1 Psychotherapy and Systems Neuroscience, Justus-Liebig-University Giessen , Giessen, Germany.
J Behav Addict. 2018 Dec 1;7(4):1143-1156. doi: 10.1556/2006.7.2018.129. Epub 2018 Dec 17.
Numerous studies have provided evidence for orthorexia nervosa (ON), an eating pattern characterized by an almost manic obsession for and fixation on healthy eating, to be of epidemiological relevance. However, there is scientific debate on whether it is merely a behavioral or lifestyle phenomenon as compared to a mental disorder. Aim of this cross-sectional study was to explore whether ON is of epidemiological and clinical relevance, and whether ON can be distinguished from other mental health disorders and healthy lifestyle features.
An online survey including a measure of orthorexic behaviors [Duesseldorf Orthorexia Scale (DOS)], well-being and distress, eating behaviors, pathological eating, anxiety and depression, addictive behaviors, obsessive-compulsive symptoms, personality, and health behaviors was completed by 713 subjects (79.8% women, 18-75 years, median age: 25 years).
Twenty-seven subjects (3.8%, 21 women) showed significant orthorexic eating (DOS ≥ 30). ON cases reported lower well-being, lower satisfaction with life, and higher current stress levels than non-ON cases. The highest percentage of variation in ON was explained by pathological eating (R = .380), followed by eating style, Mediterranean diet, compulsive symptoms, and subjective social status. Importantly, ON provided hardly any additional predictive value for well-being when also considering pathological eating.
Our data confirmed the epidemiological and clinical relevance of orthorexic behaviors, but the strong conceptual overlap with other mental health problems and pathological eating raise initial doubts as to whether ON is a distinct mental health disorder category. This co-occurrence, unique symptoms, and underlying processes need further exploration by comparing ON cases with patients with other mental disorders.
许多研究已经证明，饮食模式中有一种近乎狂热的对健康饮食的痴迷和执着，即神经性食欲过正（ON），这种模式具有流行病学意义。然而，与精神障碍相比，它是否仅仅是一种行为或生活方式现象，科学界存在争议。本横断面研究的目的是探讨 ON 是否具有流行病学和临床意义，以及 ON 是否可以与其他心理健康障碍和健康生活方式特征区分开来。
通过在线调查，包括一项衡量 orthorexic 行为的量表（Duesseldorf Orthorexia Scale，DOS），以及幸福感和压力、饮食行为、病理性饮食、焦虑和抑郁、成瘾行为、强迫症状、个性和健康行为等方面，对 713 名受试者（79.8%为女性，年龄 18-75 岁，中位数年龄：25 岁）进行了调查。
27 名受试者（3.8%，21 名女性）表现出明显的 orthorexic 饮食（DOS≥30）。ON 病例报告的幸福感、生活满意度较低，当前压力水平较高。ON 解释的变异百分比最高的是病理性饮食（R=.380），其次是饮食方式、地中海饮食、强迫症状和主观社会地位。重要的是，当同时考虑病理性饮食时，ON 对幸福感几乎没有提供额外的预测价值。
我们的数据证实了 orthorexic 行为的流行病学和临床意义，但与其他心理健康问题和病理性饮食的强烈概念重叠，最初对 ON 是否是一种独特的心理健康障碍类别提出了质疑。需要通过将 ON 病例与其他精神障碍患者进行比较，进一步探讨这种共病、独特症状和潜在过程。
