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Understanding Orthorexia Nervosa: A Study in Hungary

This study explores orthorexia nervosa and its measurement through the ORTO-15 tool in Hungary, highlighting behavioral patterns of individuals focused on quality food choices. The aim is to contribute to scientific literature by assessing validity and identifying clinical features of orthorexia nervosa.

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Understanding Orthorexia Nervosa: A Study in Hungary

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  1. When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in HungaryPresented by: Lauren Walker, Andrews Dietetic Intern. April 2015 BMC Psychiatry Varga et al 2014

  2. Orthorexia?

  3. Varga et al. When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry. 2014, 14:59

  4. Orthorexia Nervosa Anorexia Nervosa obsessive compulsive psychological disorder Indentified within professional, type A personalities. Focused on restricting calories with goal of losing weight • Proposed obsessive compulsive psychological disorder • Indentified within professional, type A personalities. • Focused on Quality of food • Not necessarily weight driven

  5. Aim of the Study • Contribute Scientific Literature • Assesment Validity • Clinical Features

  6. Hypothesis Individuals who have a tendency for Orthorexia Nervosa (ON), in addition to making healthier food choices, refuse to use drugs, alcohol, cigarettes, and take more nutritional supplements, engage in more sports activity and have more dietary restrictions that those without a tendency for ON.

  7. Methods • Online data collection • 810 participants • Females and Males • Ages 20 to 70 • Confirmatory factor analysis

  8. Distribution of Participants

  9. Males vs Females

  10. ORTO-15 • 15 multiple choice questions • 4-point Likert scale (always, often, sometimes, never) • Cognitive rational items • Clinical items • Emotional items

  11. Lifestyle

  12. Food Choices • Daily, weekly, monthly, rarely. • Health food stores

  13. ORTO-15 • 1. When eating, do you pay attention to the calories of the food? • 2. When you go in a food shop do you feel confused? • 3. In the last 3 months, did the thought of food worry you? • 4. Are your eating choices conditioned by your worry about your health status?

  14. ORTO-15 • 5. Is the taste of the food more important than the quality when you evaluate food? • 6. Are you willing to spend more money to have healthier food? • 7. Does the thought about food worry you for more than three hours a day? • 8. Do you allow yourself any eating transgression?

  15. ORTO-15 • 9. Do you think your mood affects your eating behavior? • 10. Do you think that the conviction to eat only healthy food increases self esteem? • 11. Do you think that eating healthy food changes your lifestyle (frequency of eating out, friends….)? • 12. Do you think consuming healthy food may improve your appearance?

  16. ORTO-15 • 13. Do you feel guilty when transgressing? • 14. Do you think that on the market there is also unhealthy food? • 15. At present, are you alone when having meals?

  17. Supplemental Orthorexia Questions 1. I consume only healthy foods 2. I always eat according to my eating schedule 3. Sexuality plays an important role in my life 4. Being overweight is a sign of weakness 5. I avoid food with specific colors

  18. Supplemental Orthorexia Questions cont. 6. I disapprove of people who cannot overcome their desires. 7. I think most people can be blamed for their own diseases. 8. I always eat the same meals. 9. I am critical of people who don’t follow the rules of a healthy lifestyle. 10. I spend a large amount of time preparing my meals.

  19. ORTO-11? • Poor fit of data with the factor structure • Item analysis conducted • Omitted Question #5,#6,#8,#14 • The lower the score, the higher the tendency for ON

  20. Omitted Questions: 5. Is the taste of the food more important than the quality when you evaluate food? 6. Are you willing to spend more money to have healthier food? 8. Do you allow yourself any eating transgression? 14. Do you think that on the market there is also unhealthy food?

  21. Results • ORTO-11 Mean Score: 28.83 with a standard deviation of 3.15 • ORTO-15 Mean Score: 37.87 with a standard deviation of 3.93 • Original cut-off point of 40 yielded 74.2% tendency for ON using ORTO-15

  22. Results • No significant sex differences were found on ORTO-11

  23. Results • Significant but weak correlation between orthorexia scores and age. (p<0.01) • No significant association concerning body mass index. • Participants engaged in sports, dieting and shopping at health food stores showed a higher tendency for ON, as expected.

  24. Results • No significant differences in scores with respect to: • Smoking • Caffeine use • Medicine use • Supplement use

  25. Results • Participants who encouraged friends and family to follow their healthy diet and lifestyle had ON tendencies. • Registered Dietitians • Physical Trainers • Medical career field

  26. In regards to food choices • Frequent ON tendencies: • Whole wheat • Fruit and Vegetable • Strict eating schedule (same food every day, same time) • Specialty food stores

  27. Strengths of the Study • Large sample size • Diverse population (Age, occupation)

  28. Limitations of the Study • Cultural differences • Male under-representation • No standardized criteria for ON • Internet based sampling • Self-reported data • High cut off point on scale?

  29. Clinical Relevance • Inpatient • May be difficult for them to eat “hospital food.” • Outpatient • Potential barrier to nutrient dense diet.

  30. The Verdict ORTO-15 shows promise as a screening tool. Further research will be needed.

  31. Questions?

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