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A structural modeling approach to determine the effects of orthorexia nervosa and social appearance anxiety on healthy lifestyle behaviors in young adults

Year 2024, Volume: 7 Issue: 5, 529 - 537, 27.09.2024

Fatma Elif Eroğlu , Nevin Şanlıer

https://doi.org/10.32322/jhsm.1502373

Abstract

Aims: The aim of this study is to examine the relationship between orthorexia nervosa (ON) and social appearance anxiety (SAA) and to investigate the effects of these variables on healthy lifestyle behaviors (HLB) in young adults aged 18-30 years.
Methods: A total of 408 young adult male and female volunteers, with a mean age of 21.7±2.95 years, participated in this study. A structural model was proposed to examine the effects of SAA and ON on HLB. To assess how well the study variables represented the underlying components, we first evaluated a confirmatory measurement model. Subsequently, we analyzed a structural model that allowed for the examination of multiple regression equations involving several dependent variables.
Results: SAA had a negative influence on HLB (std β=-0.673; t-value=-8.425), a significant negative relationship between ON, HLB was also promoted (std β=-0.554; t-value=-9.388). It was determined that there is a positive correlation between SAA, ON which is statistically significant (correlation coefficient=0.830; t-value=10.244).
Conclusion: It is concluded that the individuals with high social appearance anxiety do not adopt healthy lifestyle behaviors and are more prone to orthorexia nervosa.

Keywords

Healthy lifestyle behaviors social appearance anxiety orthorexia nervosa structural equation modeling

