Orthorexia Symptoms in Adolescents: Associations with Sociocultural Attitudes Toward Appearance and Body Composition

Background/Objectives: Orthorexic symptoms in adolescence may be associated with sociocultural appearance influences, but their relationship with objective body composition remains unclear. This study examined associations between orthorexic symptoms, sociocultural attitudes toward appearance, and body composition in adolescents. Methods: This cross-sectional study included 287 Polish secondary-school students aged 14–18 years. Orthorexic symptoms were assessed using the Düsseldorf Orthorexia Scale (DOS), sociocultural attitudes using the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3), and body composition by bioelectrical impedance analysis. Correlation and multiple linear regression analyses were performed. Results: DOS scores correlated positively with SATAQ-3 pressure/internalization (r = 0.407, p < 0.001), athletic internalization (r = 0.330, p < 0.001), and Information (r = 0.385, p < 0.001). These associations remained robust in Spearman sensitivity analyses. The regression model including four SATAQ-3 subscales, percentage body fat (PBF), sex, and age explained 19.2% of DOS-score variance (adjusted R2 = 0.172; F(7.279) = 9.49, p < 0.001). Pressure/internalization (β = 0.190, p = 0.053) and Information (β = 0.162, p = 0.060) did not reach conventional statistical significance. The remaining predictors were not independently associated with DOS scores. Conclusions: Orthorexic symptom severity was associated with appearance-related sociocultural variables at the bivariate level, but individual predictors were not independently significant in the adjusted model. These findings identify sociocultural factors as relevant correlates without establishing causality or excluding a role for body composition. Longitudinal studies using adolescent-validated measures and direct assessments of digital exposure are needed.