Published online Oct 19, 2022. doi: 10.5498/wjp.v12.i10.1298
Peer-review started: March 19, 2022
First decision: May 30, 2022
Revised: June 15, 2022
Accepted: September 2, 2022
Article in press: September 2, 2022
Published online: October 19, 2022
Many factors have been associated to orthorexia nervosa in university students.
To assess the prevalence of orthorexia nervosa in Italian and Spanish university students.
To assess the prevalence of orthorexia nervosa in relation to eating attitude and psychological distress.
Questionnaires were administered to evaluate orthorexia nervosa, body concerns, psychological distress, physical activity, eating attitude and starvation symptoms.
When excluding students underweight (UW), overweight (OW) or obese (OB), as well as those potentially at risk of eating disorders or presenting distress, in the resultant normal weight (NW)-K10neg-EAT-26neg subgroup, we did not find many correlations observed in the whole sample, including those between ORTO scores and Body Uneasiness Test, Starvation Symptom Inventory, Total Multidimensional Body-Self Relations Questionnaire (MBSRQ) and some of its components. Moreover, ORTO-7 resulted the only ON score unrelated with Body Mass Index, MBSRQ components and IPAQ-assessed intense activity, in the NW-K10neg-EAT-26neg subgroup. After this sort of “exclusion diagnosis”, ORTO-7 became independent from these confounding, after the exclusion of UW, OW, OB and students positive to EAT-26 and K10, suggesting the possibility of identifying orthorexic subjects with this specific questionnaire.
In some university students ON could be a symptom of other conditions related to body image concerns and distress, as well as to high physical activity and appearance, fitness, health or illness orientation. ORTO-7 became independent from these confounding factors, after the exclusion of UW, OW, OB and students positive to EAT-26 and K10, suggesting the possibility of identifying orthorexic subjects with this specific questionnaire.
Considering the overlap conditions, we suggest a decision tree for differential/exclusion diagnosis of ON.