References

  • Donini LM, Barrada JR, Barthels F, et al. A Consensus document on definition and diagnostic criteria for orthorexia nervosa. Eat Weight Disord. 2022;27(8):3695-3711.
  • Pontillo M, Zanna V, Demaria F, et al. Orthorexia nervosa, eating disorders, and obsessive-compulsive disorder: a selective review of the last seven years. J Clin Med. 2022;11(20):6134.
  • Tóth-Király I, Gajdos P, Román N, Vass N, Rigó A. The associations between orthorexia nervosa and the sociocultural attitudes: the mediating role of basic psychological needs and health anxiety. Eat Weight Disord. 2021;26(1):125-134.
  • Valente M, Brenner R, Cesuroglu T, Bunders-Aelen J, Syurina EV. “And it snowballed from there”: the development of orthorexia nervosa from the perspective of people who self-diagnose. Appetite. 2020;155:104840.
  • Waasdorp TE, Mehari K, Bradshaw CP. Obese and overweight youth: risk for experiencing bullying victimization and internalizing symptoms. Am J Orthopsychiatry. 2018;88(4):483-491.
  • Messer M, Liu C, Linardon J. Orthorexia nervosa symptoms prospectively predict symptoms of eating disorders and depression. Eat Behav. 2023;49:101734.
  • Aparicio-Martinez P, Perea-Moreno, AJ, Martinez-Jimenez MP, Redel-Macías MD, Pagliari C, Vaquero-Abellan M. Social media, thin-ideal, body dissatisfaction and disordered eating attitudes: an exploratory analysis. Int J Environ Res Public Health. 2019;16(21):4177.
  • Prnjak K, Hay P, Mond J, et al. The distinct role of body image aspects in predicting eating disorder onset in adolescents after one year. J Abnorm Psychol. 2021;130(3):236-247.
  • Sander J, Moessner M, Bauer S. Depression, anxiety and eating disorder-related impairment: moderators in female adolescents and young adults. Int J Environ Res Public Health. 2021;18(5): 2779.
  • Yurtdaş-Depboylu G, Kaner G, Özçakal S. The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents. Eat Weight Disord. 2022;27(8):3725-3735.
  • Tadena S, Kang SR, Kim SJ. The influence of social media affinity on eating attitudes and body dissatisfaction in Philippine adolescents. Child Health Nurs Res. 2020;26(1):121-129.
  • Robinson E, Haynes A, Sutin A, Daly M. Self‐perception of overweight and obesity: a review of mental and physical health outcomes. Obes Sci Pract. 2020;6(5):552-561.
  • Oberle CD, Samaghabadi RO, Hughes EM. Orthorexia nervosa: assessment and correlates with gender, BMI, and personality. Appetite. 2017;108:303-310.
  • Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat. 2015;11:385-394.
  • Tremelling K, Sandon L, Vega GL, McAdams CJ. Orthorexia nervosa and eating disorder symptoms in registered dietitian nutritionists in the United States. J Acad Nutr Diet. 2017;117(10): 1612-1617.
  • Bratman S, Knight D. Health food junkies: The rise of orthorexia nervosa-the health food eating disorder. Broadway: 2000.
  • Yakın E, Raynal P, Chabrol H. Distinguishing between healthy and pathological orthorexia: a cluster analytic study. Eat Weight Disord. 2022;27(1):325-334.
  • Varga M, Dukay-Szabó S, Túry F, van Furth Eric F. Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord. 2013;18(2):103-111.
  • Hart TA, Flora DB, Palyo SA, Fresco DM, Holle C, Heimberg RG. Development and examination of the social appearance anxiety scale. Assessment. 2008;15(1):48-59.
  • Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res. 1987;36(2):76-81.
  • Walker SN, Sechrist KR, Pender NJ. Health promotion model-instruments to measure health promoting lifestyle: health-promoting lifestyle profile [HPLP II] (Adult version). 1995.
  • Eguchi E, Iso H, Tanabe N, Yatsuya H, Tamakoshi A, Japan Collaborative Cohort Study Group. Is the association between healthy lifestyle behaviors and cardiovascular mortality modified by overweight status? The Japan collaborative cohort study. Prev Med. 2014;62:142-147.
  • World Health Organization. Measuring Obesity-classification and Description of Anthropometric Data: Report on a WHO Consultation on the Epidemiology of Obesity Warsaw, 21-23, October 1987. WHO Copenhagen: 1989.
  • Gibson RS. Principles of Nutritional Assessment. Oxford University Press: 2005.
  • Schumacker RE, Lomax RG. A Beginner’s Guide to Structural Equation Modeling. Psychology Press: 2004.
