOI: 10.1016/j.comppsych.2009.03.001. View

10.

Segura-Garcia C, Papaianni M, Caglioti F, Procopio L, Nistico C, Bombardiere L . Orthorexia nervosa: a frequent eating disordered behavior in athletes. Eat Weight Disord. 2012; 17(4):e226-33. DOI: 10.3275/8272. View

11.

Alvarenga M, Martins M, Sato K, Vargas S, Philippi S, Scagliusi F . Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15. Eat Weight Disord. 2012; 17(1):e29-35. DOI: 10.1007/BF03325325. View

12.

Varga M, Dukay-Szabo S, Tury F, van Furth E, van Furth Eric F . Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord. 2013; 18(2):103-11. DOI: 10.1007/s40519-013-0026-y. View

13.

Brytek-Matera A, Krupa M, Poggiogalle E, Donini L . Adaptation of the ORTHO-15 test to Polish women and men. Eat Weight Disord. 2014; 19(1):69-76. DOI: 10.1007/s40519-014-0100-0. View

14.

Varga M, Konkoly Thege B, Dukay-Szabo S, Tury F, van Furth E . When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry. 2014; 14:59. PMC: 3943279. DOI: 10.1186/1471-244X-14-59. View

15.

Herranz Valera J, Acuna Ruiz P, Romero Valdespino B, Visioli F . Prevalence of orthorexia nervosa among ashtanga yoga practitioners: a pilot study. Eat Weight Disord. 2014; 19(4):469-72. DOI: 10.1007/s40519-014-0131-6. View

16.

Moroze R, Dunn T, Craig Holland J, Yager J, Weintraub P . Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near-fatal "orthorexia nervosa" and proposed diagnostic criteria. Psychosomatics. 2014; 56(4):397-403. DOI: 10.1016/j.psym.2014.03.003. View

17.

Bo S, Zoccali R, Ponzo V, Soldati L, De Carli L, Benso A . University courses, eating problems and muscle dysmorphia: are there any associations?. J Transl Med. 2014; 12:221. PMC: 4256707. DOI: 10.1186/s12967-014-0221-2. View

18.

Segura-Garcia C, Ramacciotti C, Rania M, Aloi M, Caroleo M, Bruni A . The prevalence of orthorexia nervosa among eating disorder patients after treatment. Eat Weight Disord. 2014; 20(2):161-6. DOI: 10.1007/s40519-014-0171-y. View

19.

Asil E, Surucuoglu M . Orthorexia Nervosa in Turkish Dietitians. Ecol Food Nutr. 2015; 54(4):303-13. DOI: 10.1080/03670244.2014.987920. View

20.

Koven N, Abry A . The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat. 2015; 11:385-94. PMC: 4340368. DOI: 10.2147/NDT.S61665. View