Abstract
BackgroundOrthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding 'pure' eating behaviors. Many scales have been established and display good results regarding reliability and validity measures, including but not limited to ORTO-R (revised version of ORTO-15), Eating Habits Questionnaire, Teruel Orthorexia Scale (TOS) and the Düsseldorf Orthorexia Scale (DOS). Among these, the DOS seems to be a promising measure for multiple reasons. The current paper aims to validate the DOS, a measure of ON, in a non-Western population of Lebanese adolescents.MethodsThis was a cross-sectional designed study, conducted between May and June 2020, which enrolled 555 adolescents (15–18 years old; 75.7% females). Due the coronavirus pandemic outbreak, the data were gathered through snowball sampling using an online questionnaire. The DOS, TOS and ORTO-R scales were used in this study to screen for orthorexic tendencies and behaviors.ResultsWe tested four competing structural models of the DOS assessing its factorial validity. The results of the current investigation revealed that the one-factorial model is the best one to represent the structure of the questionnaire. We provided evidence for validity for the DOS through demonstrating that it correlates significantly with other measures of orthorexic behaviours (Teruel Orthorexia Scale and ORTO-R). Finally, we have gathered evidence that the orthorexic behaviours as measured by DOS are not associated with age (r = −.02; p = .589), household crowding index (r = .02; p = .578), and Body Mass Index (r = .04; p = .297). Yet, females as compared to males achieved higher scores (M = 20.07, SD = 6.38 vs M = 18.29, SD = 6.37; p = .005; d = .28).ConclusionThe Arabic version of the DOS seems to be a structurally valid and internally consistent questionnaire measuring orthorexic eating behavior in a sample of Lebanese adolescents. This tool may be useful for psychologists, psychiatrists, dietitians and other clinicians in the assessment and the treatment of the multidimensional nature of ON.
Highlights
Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding ’pure’ eating behaviors
The Düsseldorf Orthorexia Scale (DOS) seems to be a promising measure for several reasons: (1) this tool is very short, it is a timeefficient screening tool, (2) its items are short, easy and comprehensible, it is suitable for individuals with lower education or for younger adolescents, (3) it has been validated in several languages, allowing comparisons between different countries and cultures, (4) it was created in a thorough and comprehensive process, starting from an item pool comprising almost 200 statements
The mean scores of the scales used in this study were as follows: DOS (19.64 ± 6.42), Teruel Orthorexia Scale (TOS) orthorexia nervosa (5.23 ± 4.82), TOS healthy orthorexia (10.15 ± 5.83) and ORTO (15.16 ± 3.98)
Summary
Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding ’pure’ eating behaviors. The validity and reliability of this tool has been frequently questioned as for instance, it has an unstable factorial structure and is not suitable for the assessment of the prevalence of orthorexic behaviours [17, 18] To address these issues, a revised version, that is the ORTO-R [19] was proposed, which is not solving its parent measures limitations, it apparently reduces their influence [20]. A revised version, that is the ORTO-R [19] was proposed, which is not solving its parent measures limitations, it apparently reduces their influence [20] In response to such difficulties, other scales such as the Eating Habits Questionnaire (EHQ) [21], the Düsseldorf Orthorexia Scale (DOS) [22], and the Teruel Orthorexia Scale (TOS) [23, 24] have been established and display good results regarding reliability and validity measures [23]. Some of the other questionnaires, on the other hand, are based on a smaller pre-selection or were constructed on the basis of expert opinions, which may have disadvantages
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