  • Stevens J. Applied Multivariate Statistics for the Social Sciences (Vol. 4). Lawrence Erlbaum Associates: 2002.
  • Raykov T, Marcoulides GA. A First Course in Structural Equation Modeling. Routledge: 2012.
  • Anderson JC, Gerbing DW. Structural equation modeling in practice: a review and recommended two-step approach. Bullet Psych. 1988;103(3):411.
  • Byrne B. M. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. Taylor & Francis: 2010.
  • Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol Methods Res, 1992;21(2):230-258.
  • Fornell, C, Larcker D. Evaluating structural equation modeling with unobserved variables and measurement error, J Mark Res. 1981;18(1):39-50.
  • Hair JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis with Readings (Vol. 6). Pearson Prentice Hall: 2006.
  • Hair JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis (Fifth Edition ed.). Englewood Cliffs: Printice-Hall Inc: 1998.
  • Chau PY, Lai VS. An empirical investigation of the determinants of user acceptance of internet banking. J Org Comp Elect Com. 2003;13(2):123-145.
  • Levinson CA, Rodebaugh TL. Clarifying the prospective relationships between social anxiety and eating disorder symptoms and underlying vulnerabilities. Appetite. 2016;107:38-46.
  • Nerini A, Matera C, Stefanile C. Siblings’ appearance-related commentary, body dissatisfaction, and risky eating behaviors in young women. Eur Rev Appl Psychol. 2016;66(6):269-276.
  • Brosof LC, Levinson CA. Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: a six month three wave longitudinal study. Appetite. 2017;108:335-342.
  • Bergunde L, Dritschel B. The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism. PLoS One. 2020;15(1):e0227564.
  • Rica R, Solar M, Moreno-Encinas A, Foguet S, Compte EJ, Sepúlveda AR. Physical appearance perfectionism: psychometric properties and factor structure of an assessment instrument in a representative sample of males. Front Psychol. 2022;13:806460.
  • Beadle ES, Cain A, Akhtar S, Lennox J, McGuire L, Troop NA. Development and validation of the body compassion questionnaire. Health Psychol Behav Med. 2021;9(1):951-988.
  • Simon PD, Cu SMO, De Jesus KEM, Go NTS, Lim KTF, Say CLC. Worried about being imperfect? The mediating effect of physical appearance perfectionism between Instagram addiction and body esteem. Pers Individ Dif. 2022;186:111346.
  • Altman JK, Linfield K, Salmon PG, Beacham AO. The body compassion scale: development and initial validation. J Health Psychol. 2020;25(4):439-444.
  • Mills JS, Musto S, Williams L, Tiggemann M. “Selfie” harm: Effects on mood and body image in young women. Body Image. 2018;27:86-92.
  • McComb SE, Mills JS. The effect of physical appearance perfectionism and social comparison to thin-, slim-thick-, and fit-ideal Instagram imagery on young women’s body image. Body Image. 2022;40:165-175.
  • Brytek-Matera A, Krupa M, Poggiogalle E, Donini LM. Adaptation of the ORTHO-15 test to Polish women and men. Eat Weight Disord. 2014;19(1):69-76.
  • Segura-García C, Papaianni MC, Caglioti F, et al. Orthorexia nervosa: a frequent eating disordered behavior in athletes. Eat Weight Disord. 2012;17:e226-e233.
  • Roncero M, Barrada JR, García-Soriano G, Guillén V. Personality profile in orthorexia nervosa and healthy orthorexia. Front Psychol. 2021;12:710604.
  • Cena H, Barthels F, Cuzzolaro M, et al. Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord. 2019;24(2):209-246.
  • Bratman S. Orthorexia vs. theories of healthy eating. Eat Weight Disord. 2017;22(3):381-385.
  • Horovitz O, Argyrides M. Orthorexia and orthorexia nervosa: a comprehensive examination of prevalence, risk factors, diagnosis, and treatment. Nutrients. 2023;15(17):3851.
  • Bundros J, Clifford D, Silliman K, Morris MN. Prevalence of orthorexia nervosa among college students based on Bratman’s test and associated tendencies. Appetite. 2016;101:86-94.
  • Dolapoglu N, Ozcan D, Tulaci RG. Is orthorexia nervosa a non-specific eating disorder or a disease in the spectrum of obsessive-compulsive disorder?. Cureus. 2023;15(5):e38451.
  • Barthels F, Meyer F, Pietrowsky R. Orthorexic eating behavior. A new type of disordered eating. Ernahrungs Umschau. 2015; 62(10):156-161.
  • Barnes MA, Caltabiano ML. The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eat Weight Disord. 2017;22:177-184.

