Abstract
Orthorexia nervosa (ON) is the excessive preoccupation with healthy eating that involves feelings of guilt for non-compliance with self-imposed dietary rules, dietary restraint, and global impairment. Most studies have looked for associations between ON and eating problems or obsessive-compulsive traits, however, there are no studies linking orthorexia nervosa with other pathologies such as addiction. The aim of this research is to evaluate the existing evidence on the relationship between ON and addiction. For this purpose, a systematic review of empirical studies is carried out, performing a search in different databases. The focus is on empirical studies published from 2013 onwards. The concepts orthorexia and addiction were addressed in Spanish and English. The systematic review was carried out following the PRISMA 2009 method. The results show an association between orthorexia nervosa and behavioral addictions. The main findings allow knowing that there is an association between predisposing and/or maintaining variables of orthorexia and addictions which are perfectionism, body dissatisfaction, emotional dyscontrol and food restriction. Knowing that orthorexia nervosa and behavioral addictions share certain clinical factors allows us to focus both on their prevention and on the development of transdiagnostic treatmentsReferences
Alcaraz, C. F., Sebastian, M. J. Q. y Quiles, Y. (2021). Atención plena y conciencia corporal en mujeres con un trastorno de la conducta alimentaria. Informació psicològica, (121), 58-70.
Argüelles Prendes, S. (2023). Relación entre el uso de Redes Sociales y la Ortorexia Nerviosa.
Azzi, R., Mhanna, M., Hallit, S., Obeid, S. y Soufia, M. (2023). Attachment styles and orthorexia nervosa among Lebanese adolescents: The indirect effect of self-esteem. Archives de Pediatrie: Organe Officiel de La Societe Francaise de Pediatrie, 30(5), 314–320. https://doi.org/10.1016/j.arcped.2023.04.
Barrada, J. R. y Roncero, M. (2018). Bidimensional Structure of the Orthorexia: Development and Initial Validation of a New Instrument. Anales de Psicología, 34(2), 283. Doi:10.6018/analesps.34.2.299671
Barthels, F. (2023). New developments in orthorexia research: use of social media, Healthy Orthorexia and testimonials from affected individuals. Ernahrungs Umschau, 70(3), 36-40. https://doi.org/10.4455/eu.2023.00
Bratman, S. (2017). Orthorexia vs. theories of healthy eating. Eating and Weight Disorders, 22(3), 381–385. https://doi.org/10.1007/ s40519-017-0417-6.
Brytek-Matera, A. (2012). Orthorexia nervosa—an eating disorder, obsessive-compulsive disorder or disturbed eating habit?. Archives Psychiatry Psychother 1(1), 55–60.
Carbonell, X. (2020). El diagnóstico de adicción a videojuegos e el DSM-5 y la CIE-11: Retos y oportunidades para clínicos. Papeles del psicólogo, 41(3), 211-218. https://doi.org/10.23923/pap.psicol2020.2935
Del Castillo, J. A. G. (2013). Adicciones tecnológicas: el auge de las redes sociales. Salud y drogas, 13(1), 5-13.
Dell'Osso, L., Cremone, I. M., Chiarantini, I., Arone, A., Casagrande, D., Massimetti, G., Carmassi, C. y Carpita, B. (2022). Investigating Orthorexia Nervosa With the ORTO-R in a Sample of University Students With or Without Subthreshold Autism Spectrum: Focus on Dietary Habits and Gender Differences. Frontiers in psychiatry, 13, 900880. https://doi.org/10.3389/fpsyt.2022.900880
Dunn, T. M. y Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating behaviors, 21, 11-17.
Fidan, T., Ertekin, V., Isikay, S. y Kirpinar, I. (2010). Prevalencia de ortorexia entre estudiantes de medicina en Erzurum. Turquía. Comprehensive Psychiatry, 51(1), 49–54. https://doi.org/10.1016/j.comppsych.2009.03.001
Flórez, J. A. R., Jiménez-Tabares, J. S., Marín-Moreno, B. S. y Chalarca-Marulanda, A. S. (2023). Comportamiento y estados de ánimo relacionados con el consumo de sustancias psicoactivas. Revista de Psicología Universidad de Antioquia, 15(1), 1-24.
