Detection of Orthorexia Nervosa with the Turkish Version of ONI in Dietitians: A Pilot Study

Year 2024, , 18 - 24, 20.03.2024

Seda Kaya , Zeynep Uzdil , Funda Pınar Çakıroğlu

https://doi.org/10.53424/balikesirsbd.1256569

Abstract

Objective: Orthorexia Nervosa (ON) is defined pathological condition in which righteous eating obsession. It is known that dietitians may be trend to ON in developing healthy eating habits as a result of nutrition education and dietetic practices. This study aimed to determine ON tendency and eating attitude with the Orthorexia Nervosa Inventory (ONI), which includes all diagnostic criteria, in dietitians in the risk group for ON. Materials and Methods: This cross-sectional study was carried out in December 2022 and February 2023 among 206 dietitians in Turkey. Participants completed questionnaire related to individual characteristics, ONI, and Eating Attitude Test-26 (EAT-26). Results: The mean score of ONI in dietitians was 37.5±9.7. The total score of ONI and the median value of all ONI sub-dimensions were statistically significantly higher in dietitians with abnormal eating behavior. There is a positive moderate relationship between the total score of EAT-26 and the total score of ONI (r=0.502, p<0.01). The total score of EAT-26 is positively correlated with ONI sub-dimensions and total score of ONI. On the other hand, this study does not support nutritional education's concerns that increased preoccupation with healthy eating may lead to disordered eating patterns. Conclusion: More longitudinal, prospective studies are needed to assess whether ON and eating disorders progress in dietitians. These studies are very important because dietitians also provide counseling to other people in the field of nutrition and affect their nutrition programs.

Keywords

Orthorexia nervosa, Eating disorders, Eating attitude, Dietetians, Nutritionists

Supporting Institution

No financial support has been received.

Project Number

-

Thanks

The authors thank the dietitians who contributed to this study.