Year 2024, Volume: 7 Issue: 5, 529 - 537, 27.09.2024

Fatma Elif Eroğlu , Nevin Şanlıer

https://doi.org/10.32322/jhsm.1502373

Abstract

References

  • Donini LM, Barrada JR, Barthels F, et al. A Consensus document on definition and diagnostic criteria for orthorexia nervosa. Eat Weight Disord. 2022;27(8):3695-3711.
  • Pontillo M, Zanna V, Demaria F, et al. Orthorexia nervosa, eating disorders, and obsessive-compulsive disorder: a selective review of the last seven years. J Clin Med. 2022;11(20):6134.
  • Tóth-Király I, Gajdos P, Román N, Vass N, Rigó A. The associations between orthorexia nervosa and the sociocultural attitudes: the mediating role of basic psychological needs and health anxiety. Eat Weight Disord. 2021;26(1):125-134.
  • Valente M, Brenner R, Cesuroglu T, Bunders-Aelen J, Syurina EV. “And it snowballed from there”: the development of orthorexia nervosa from the perspective of people who self-diagnose. Appetite. 2020;155:104840.
  • Waasdorp TE, Mehari K, Bradshaw CP. Obese and overweight youth: risk for experiencing bullying victimization and internalizing symptoms. Am J Orthopsychiatry. 2018;88(4):483-491.
  • Messer M, Liu C, Linardon J. Orthorexia nervosa symptoms prospectively predict symptoms of eating disorders and depression. Eat Behav. 2023;49:101734.
  • Aparicio-Martinez P, Perea-Moreno, AJ, Martinez-Jimenez MP, Redel-Macías MD, Pagliari C, Vaquero-Abellan M. Social media, thin-ideal, body dissatisfaction and disordered eating attitudes: an exploratory analysis. Int J Environ Res Public Health. 2019;16(21):4177.
  • Prnjak K, Hay P, Mond J, et al. The distinct role of body image aspects in predicting eating disorder onset in adolescents after one year. J Abnorm Psychol. 2021;130(3):236-247.
  • Sander J, Moessner M, Bauer S. Depression, anxiety and eating disorder-related impairment: moderators in female adolescents and young adults. Int J Environ Res Public Health. 2021;18(5): 2779.
  • Yurtdaş-Depboylu G, Kaner G, Özçakal S. The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents. Eat Weight Disord. 2022;27(8):3725-3735.
  • Tadena S, Kang SR, Kim SJ. The influence of social media affinity on eating attitudes and body dissatisfaction in Philippine adolescents. Child Health Nurs Res. 2020;26(1):121-129.
  • Robinson E, Haynes A, Sutin A, Daly M. Self‐perception of overweight and obesity: a review of mental and physical health outcomes. Obes Sci Pract. 2020;6(5):552-561.
  • Oberle CD, Samaghabadi RO, Hughes EM. Orthorexia nervosa: assessment and correlates with gender, BMI, and personality. Appetite. 2017;108:303-310.
  • Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat. 2015;11:385-394.
  • Tremelling K, Sandon L, Vega GL, McAdams CJ. Orthorexia nervosa and eating disorder symptoms in registered dietitian nutritionists in the United States. J Acad Nutr Diet. 2017;117(10): 1612-1617.
  • Bratman S, Knight D. Health food junkies: The rise of orthorexia nervosa-the health food eating disorder. Broadway: 2000.
  • Yakın E, Raynal P, Chabrol H. Distinguishing between healthy and pathological orthorexia: a cluster analytic study. Eat Weight Disord. 2022;27(1):325-334.
  • Varga M, Dukay-Szabó S, Túry F, van Furth Eric F. Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord. 2013;18(2):103-111.
  • Hart TA, Flora DB, Palyo SA, Fresco DM, Holle C, Heimberg RG. Development and examination of the social appearance anxiety scale. Assessment. 2008;15(1):48-59.
  • Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res. 1987;36(2):76-81.
  • Walker SN, Sechrist KR, Pender NJ. Health promotion model-instruments to measure health promoting lifestyle: health-promoting lifestyle profile [HPLP II] (Adult version). 1995.
  • Eguchi E, Iso H, Tanabe N, Yatsuya H, Tamakoshi A, Japan Collaborative Cohort Study Group. Is the association between healthy lifestyle behaviors and cardiovascular mortality modified by overweight status? The Japan collaborative cohort study. Prev Med. 2014;62:142-147.
  • World Health Organization. Measuring Obesity-classification and Description of Anthropometric Data: Report on a WHO Consultation on the Epidemiology of Obesity Warsaw, 21-23, October 1987. WHO Copenhagen: 1989.
