Too healthy for their own good: Orthorexia nervosa and compulsive exercise in the community

Abstract Background The similarities and differences between the orthorexia nervosa symptoms (ONs) and the symptoms and correlates of eating disorders listed in the DSM-5 need to be elucidated. ONs were examined in a volunteer community sample in conjunction with compulsive exercise, disordered eating, as well as emotional and behavioral correlates of eating disorders. Methods Participants were 561 adult volunteers (93 men, 17.09%) aged 19–72 (M = 32.7 ± 11), recruited via social media networks. Participants self-reported online on the following measures: Düsseldorf Orthorexia Scale, Compulsive Exercise Test, Retrospective Child Feeding Questionnaire, Experiences in Close Relationships, Difficulties in Emotional Regulation Scale, Toronto Alexithymia Scale, and Eating Disorder Examination Questionnaire 13. Data was downloaded and analyzed in SPSS26 and Amos26. Results A theoretical model of the connections between the study variables was tested via SEM and confirmed. The profiles of participants with high, average and low levels of ONs were compared. Participants with the highest levels also scored highest for compulsive exercise, insecure attachment, alexithymia, emotion regulation difficulties, weight and shape concerns, body dissatisfaction, restriction, bingeing, purging and recollections of their parents being concerned about their overweight, and restricting and monitoring their intake of calorie-rich foods as children. Discussion High levels of ONs are related to disordered eating attitudes and behaviors, as well as to emotional and behavioral correlates of eating disorders. It is unclear to what extent these ONs are distinguishable from symptoms of other eating disorders listed in the DSM-5. Longitudinal studies may help to elucidate distinct trajectories and risk factors of ON. Level of evidence Level III, case–control analytic study.