Orthorexia Nervosa: Exploring the Psychological Underpinnings and Predictors in Women
In recent years, the phenomenon of orthorexia nervosa has increasingly captured the attention of mental health professionals and researchers alike. Defined by an unhealthy obsession with eating foods considered healthy or pure, this condition straddles the border between a conscientious lifestyle and a debilitating psychological disorder. A new study published in BMC Psychology expands on this conversation by identifying key psychological predictors associated with orthorexia nervosa in women, unpacking the complex interplay between eating attitudes, emotional regulation difficulties, anxiety, depression, and self-esteem.
Orthorexia nervosa remains a relatively novel diagnostic concept, not formally classified in major psychiatric manuals like the DSM-5, yet its increasing prevalence, particularly among women, underscores the urgent need for empirical clarity. The research led by Yöyen, Dereli, and Barış leverages a robust methodological framework to illuminate how these psychological factors interact, potentially contributing to the development and maintenance of orthorexic behaviors. This approach provides critical insight into not just the behaviors themselves, but the emotional and cognitive vulnerabilities that underlie them.
One of the primary psychological constructs examined in the study is eating attitudes. These refer to an individual's beliefs, feelings, and predispositions relative to food and dietary behaviors. In the context of orthorexia nervosa, a pathological fixation on "clean" eating frequently transcends health consciousness and moves toward ritualistic or anxiety-driven patterns. The researchers found that maladaptive eating attitudes significantly correlate with orthorexic tendencies, suggesting that how women perceive and approach food might predispose them to this condition.
Emotional regulation difficulties emerge as another critical factor in predicting orthorexia nervosa. Emotional regulation is the ability to manage and respond to emotional experiences appropriately. The study highlights that women who struggle to regulate emotions effectively are more susceptible to developing orthorexic behaviors as a maladaptive coping strategy. This connection makes intuitive sense; when individuals cannot adequately navigate negative emotions such as stress or sadness, they may seize on strict dietary rules as a means of exerting control and gaining perceived emotional stability.
In addition to emotional regulation, comorbid anxiety and depression are closely intertwined with orthorexia nervosa. Anxiety disorders, characterized by excessive worry and tension, naturally feed into the rigidity and fear of contamination or impurity that orthorexic individuals often display. The data from the study points to a significant correlation between heightened anxiety symptoms and orthorexic behaviors. Similarly, depression -- with its hallmark feelings of low mood and self-worth -- also appears to amplify orthorexic tendencies, possibly through negative self-appraisals that exacerbate the urge to perfect one's diet as an external validation mechanism.
Notably, lowered self-esteem is implicated as a subtle yet powerful predictor in the research findings. Self-esteem encompasses an individual's subjective evaluation of their worth and competence. Women exhibiting lower self-esteem reportedly feel compelled to adhere strictly to dietary norms, potentially as a compensatory mechanism to bolster self-image. This psychological dynamic offers a profound lens on orthorexia: the disorder may function as a maladaptive strategy to negotiate feelings of inadequacy by imposing rigorous self-imposed standards on nutrition.
The study's methodological rigor deserves highlighting. Employing standardized psychological scales and carefully controlled sampling, the researchers painted a comprehensive psychological profile of orthorexic women, allowing for more generalizable conclusions. Their multidimensional approach addresses an essential critique of past studies, which often isolated variables without acknowledging their intricate interdependence. By integrating eating attitudes, emotional regulation, anxiety, depression, and self-esteem into a singular explanatory model, this research moves the field closer to holistic understanding.
Delving deeper into the cognitive processes, the study offers intriguing implications for the neural and psychological mechanisms underlying orthorexia nervosa. The link between emotional regulation difficulties and obsessive dietary restrictions hints at dysfunctions in brain circuits responsible for impulse control and reward processing. Such dysfunctions have been noted in other eating pathology contexts, further underscoring the potential neuropsychological commonalities that merit further neuroscientific investigation.
Clinical implications of these findings are manifold. Mental health professionals treating women with orthorexia nervosa may undertake more targeted assessments of emotional regulation capacities alongside routine exploration of anxiety and depressive symptoms. Treatment modalities that integrate cognitive-behavioral therapy aimed at improving emotion regulation skills hold promise for addressing the root psychological vulnerabilities identified. Moreover, enhancing self-esteem through supportive interventions could serve as a protective factor against relapse.
This investigation also prompts a broader reflection on societal and cultural factors influencing orthorexia nervosa. Modern society's glorification of "clean eating," wellness culture, and pervasive diet trends may inadvertently reinforce pathological eating behaviors among vulnerable individuals. The study underscores the importance of distinguishing between health-conscious eating and orthorexia nervosa, where obsessive preoccupation disrupts social functioning and well-being. Public health messaging should consider these distinctions to avoid stigmatizing healthy practices while remaining vigilant about emerging disorders.
Furthermore, the gendered aspect of orthorexia nervosa revealed in the study aligns with historical patterns in eating disorder epidemiology, where women disproportionately experience these conditions. Social pressures related to body image, femininity, and control dynamics likely interact with the psychological predictors to increase vulnerability in women. Future research would benefit from exploring these intersections to design culturally sensitive interventions.
The research also raises questions about the progression and trajectory of orthorexia nervosa. Is this disorder a transient phase in some individuals or a chronic condition in others? The interplay of emotional regulation difficulties and mood disorders suggests that without intervention, orthorexic behaviors may become entrenched. Longitudinal studies are needed to map out these developmental pathways and identify critical points for early intervention.
In terms of prevention, educating women about healthy emotional regulation strategies and fostering resilience against anxiety and depression could mitigate orthorexia risk. Schools, workplaces, and healthcare systems might implement programs aimed at improving psychological flexibility and adaptive coping mechanisms, potentially curbing the growth of orthorexic behaviors before they manifest as clinical concerns.
The findings also have implications for diagnostic clarity. As orthorexia nervosa remains unofficial in many classification systems, the psychological predictors outlined could inform future criteria to distinguish this disorder from related conditions such as anorexia nervosa or obsessive-compulsive disorder. Recognizing the unique constellation of emotional and cognitive features could enhance diagnostic accuracy and therapeutic precision.
In sum, the work by Yöyen, Dereli, and Barış represents a significant advance in the empirical understanding of orthorexia nervosa in women. By elucidating the predictive roles of eating attitudes, emotional regulation difficulties, anxiety, depression, and self-esteem, they chart a nuanced psychological landscape that points toward integrated models of assessment and intervention. Their study not only expands scientific knowledge but also opens pathways for more compassionate and effective mental health care tailored to individuals grappling with this complex disorder.
As orthorexia nervosa continues to emerge from the shadows of mental health research, contributions like this serve as vital beacons guiding clinicians, researchers, and public health advocates. It is through such detailed inquiry into psychological predictors and mechanisms that we can better identify those at risk, refine treatment approaches, and ultimately improve outcomes for women worldwide facing the challenges of orthorexia nervosa.
Subject of Research: Psychological predictors of orthorexia nervosa in women, focusing on eating attitudes, emotional regulation difficulties, anxiety, depression, and self-esteem.
Article Title: Predictors of orthorexia nervosa in women: eating attitudes, emotional regulation difficulties, anxiety, depression and self-esteem.
Article References:
Yöyen, E., Dereli, Ş. & Barış, T.G. Predictors of orthorexia nervosa in women: eating attitudes, emotional regulation difficulties, anxiety, depression and self-esteem. BMC Psychol 13, 554 (2025). https://doi.org/10.1186/s40359-025-02904-9