Predictors of orthorexia nervosa in women: eating attitudes, emotional regulation difficulties, anxiety, depression and self-esteem

Although orthorexia nervosa, defined as excessive preoccupation with healthy food consumption, is not yet included as a disease in current classification systems (DSM-5, ICD-10), it is a psychopathology that is attracting increasing attention with a growing number of studies on the subject. The aim of this study was to examine the predictors of eating attitudes, emotion dysregulation, depression, anxiety and self-esteem in orthorexia nervosa, which are considered in the literature to be related to orthorexia nervosa. Data were collected using Eating Attitude Short Form, Difficulties in Emotion Regulation Scale, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Beck Anxiety Inventory and Orthorexia Nervosa Rating Scale Short Form. Data were collected from 380 female participants via social media platforms using snowball sampling. Pearson correlation analysis, multiple linear regression analysis and hierarchical regression analysis were used for data analysis and significance was accepted as p < 0.05. Correlation analysis showed that there was a negative and moderate relationship between orthorexia nervosa and eating attitude scores (r = -.407**, p < .001). Linear regression analysis showed that eating attitude (β = -.393, t = -8.223, p < .01), depression (β = .141, t = 2.371, p < .05) and anxiety (β = -.147, t = -2.492, p < .05) scores were statistically significant predictors of the orthorexia nervosa scale scores. The established model explains 18.5% of the variance in the orthorexia nervosa score. Hierarchical regression analysis showed that eating attitude score (β = -.224, t = -8.651, p < .01) predicted orthorexia nervosa and the model explained 16.5% of the orthorexia nervosa score variance. In addition hierarchical regression analysis showed that the variables paying attention to diet (β = 1.052, t = 3.980, p < .01), eating natural foods (β = 1.405, t = 2.941, p < .01) and changing behaviour when given information about healthy eating (β = 1.322, t = 6.117, p < .01) predicted orthorexia nervosa scores and explained 32.1% of the variance. The results show that as pathological eating attitudes increase, orthorexia nervosa decreases, and as anxiety and depression levels increase, orthorexia nervosa increases. In addition, as people's tendency to eat natural foods, their tendency to pay attention to their diet, and the way they reflect this information in their behaviour increases, so do their levels of orthorexia nervosa. The results may guide clinicians in treatment and health policy developers in public health policy.