Orthorexia Nervosa, Weight Bias, and Adverse Childhood Events Among Nutrition Students

Nutrition student education focuses on teaching future nutrition professionals how to assist clients in health promotion, but many students and professionals in the field display disordered eating tendencies and weight bias. Adverse childhood experiences (ACEs) are a risk factor for the development of eating disorders but have not been studied in this population. The aim of this study was to explore the prevalence and associations between orthorexia (ON), weight bias, and ACEs among nutrition students, and their perceptions of the impact of nutrition curriculum on their diet and body. A mixed methods survey consisting of sociodemographic questions, ON tendencies, weight bias, ACEs, and perceptions of curriculum content was distributed to university nutrition programs in 12 mid-southeast states with the U.S. Pearson’s Chi-squared test, Fisher’s exact test, Person’s correlation test, and independent samples t-tests assessing the relationship between variables. Open-ended responses were analyzed using inductive analysis. Of 164 respondents, the majority were female (92.1%) and white (82.0%). The mean ORTO-R (measure of orthorexia tendencies) was 14.57, 49.4% had a dysfunctional family (exposure to at least one family dysfunction), and participants demonstrated moderate levels of implicit weight prejudice, M=0.42, SD=0.38, denoting a significant level of bias (P<0.001). Undergraduates reported significantly greater ON symptoms than graduate students (P<0.001). No significant associations between ON, weight bias, and ACEs were present. From the open-ended responses, negative curriculum impacts were perceived guilt and shame, commonly from self-assessment activities. Positive curriculum impacts were most often an improved relationship with food and learning about body inclusivity. Nutrition students are future nutrition professionals who will interact with clients for health promotion. Policies and procedures to support nutrition students with disordered eating are warranted, along with adapting current curriculum content to decrease stigma and encourage food and body inclusivity.