References

• Abdullah, M. A., Al Hourani, H. M., & Alkhatib, B. (2020). Prevalence of orthorexia nervosa among nutrition students and nutritionists: Pilot study. Clinical Nutrition ESPEN, 40, 144-148. https://doi:10.1016/j.clnesp.2020.09.175
• Agopyan, A., Kenger, E. B., Kermen, S., Ulker, M. T., Uzsoy, M. A., & Yetgin, M. K. (2019). The relationship between orthorexia nervosa and body composition in female students of the nutrition and dietetics department. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24, 257-266. https://doi:10.1007/s40519-018-0565-3
• Aksoydan, E., & Camci, N. (2009). Prevalence of orthorexia nervosa among Turkish performance artists. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 14(1), 33-37. https://doi:10.1007/bf03327792
• Asil, E., & Sürücüoğlu, M. S. (2015). Orthorexia Nervosa in Turkish Dietitians. Ecology of Food and Nutrition, 54(4), 303-313. https://doi:10.1080/03670244.2014.987920
• Barthels, F., Meyer, F., & Pietrowsky, R. (2015). Orthorexic eating behavior. A new type of disordered eating. Ernahrungs Umschau, 62(10), 156-161.
• Bratman, S. (1997). Orthorexia essay. URL: www. orthorexia. com/original-orthorexia-essay/Zugriff 16.03, 17.
• Cena, H., Barthels, F., Cuzzolaro, M., Bratman, S., Brytek-Matera, A., Dunn, T., . . . Donini, L. M. (2019). Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24, 209-246. https://doi:10.1007/s40519-018-0606-y
• Cooper, Z., & Fairburn, C. G. (2011). The evolution of “enhanced” cognitive behavior therapy for eating disorders: Learning from treatment nonresponse. Cognitive and Behavioral Practice, 18(3), 394-402. https://doi:10.1016/j.cbpra.2010.07.007
• Çobanoğlu, Z., & Akman, M. (2021). Consideration of healthy eating obsession (orthorexia nervosa) for students educated in nutrition and dietetics department. Journal of Pharmacy and Pharmacology, 9, 35-43. https://doi:10.17265/2328-2150/2021.02.001
• Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11-17. https://doi:10.1016/j.eatbeh.2015.12.006
• Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11-17.
• Ergüney-Okumuş, F. E., & Sertel-Berk, H. Ö. (2019). Yeme Tutum Testi Kısa Formunun (YTT-26) Üniversite Örnekleminde Türkçeye Uyarlanması ve Psikometrik Özelliklerinin Değerlendirilmesi. Psikoloji Çalışmaları, 40(1).
• Fidan, T., Ertekin, V., Işikay, S., & Kirpinar, I. (2010). Prevalence of orthorexia among medical students in Erzurum, Turkey. Comprehensive Psychiatry, 51(1), 49-54. https://doi:10.1016/j.comppsych.2009.03.001
• Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273-279. https://doi:10.1017/s0033291700030762
• Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: psychometric features and clinical correlates. Psychological Medicine, 12(4), 871-878. https://doi:10.1017/s0033291700049163
• Gkiouleka, M., Stavraki, C., Sergentanis, T. N., & Vassilakou, T. (2022). Orthorexia nervosa in adolescents and young adults: a literature review. Children (Basel), 9(3). https://doi:10.3390/children9030365
• Hyrnik, J., Janas-Kozik, M., Stochel, M., Jelonek, I., Siwiec, A., & Rybakowski, J. K. (2016). The assessment of orthorexia nervosa among 1899 Polish adolescents using the ORTO-15 questionnaire. International Journal of Psychiatry in Clinical Practice, 20(3), 199-203. https://doi:10.1080/13651501.2016.1197271
• IBM SPSS statistics for windows, version 26.0. IBM Corp, Armonk, NY
• Kaya, S., Uzdil, Z., & Çakıroğlu, F. P. (2022). Validation of the Turkish version of the Orthorexia Nervosa Inventory (ONI) in an adult population: its association with psychometric properties. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 27(2), 729-735. https://doi:10.1007/s40519-021-01199-0
• Kinzl, J. F., Hauer, K., Traweger, C., & Kiefer, I. (2006). Orthorexia nervosa in dieticians. Psychotherapy and Psychosomatics, 75(6), 395-396. https://doi:10.1159/000095447
• Koven, N. S., & Abry, A. W. (2015). The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385-394. https://doi:10.2147/ndt.S61665
• Kummer, A., Dias, F. M., & Teixeira, A. (2008). On the concept of orthorexia nervosa. Scandinavian Journal of Medicine & Science in Sports, 18(3), 395-396; author reply 397.
• Mahn, H. M., & Lordly, D. (2015). A Review of Eating Disorders and Disordered Eating amongst Nutrition Students and Dietetic Professionals. Canadian Journal of Dietetic Practice and Research, 76(1), 38-43. https://doi:10.3148/cjdpr-2014-031
• Malmborg, J., Bremander, A., Olsson, M. C., & Bergman, S. (2017). Health status, physical activity, and orthorexia nervosa: A comparison between exercise science students and business students. Appetite, 109, 137-143. https://doi:10.1016/j.appet.2016.11.028
• Moroze, R. M., Dunn, T. M., Craig Holland, J., Yager, J., & Weintraub, P. (2015). Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near-fatal "orthorexia nervosa" and proposed diagnostic criteria. Psychosomatics, 56(4), 397-403. https://doi:10.1016/j.psym.2014.03.003
• Oberle, C. D., De Nadai, A. S., & Madrid, A. L. (2020). Orthorexia Nervosa Inventory (ONI): development and validation of a new measure of orthorexic symptomatology. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(2), 609-622. https://doi:10.1007/s40519-020-00896-6
• Oberle, C. D., Samaghabadi, R. O., & Hughes, E. M. (2017). Orthorexia nervosa: Assessment and correlates with gender, BMI, and personality. Appetite, 108, 303-310. https://doi:10.1016/j.appet.2016.10.021
• Rogoza, R., Brytek-Matera, A., & Garner, D. (2016). Analysis of the EAT-26 in a non-clinical sample. Archives of Psychiatry and psychotherapy, 18(2), 54-58.
• Rogoza, R., & Donini, L. M. (2021). Introducing ORTO-R: a revision of ORTO-15. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(3), 887-895.
• Pugh, M., & Waller, G. (2016). The anorexic voice and severity of eating pathology in anorexia nervosa. international Journal of Eating Disorders, 49(6), 622-625. https://doi:10.1002/eat.22499
• Sánchez, F. G., & Rial, B. R. (2005). Orthorexia nervosa. A new eating behavior disorder. Actas Espanolas de Psiquiatria, 33(1), 66-68.
• Strahler, J., Hermann, A., Walter, B., & Stark, R. (2018). Orthorexia nervosa: A behavioral complex or a psychological condition? Journal of Behavioral Addictions, 7(4), 1143-1156. https://doi:10.1556/2006.7.2018.129
• Tremelling, K., Sandon, L., Vega, G. L., & McAdams, C. J. (2017). Orthorexia nervosa and eating disorder symptoms in registered dietitian nutritionists in the United States. Journal of the Academy of Nutrition and Dietetics, 117(10), 1612-1617. https://doi:10.1016/j.jand.2017.05.001
• World Health Organization (WHO). Erişim linki: https://www.euro.who.int/en/health-topics/disease- prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. (accessed February 2023)