Freire, G. L. M., Fidelix, Y. L., Fiorese, L., de Sousa Fortes, L., de Oliveira, D. V. Y do Nascimento Junior, J. R. A. (2023). Does Muscle Dysmorphy Predict Exercise Dependence and Orthorexia in Brazilian Exercise Practitioners?. Revista eoría gía: eoría e Prática, 25(1), ePTPPA14384-ePTPPA14384.
Grajek, M., Krupa-Kotara, K., Sas-Nowosielski, K., Misterska, E. y Kobza, J. (2022). Prevalence of Orthorexia in Groups of Students with Varied Diets and Physical Activity (Silesia, Poland). Nutrients, 14(14). https://doi.org/10.3390/nu1414281
Hafstad, S. M., Bauer, J., Harris, A. Y Pallesen, S. (2023). The prevalence of orthorexia in exercising populations: a systematic review and meta-analysis. Journal of Eating Disorders, 11(1), 1-14.
Hallit, S., Azzi, V., Malaeb, D. y Obeid, S. (2022). Any overlap between orthorexia nervosa and obsessive–compulsive disorder in Lebanese adults? Results of a cross-sectional study and validation of the 12-item and 4-item obsessive– compulsive inventory (OCI-12 and OCI-4). Boston Medical Center Psychiatry, 22(1), 1–9. https://doi.org/10.1186/s12888-022-04119-3
Hasin, D., Scmulewitz, D., Stohl, Malka., Greenstein, E., Roncone, S., Aharonovich E. y Wall Melanie. (2020). Test-retes reliability of DSM-5 substance disorder measures as assessed with the PRISM-5, a clinician-administered diagnostic interview. Drug Alcohol Dependence, 216. https://doi.org/10.1016/j.drugalcdep.2020.108294.
Horovitz, O. y Argyrides, M. (2023). Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment. Nutrients, 15(17). https://doi.org/10.3390/un15173851
Lasson, C., Rousseau, A., Vicente, S., Goutaudier, N., Romo, L., Ronero, M. y Ramón Barrada, J. (2023). Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS). Journal of Eating Disorder (11),65. https://doi.org/10.1186/s40337-023-00764-5
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P., Clarke, M., Devereaux, P. J., Kleijnen, J. y Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PloS medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100
López-Gil, J. F., Tárraga-López, P. J., Hershey, M. S., López-Bueno, R., Gutiérrez-Espinoza, H., Soler-Marín, A. y Victoria-Montesinos, D. (2023). Overall proportion of orthorexia nervosa symptoms: A systematic review and meta-analysis including 30 476 individuals from 18 countries. Journal of Global Health, 13. https://doi.org/10.7189/jogh.13.04087
López, M. C. (2014). Medicina, cultura y alimentación: la construcción del alimento indígena en el imaginario médico occidental a través de la visión del doctor Francisco Hernández. Anales de Antropología, 48(1), 59-77.
Marazzitti, D., Presta, S., Baroni, S., Silvertri, S. y Dell’Osso, L. (2014). Behavioral addictions: a novel challenge for psychopharmacology. CNS Spectr. Cambridge University Press, 19, 486-495. Doi: 10.1017/S1092852913001041.
Mauro Martín, I. S., Garicano Vilar, E., González Fernández, M., Villacorta Pérez, P., Gamarra, A. M., Miralles Rivera, B., Figueroa Borque, M., Sánchez, N. A., Bonilla Navarro, M. Á., Arranz Poza, P., Bemal Maurandi, M. D., Ruiz León, A. M., Moraleda Ponzol, E. y de la Rosa, L. de la C. (2014). Hábitos alimentarios y psicológicos en personas que realizan ejercicio físico. Nutrición Hospitalaria, 30(6), 1324–1332. https://doi.org/10.3305/nh.2014.30.6.7838
Moroze, R. M., Dunn, T. M., Holland, J. C., Yager, J. y Weintraub, P. (2015). Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near-fatal “orthorexia nervosa” and proposed diagnostic criteria. Psychosomatics, 56(4), 397-403.
