Table 2.
Methodologies and results of the investigated studies.
| Study | Sample | Method(s) | Measures | Results |
|---|---|---|---|---|
| Barnes and Catalbiano [50] | Sample: 220 adults (180 university psychology students, 40 recruited from Facebook; 46 male, 154 female; age range: 17–62 years [M = 23.81, SD = 8.40]) | Experimental study | ORTO-15; MPS; MBSRQ-AS; RSQ; RSES |
History of an ED was the strongest predictor of ON; ORTO-15 scores were significantly correlated with perfectionism and fearful and dismissing attachment styles, but not with self-esteem |
| Novara et al. [51] | Sample: 302 university students in northern Italy. Total sample divided into two groups: “High EHQ” (n = 43; 22 male, 21 female, age range: 18–31 years [M = 20.60, SD = 2.44]) and “Low EHQ” (n = 259; 41.5% male, 58.5% female; age range: 18–49 years [M = 20.83, SD = 3.33]) | Experimental study | EHQ-21; EDI-3; OCI-R; WDQ; PSWQ; MPS; BAI; BDI-II |
Association between ON and perfectionism, anxious and depressive symptoms, and ED symptoms |
| Brytek-Matera et al. [49] | Sample: 52 women diagnosed with an ED (Mage = 22.81, SD = 3.80) | Experimental study | ORTO-15; MBSRQ; EAT-26 |
Lower level of eating pathology associated with more frequent orthorexic behaviors; higher level of eating pathology associated with less frequent orthorexic behaviors; ON negatively predicted by eating pathology, weight concern, health orientation, and appearance orientation |
| Barthels et al. [48] | Sample: 42 female anorexic patients with orthorexic eating behaviors (Mage = 21.17, SD = 6.88; MBMI = 15.97, SD = 1.52 kg/m2) Control group: 30 females (Mage = 22.10, SD = 7.43 years; MBMI = 21.83, SD = 2.75 kg/m2) |
Experimental study | DOS; EDI-2; DKB-35; BPNS-E; MIHT |
Orthorexic eating behaviors might represent coping mechanisms for patients with anorexic eating behaviors, and healthier ways of controlling food intake than focusing on low-calorie foods |
| Rania et al. [54] | Sample: 4 women with a prior psychiatric disorder (Mage = 35) | Case report | ORTO-15; SCID-5-CV |
Some psychiatric conditions, across a diagnostic continuum, may lead to ON |
| Łucka et al. [47] | Sample: 864 adolescents and young adults from the general population (265 male, 599 female; age range: 13–30 years) | Experimental study | ORTO-15; EAT-26; MOCI |
Significant association between EDs (EAT-26) and ON (ORTO-15); no significant relationship between the severity of obsessive-compulsive symptoms (MOCI) and orthorexia (ORTO-15) |
| Vaccari et al. [52] | OCD group: 50 patients Control group 1: 42 patients with a diagnosed anxiety or depressive disorder Control group 2:236 subjects from the general population |
Multi-center, observational, controlled study | ORTO-15; ORTO-R; OCI-R |
More ON symptoms among widowers relative to subjects with a partner and separated/divorced subjects; ON symptoms more prevalent in less educated subjects and those engaging in high-frequency physical activity; ORTO-R variation associated with a positive OCI-R score |
| Yilmaz et al. [53] | Sample: 189 individuals (79 outpatients with OCD, 68 healthy controls who regularly engaged in exercise, 69 healthy controls who did not regularly engage in exercise; age range: 18–65 years) | Experimental study | SCID-5/CV Y-BOCS; EAT-40; ORTO-11; HAS |
Orthorexic symptoms increased in the E + HC group as eating attitude deteriorated; orthorexic tendencies were higher in subjects with order-symmetry obsessions than in those with no such obsessions |
| Bartel et al. [12] | Sample: 512 individuals recruited through social media, an undergraduate psychology pool, and the general student body of a university in Western Canada (89 male, 423 female; Mage = 24.5 years) | Experimental study | EDE-Q; rBOT; ORTO-15; OCI-R; FMPS; FCQ |
Strong correlation between ON and EDE-Q (r = 0.63); correlation between ON and OCI-R total scales (r = 0.27); controlling for EDE-Q scores, only a small or no association between ON and OC symptoms (r = 0.08) |
| Strahler et al. [46] | Sample: 713 subjects recruited through public advertisements in local shops and mailing lists from universities in the broader Giessen/Marburg area (20.2% male, 79.8% female; age range: 18–75 years [M = 25]) | Cross-sectional study | DOS; WHO-5; PSS-10; RS-13; WREQ; EDE-Q8; PHQ-9; HADS; AUDIT; Y-BOCS; GPPAQ |
Strong correlation between ON and other mental disorders; ON no more prevalent than other forms of restrictive dieting and not associated with physical activity levels within a healthy lifestyle |
MPS: Multidimensional Perfectionism Scale; MBSRQ-AS: Multidimensional Body-Self Relations Questionnaire-Appearance Scale; RSQ: Relationship Scales Questionnaire; RSES: Rosenberg Self-Esteem Scale; EHQ-21: Eating Habits Questionnaire; EDI-3: Eating Disorder Inventory-3; OCI-R: Obsessive Compulsive Inventory-Revised; BAI: Beck Anxiety Inventory; BDI-II: Beck Depression Inventory-Second Edition; WDQ: Worry Domains Questionnaire; PSWQ: Penn State Worry Questionnaire; MBSRQ: Multidimensional Body-Self Relations Questionnaire; EAT-26: Eating Attitude Test; DOS: Düsseldorfer Orthorexie Skala; EDI-2: Eating Disorder Inventory-2; DSB-35: DresdnerKorperbildfragebogen; BPNS-E: Basic Psychological Needs Scale; MIHT: Multidimensional Inventory of Hypochondriacal Traits; EDE-Q: Eating Disorder Questionnaire; SCID-5-CV: Structured Clinical Interview for DSM-5; MOCI: Maudsley Obsessive Compulsive Inventory; Y-BOCS: Yale Brown Obsessive-Compulsive Scale and Symptom Checklist; HAS: Hamilton Anxiety Scale; WHO-5: World Health Organization Well-Being Index; PSS-10: Perceived Stress Scale; WREQ: Weight-Related Eating Questionnaire; EDE-Q8: Eating Disorder Examination—Questionnaire; PHQ-9: Patient Health Questionnaire; HADS: Hospital Anxiety and Depression Scale; AUDIT: Alcohol Use Disorders Identification Test; GPPAQ: General Practice Physical Activity Questionnaire.