Is the prevalence of orthorexia nervosa in an Australian university population 6.5%?
To survey Australian adults at a Sydney university about: their tendencies towards the proposed health food eating disorder, orthorexia nervosa (and to estimate the prevalence of this condition), their eating behaviours, and their body image.
A pilot, cross-sectional and descriptive online survey was conducted on staff and students at the University of New South Wales, Sydney. The primary outcome was the score on the most commonly used and validated measure of orthorexic behaviours, the ORTO-15. The point prevalence of orthorexia nervosa was estimated using the ORTO-15 cut-off score of < 35. Other outcomes were the Eating Attitudes Test-26 and the Body Shape Questionnaire-34.
In the sample of 92 Australian adults recruited at a university, there was a point prevalence rate for orthorexia nervosa of 21% when using the ORTO-15 cut-off value of < 35. If criteria A and B of proposed diagnostic criteria for the condition were also taken into consideration (i.e. someone with orthorexia nervosa would display disordered healthy eating tendencies; as well as were: underweight, or had marked concern with their body shape, or had significant impairment of functioning in work life or social life), the true prevalence rate could be considered to be 6.5%.
Using the ORTO-15 tool alone may overestimate the true prevalence of orthorexia nervosa. Further research into the accurate diagnosis and treatment of orthorexia nervosa is needed.
Level of evidence
Level V, descriptive study.
KeywordsFeeding and eating disorders Orthorexia nervosa Healthy eating Feeding behavior Diet Reducing Body image
The author would like to thank Daniela Schäfera for contributing to data collection and Elena Syurina for helping with the study design.
Compliance with ethical standards
Conflict of interest
The author has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the UNSW Sydney Human Research Ethics Committee (Approval Number HC15086).
Informed consent was obtained from all individual participants included in the study.
- 3.Moroze RM, Dunn TM, Holland JC, 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.org/10.1016/j.psym.2014.03.003 CrossRefPubMedGoogle Scholar
- 4.American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition. Feeding and eating disorders. https://doi.org/10.1176/appi.books.9780890425596.dsm10
- 6.Parra-Fernandez ML, Rodríguez-Cano T, Onieva-Zafra MD, Perez-Haro MJ, Casero-Alonso V, Muñoz Camargo JC, Notario-Pacheco B (2018) Adaptation and validation of the Spanish version of the ORTO-15 questionnaire for the diagnosis of orthorexia nervosa. PLoS One 13(1):e0190722. https://doi.org/10.1371/journal.pone.0190722 CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med 12:871–878. http://www.eat-26.com/. Accessed 10 Mar 2018
- 10.Cooper PJ, Taylor MJ, Cooper Z, Fairburn CG (1986) The development and validation of the body shape questionnaire. Int J Eat Disord 6:485–494. http://www.psyctc.org/tools/bsq/. Accessed 10 Mar 2018
- 11.Ramacciotti CE, Perrone P, Coli E, Burgalassi A, Conversano C, Massimetti G, Dell’Osso L (2011) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15). Eat Weight Disord 16(2):e127–e130. https://doi.org/10.1007/BF03325318 CrossRefPubMedGoogle Scholar
- 17.Brytek-Matera A, Fonte ML, Poggiogalle E, Donini LM, Cena H (2017) Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students. Eat Weight Disord 22:609. https://doi.org/10.1007/s40519-017-0427-4 CrossRefPubMedGoogle Scholar