Oberle C. D., Samaghabadi R. O. y Hughes E. M. (2017). Orthorexia nervosa: assessment and correlates with gender, BMI, and personality. Appetite, 108, 303–310. https://doi.org/10.1016/j. appet.2016.10.021
Oberle, C. D., Watkins, R. S. y Burkot, A. J. (2017). Orthorexic eating behaviors related to exercise addiction and internal motivations in a sample of university students. Eating and Weight Disorders Studies on Anorexia, Bulimia and Obesity, 23(1), 67–74. Doi:10.1007/s40519-017-0470-1
Parra Fernández, M. L. (2019). Riesgo de Ortorexia: adaptación y validación al español del cuestionario (ORTHO-15). [Tesis de doctorado, Universidad de castilla-la mancha]. http://hdl.handle.net/10578/20453.
Petry, N. M., Zajac, K., & Ginley, M. K. (2018). Behavioral Addictions as Mental Disorders: To Be or Not To Be?. Annual review of clinical psychology, 14, 399–423. https://doi.org/10.1146/annurev-clinpsy-032816-045120
Rodríguez, M. R., Hodann-Caudevilla, R. M., Páramo, Í. A. y Molina-Ruiz, R. M. (2023). Adicciones sin sustancia o adicciones comportamentales. Medicine-Programa de Formación Médica Continuada Acreditado, 13(85), 4998-5009.
Rudolph, S. (2018). The connection between exercise addiction and orthorexia nervosa in German fitness sports. Eating and Weight Disorders, 23(5), 581–586. https://doi.org/10.1007/s40519-017- 0437-2.
Ruiz, Á. y Quiles, Y. (2021). Prevalencia de la Ortorexia Nerviosa en estudiantes universitarios españoles: relación con la imagen corporal y con los trastornos alimentarios. Anales de psicología, 37(3), 493-499.
Ryman, F. V. M., Cesuroglu, T., Bood, Z. M. y Syurina, E. V. (2019). Orthorexia nervosa: disorder or not? Opinions of Dutch health professionals. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.00555
Starcevic. (2016). Behavioural addictions: A challenge for psychopathology and psychiatric nosology. Aust New Zeal Journal Psychiatry. SAGE publications Sage UK: London, England, 50(8), 721-725. Doi: 10.1177/0004867416654009
Strahler, J., Wachten, H. Y Mueller-Alcazar, A. (2020). Obsessive healthy eating and orthorexic eating tendencies in sport and exercise contexts: A systematic review and meta-analysis. Journal of Behavioral Addictions, 10(3), 456-470.
Strahler J., Wachten H., Stark R. y Walter, B. (2021). Alike and different: Associations between orthorexic eating behaviors and exercise addiction. Journal Eating Disorder, 54(8), 1415-1425. Doi: 10.1002/eat.23525. PMID: 33955559.
White, M., Berry, R. y Rodgers, R. F. (2020). Body image and body change behaviors associated with orthorexia symptoms in males. Body Image, 34, 46–50. Doi: 10.1016/j.bodyim.2020.05.003
Yılmazel G. (2021). Orthorexia tendency and social media addiction among candidate doctors and nurses. Perspectives in psychiatric care, 57(4), 1846–1852. https://doi.org/10.1111/ppc.12758
Zańko, A., Mielech, A., Plyton, T., Anud, S., Smarkusz-Zarzecka, J., Pietraszewska, B. y Milewski, R. (2019). How Does Orthorexia Nervosa Assessment Tools Can Differ–Comparison of Two Questionnaires: BOT and ORTO-15. Studies in Logic, Grammar and Rhetoric, 60(1), 33-48.
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