Association of Orthorexic Tendencies with Obsessive-Compulsive Symptoms, Eating Attitudes and Exercise

Hamdi Yılmaz, Gonca Karakuş, Lut Tamam, Mehmet Emin Demirkol, Zeynep Namlı, Caner Yeşiloğlu Department of Psychiatry, Çukurova University School of Medicine, Adana, TurkeyCorrespondence: Lut Tamam Mehmet Emin DemirkolDepartment of Psychiatry, Çukurova University School of Medicine, Adana, TurkeyTel + 90 533 6306006; +90 535 5849684Fax +90 322 3386204Email ltamam@gmail.com; emindemirkol@gmail.comPurpose: The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder (OCD), and other mental disorders. Individuals with orthorexic tendencies may have high physical activity as well as a healthy diet. This study aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features.Patients and Methods: We included 63 patients diagnosed with OCD, 63 healthy volunteers who perform physical exercises at least three days a week, at least 30 minutes a day, and 63 healthy volunteers who do not perform physical exercises regularly. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale, ORTO-11 Scale, Eating Attitude Test, Hamilton Anxiety Scale, and Structured Clinical Interview for DSM-5 Disorders (SCID-5 CV) were administered to all participants. OCD data form was also applied to patients with OCD diagnosis.Results: We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with OCD (p< 0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with OCD (p> 0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who regularly performed physical exercises and patients with OCD (p< 0.05). The orthorexic tendencies of participants who regularly performed physical exercises were higher than those diagnosed with OCD and healthy individuals who did not perform physical exercises.Conclusion: The absence of a significant relationship between disorder severity and orthorexia nervosa in patients diagnosed with OCD and the increase in orthorexic tendencies as the deterioration in eating attitudes increases in both patients with OCD and the participants who regularly perform physical exercises suggest that orthorexia nervosa may be closer to the eating disorders group than obsessive-compulsive spectrum. Studies with large samples and different diagnoses are needed to determine the place of orthorexia nervosa in diagnosis and classification systems.Keywords: orthorexia nervosa, obsessive-compulsive disorder, eating attitudes, exercise