Relationship between orthorexia nervosa, healthy orthorexia, and individual characteristics of physically active Brazilian adults

While adopting a healthy diet is widely encouraged and socially valued, it can become pathological when characterized by rigidity, preoccupation, and resulting psychosocial impairment. This dichotomy has led to the conceptual distinction between orthorexia nervosa (ON), a potentially harmful obsession with healthy eating, and healthy orthorexia (HO), a non-pathological interest in healthy eating. However, the relationships between individual characteristics and these orthorexia dimensions remain insufficiently explored, particularly among physically active individuals. This study examined the relationships between individual characteristics and ON and HO in a sample of physically active Brazilian adults. This cross-sectional study included 1,359 participants (72.6% women; mean age: 29.5 ± 8.8 years) who completed an online survey assessing sociodemographic data and the Teruel Orthorexia Scale (TOS). Confirmatory factor analysis and structural equation modeling (SEM) were used to refine the TOS measurement model and to investigate the relationships among the study variables. The original two-factor structure of the TOS was retained, but nine items were removed to improve model fit, resulting in a refined version used in the SEM analysis. Higher HO scores were related to being female, older age, more frequent exercise, use of dietary supplements, adherence to appearance-focused diets, no history of cosmetic surgery, and normal weight status. Higher ON scores were related to being female, being employed, having a history of eating disorders, engaging in regular physical activity, and following appearance-focused diets. Distinct individual characteristics were related to ON and HO, underscoring the importance of tailored prevention and intervention strategies to address potentially dysfunctional eating patterns among physically active adults.