What is more likely in orthorexia nervosa: perfectionism or OC symptoms? A bayesian method in clinical and non-clinical samples

TL;DR

This study explores whether perfectionism or obsessive-compulsive symptoms are more linked to orthorexia nervosa in clinical and non-clinical groups.

Contribution

The study introduces Bayesian models to assess how perfectionism and OCD symptoms predict orthorexia nervosa dimensions in different at-risk populations.

Findings

Orthorexia-related problems were most prevalent in patients with eating disorders, affecting nearly 50%.

Perfectionism was identified as a risk factor for orthorexia in all three groups studied.

Patients and dieters showed similar patterns in orthorexia knowledge but different interactions in feelings.

Abstract

Orthorexia Nervosa (ON) exhibits specific features that may overlap with Obsessive-Compulsive Disorder (OCD), Perfectionism Striving (PS), and Perfectionism Concern (PC). While previous literature has shown predictiveness in different characteristics of ON, this study aimed to determine if PS, PC and OCD symptoms could predict ON dimensions in at-risk populations using Bayesian models.

The study enrolled 622 individuals from three different at-risk populations: people who were following treatment for an Eating Disorder (Patients), people who were following a diet (Dieters) and University students with a degree in medicine or nursing (Students).

Using Bayesian probabilistic methods and considering group factors, the model was enhanced highlighting that ON characterised Patients, Dieters, and Students. The predictiveness of OC features, PS, and PC in different ON characteristics was confirmed in each group, and different patterns were observed in the three groups. Regarding problems related to ON, predictors were higher in Patients, followed by Dieters and Students. Posterior Predictive Distribution (PPD) showed that almost 50% of Patients incur ON-related problems. In ON knowledge, Patients and Dieters are very similar. When feelings related to ON were considered, Patients and Dieters showed different interactions.

Clinicians should consider that one in two patients suffering from EDs might develop ON-related problems. People on a diet could show similar patterns of symptoms to patients in ON knowledge and feelings. Finally, our results confirm that perfectionism represents a risk factor for ON in each group considered.

The online version contains supplementary material available at 10.1186/s40359-025-02517-2.

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