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. 2024 Jan 10;29(1):6.
doi: 10.1007/s40519-023-01629-1.

Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive-compulsive symptoms

Affiliations

Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive-compulsive symptoms

Phillipa Ann Huynh et al. Eat Weight Disord. .

Abstract

Purpose: Orthorexia nervosa (ON), a proposed disorder describing an obsessive focus on "healthy" eating, is characterised as having overlapping symptoms with obsessive-compulsive disorder. However, ON/obsessive-compulsive (OC) symptom relationships are inconsistently reported. The current study aimed to investigate if the contribution of OC symptoms and beliefs explain variability in ON symptoms and determine if perfectionism, a transdiagnostic factor, moderates the ON/OC symptom relationship.

Methods: The study comprised 190 participants (Mage = 28.63, SDage = 9.88; 80% female) recruited via an undergraduate research programme, social media, advocacy organisations, and a participant registry. Participants completed an online questionnaire assessing ON, OC, and perfectionism symptoms.

Results: A linear regression analysis found OC symptoms and beliefs explained 22.9% variability in ON symptoms (p < 0.001, f2 = 0.38) and perfectionism moderated the ON/OC symptom relationship, where higher levels of perfectionism with higher levels of OC symptoms was associated with higher levels of ON symptoms, explaining 2.2% variability (p = .01, f2 = 0.03).

Conclusion: OC symptoms appear more common in ON than previous studies indicate. However, the interaction between perfectionism and OC symptoms may drive obsessions in ON. Findings help refine our current understanding of ON phenomenology with implications for ON treatment development. Future research should further explore perfectionism in ON phenomenology.

Level of evidence: Level V (Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees).

Keywords: Eating disorders; Healthy eating; Obsessive–compulsive; Orthorexia nervosa; Perfectionism.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Interaction effect of OC symptoms and perfectionism symptoms on predicted ON symptom scores. Independent variables centred to mean
Fig. 2
Fig. 2
Model of study findings. β = Based on mean-centred variables; *p < 0.05, **p < 0.01

References

    1. Dunn TM, Bratman S. On orthorexia nervosa: a review of the literature and proposed diagnostic criteria. Eat Behav. 2016;21(1):11–17. doi: 10.1016/j.eatbeh.2015.12.006. - DOI - PubMed
    1. Bratman S. Health food junkie. Yoga J. 1997;136(1):42–50.
    1. American Psychiatric Association. Obsessive-compulsive and related disorders. Diagnostic and statistical manual of mental disorders. 5th ed. 2022.
    1. Zagaria A, Vacca M, Cerolini S, Ballesio A, Lombardo C. Associations between orthorexia, disordered eating, and obsessive–compulsive symptoms: a systematic review and meta-analysis. Int J Eat Disord. 2021;55(3):295–312. doi: 10.1002/eat.23654. - DOI - PubMed
    1. Shafran R, Cooper Z, Fairburn CG. Clinical perfectionism: a cognitive–behavioural analysis. Behav Res Ther. 2002;40(7):773–791. doi: 10.1016/S0005-7967(01)00059-6. - DOI - PubMed