Orthorexia Nervosa Tendencies in Two Cohorts of Polish Young Adults: A Comparative Analysis of Prevalence, Correlates, and Comorbidity

Abstract

Background: The rising focus on dietary choices has contributed to maladaptive eating patterns, including orthorexia nervosa (ON)-a pathological preoccupation with healthy eating. This study investigated ON prevalence and correlates in two Polish young adult cohorts to address inconsistencies in the existing literature and ON's ambiguous nosological status. We explored its complex interplay with specific lifestyle and sociodemographic factors. Methods: The study sample consisted of 412 young adults, comprising Group 1 (G1; n = 136; 95 women, 38 men, and 3 non-binary individuals) and Group 2 (G2; n = 264; 194 women, 65 men, and 5 non-binary individuals). Data collection utilized a proprietary questionnaire for sociodemographic and health, the ORTO-15 questionnaire (cut-off < 35 points) for ON risk, and the EAT-26 for eating disorder (ED) risk. Depression was self-assessed. An analysis of sociodemographic, clinical, and lifestyle data was conducted to explore the association with orthorexia risk. Results: ON risk was identified in 26.5% of participants in G1 and 76.8% in G2. Logistic regression analysis identified different, independent predictors of ON risk for each group. In G1, these were depressive symptoms (OR = 2.52) and a co-occurring risk of eating disorders (ED) (OR = 11.37). In contrast, for G2, the predictors were smoking (OR = 2.14) and, inversely, a lower ED risk (OR = 0.16). No consistent associations were found with ON risk and age, gender, education, residence, or occupational status. Conclusions: This study confirms a strong link between ON and other eating disorders. The high ON prevalence in G2, combined with low internal consistency of ORTO-15, suggests tool limitations in specific populations. These findings highlight the need for more precise ON diagnostic tools and further research into its correlates, including body image, specific lifestyle factors, and its role within eating pathology.

Keywords: BMI; EAT-26; ON; ORTO-15; eating disorders; gender; orthorexia nervosa; prevalence; smoking; students; young adults.