Abstract
PurposeThe ORTO-11-ES questionnaire is a tool to assess the pathological obsession displayed by some individuals regarding healthy eating. The aims of this study were (1) to confirm the factor structure of the Spanish version of ORTO-11-ES using confirmatory factor analysis (CFA) and (2) to examine the possible association between the ORTO-11-ES score, gender and body mass index (BMI).MethodsThe sample comprised 492 students from the University of Castilla la Mancha, Spain. Of these, 280 were women (56.9%). Participants were surveyed using the ORTO-11-ES questionnaire.ResultsThe confirmatory factor analysis (CFA) supported the 11 elements and 3 domains of this tool as the better fitting model; for the Comparative Fit Index (CFI) and the Tucker–Lewis Index (TLI), the values were 0.94 and 0.91, respectively, and the Root Mean-Square Error of Approximation (RMSEA) was 0.058. The tendency towards orthorexic behavior is more associated with the female gender. The BMI had no influence on the tendency for ON.ConclusionsThis study is the first attempt to confirm the three-factor structure of a Spanish version of the ORTO-15 questionnaire. These findings suggest that the ORTO-11-ES may be a valuable tool for identifying subjects with specific eating behavior patterns. This information may be useful for health professionals involved in the research, development and implementation of interventions catered to individuals suffering from this eating disorder.Level of evidenceLevel V, descriptive cross-sectional study.
Highlights
Orthorexia nervosa (ON) is the term given to a constellation of pathological attitudes and behaviors related to attempts to eat only “healthy” or “pure” food [1]
The mean body mass index (BMI), calculated based on the weights and heights reported by participants was 22.21 (± 7.97) for women and 23.43 (± 3.81) for men
The confirmatory factor analysis (CFA) confirmed that the three-dimensional solution has an excellent goodness-of-fit (χ2 = 64.13, p = 0.01; CMIN/DF = 1.17; Comparative Fit Index (CFI) = 0.99; Tucker–Lewis Index (TLI) = 0.98; Root Mean-Square Error of Approximation (RMSEA) = 0.03, PCLOSE = 0.9; SRMR = 0.04; see Fig. 1)
Summary
Orthorexia nervosa (ON) is the term given to a constellation of pathological attitudes and behaviors related to attempts to eat only “healthy” or “pure” food [1]. ON can lead to physical, psychological, and social impairments, such as malnutrition, isolation, and decreased quality of life [1, 2]. The potential severity of the physical and psychological effects of ON vary considerably, depending on the duration of the behaviors, the specifics of an individual’s eating choices, the level of adherence to food rules, and any underlying or co-occurring conditions. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity (2018) 23:745–752 studies are lacking, there is anecdotal evidence that this type of dietary extremism is associated with a tendency for affected individuals to seek isolation, limiting social interaction with others [1, 6]. If unable to conform to food rules or dietary ideals, an individual with ON tendencies may develop feelings of self-blame, distorted cognitions, and even psychosis. Alterations in brain chemistry, dopamine and serotonin, may cause feelings of euphoria and/or anxiety [7, 8]
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