Observational Study
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World J Psychiatry. Oct 19, 2022; 12(10): 1298-1312
Published online Oct 19, 2022. doi: 10.5498/wjp.v12.i10.1298
Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students
Paola Aiello, Elisabetta Toti, Débora Villaño, Anna Raguzzini, Ilaria Peluso
Paola Aiello, Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University, Rome 00185, Italy
Elisabetta Toti, Anna Raguzzini, Ilaria Peluso, Research Centre for Food and Nutrition, Council for Agricultural Research and Economics, Rome 00178, Italy
Débora Villaño, Food Science and Technology Department, UCAM, Murcia 30107, Spain
Author contributions: Peluso I and Villaño D contributed to the conceptualization; Aiello P, Toti E and Raguzzini A contributed to the investigation; Aiello P and Peluso I contributed to the original draft preparation; Toti E, Raguzzini A and Villaño D contributed to the review and editing; Peluso I contributed to the supervision.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee for Human Experimentation of the La Sapienza University of Rome (protocol code 1382/2019, approved on 16 July 2019) and by the Ethics Committee of the Catholic University of Murcia (UCAM) (protocol code CE071906, approved on 3 July 2019).
Informed consent statement: Informed consent was obtained from all subjects involved in the study. Volunteers did not sign consent to share single individual data, but only cumulative results.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ilaria Peluso, PhD, Research Scientist, Research Centre for Food and Nutrition, Council for Agricultural Research and Economics, Via Ardeatina 546, Rome 00178, Italy. ilaria.peluso@crea.gov.it
Received: March 19, 2022
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
ARTICLE HIGHLIGHTS
Research background

Many factors have been associated to orthorexia nervosa in university students.

Research motivation

To assess the prevalence of orthorexia nervosa in Italian and Spanish university students.

Research objectives

To assess the prevalence of orthorexia nervosa in relation to eating attitude and psychological distress.

Research methods

Questionnaires were administered to evaluate orthorexia nervosa, body concerns, psychological distress, physical activity, eating attitude and starvation symptoms.

Research results

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.

Research conclusions

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.

Research perspectives

Considering the overlap conditions, we suggest a decision tree for differential/exclusion diagnosis of ON.