Validity and reliability of the Turkish version of the ORTO-R in an adolescent clinical sample

Orthorexia nervosa refers to a pathological preoccupation with healthy eating characterized by rigid dietary rules, excessive concern about food purity, and distress when these rules are violated. Despite growing clinical interest, validated instruments for assessing orthorexic tendencies in children and adolescents remain limited. This study aimed to evaluate the validity and reliability of the Turkish version of the ORTO-R Scale in a clinical sample of adolescents and to examine its associations with eating-related and anxiety symptoms. A total of 132 participants aged 12–17 years were recruited from a child and adolescent psychiatry outpatient clinic. Participants completed the ORTO-R Scale, the Eating Attitudes Test-26, the Orthorexia Nervosa Inventory, and the Revised Child Anxiety and Depression Scale, and psychiatric diagnoses were assessed using a semi-structured clinical interview. The ORTO-R demonstrated good internal consistency, with Cronbach’s α and McDonald’s ω coefficients of 0.77. Confirmatory factor analysis identified a three-factor structure with favorable overall model fit. Total ORTO-R scores showed moderate positive correlations with orthorexic and eating disorder symptoms and low-to-moderate correlations with anxiety symptoms. The Turkish version of the ORTO-R showed promising preliminary psychometric properties in this psychiatric outpatient sample, including acceptable internal consistency and meaningful associations with related measures. Further studies in larger, more diverse, and community-based samples are needed to confirm its validity, reliability, and clinical utility.