  • Gibson RS. Principles of Nutritional Assessment. Oxford University Press: 2005.
  • Schumacker RE, Lomax RG. A Beginner’s Guide to Structural Equation Modeling. Psychology Press: 2004.
  • Stevens J. Applied Multivariate Statistics for the Social Sciences (Vol. 4). Lawrence Erlbaum Associates: 2002.
  • Raykov T, Marcoulides GA. A First Course in Structural Equation Modeling. Routledge: 2012.
  • Anderson JC, Gerbing DW. Structural equation modeling in practice: a review and recommended two-step approach. Bullet Psych. 1988;103(3):411.
  • Byrne B. M. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. Taylor & Francis: 2010.
  • Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol Methods Res, 1992;21(2):230-258.
  • Fornell, C, Larcker D. Evaluating structural equation modeling with unobserved variables and measurement error, J Mark Res. 1981;18(1):39-50.
  • Hair JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis with Readings (Vol. 6). Pearson Prentice Hall: 2006.
  • Hair JF, Anderson RE, Tatham RL, Black WC. Multivariate Data Analysis (Fifth Edition ed.). Englewood Cliffs: Printice-Hall Inc: 1998.
  • Chau PY, Lai VS. An empirical investigation of the determinants of user acceptance of internet banking. J Org Comp Elect Com. 2003;13(2):123-145.
  • Levinson CA, Rodebaugh TL. Clarifying the prospective relationships between social anxiety and eating disorder symptoms and underlying vulnerabilities. Appetite. 2016;107:38-46.
  • Nerini A, Matera C, Stefanile C. Siblings’ appearance-related commentary, body dissatisfaction, and risky eating behaviors in young women. Eur Rev Appl Psychol. 2016;66(6):269-276.
  • Brosof LC, Levinson CA. Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: a six month three wave longitudinal study. Appetite. 2017;108:335-342.
  • Bergunde L, Dritschel B. The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism. PLoS One. 2020;15(1):e0227564.
  • Rica R, Solar M, Moreno-Encinas A, Foguet S, Compte EJ, Sepúlveda AR. Physical appearance perfectionism: psychometric properties and factor structure of an assessment instrument in a representative sample of males. Front Psychol. 2022;13:806460.
  • Beadle ES, Cain A, Akhtar S, Lennox J, McGuire L, Troop NA. Development and validation of the body compassion questionnaire. Health Psychol Behav Med. 2021;9(1):951-988.
  • Simon PD, Cu SMO, De Jesus KEM, Go NTS, Lim KTF, Say CLC. Worried about being imperfect? The mediating effect of physical appearance perfectionism between Instagram addiction and body esteem. Pers Individ Dif. 2022;186:111346.
  • Altman JK, Linfield K, Salmon PG, Beacham AO. The body compassion scale: development and initial validation. J Health Psychol. 2020;25(4):439-444.
  • Mills JS, Musto S, Williams L, Tiggemann M. “Selfie” harm: Effects on mood and body image in young women. Body Image. 2018;27:86-92.
  • McComb SE, Mills JS. The effect of physical appearance perfectionism and social comparison to thin-, slim-thick-, and fit-ideal Instagram imagery on young women’s body image. Body Image. 2022;40:165-175.
  • Brytek-Matera A, Krupa M, Poggiogalle E, Donini LM. Adaptation of the ORTHO-15 test to Polish women and men. Eat Weight Disord. 2014;19(1):69-76.
  • Segura-García C, Papaianni MC, Caglioti F, et al. Orthorexia nervosa: a frequent eating disordered behavior in athletes. Eat Weight Disord. 2012;17:e226-e233.
  • Roncero M, Barrada JR, García-Soriano G, Guillén V. Personality profile in orthorexia nervosa and healthy orthorexia. Front Psychol. 2021;12:710604.
  • Cena H, Barthels F, Cuzzolaro M, et al. Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord. 2019;24(2):209-246.
  • Bratman S. Orthorexia vs. theories of healthy eating. Eat Weight Disord. 2017;22(3):381-385.
  • Horovitz O, Argyrides M. Orthorexia and orthorexia nervosa: a comprehensive examination of prevalence, risk factors, diagnosis, and treatment. Nutrients. 2023;15(17):3851.
  • Bundros J, Clifford D, Silliman K, Morris MN. Prevalence of orthorexia nervosa among college students based on Bratman’s test and associated tendencies. Appetite. 2016;101:86-94.
  • Dolapoglu N, Ozcan D, Tulaci RG. Is orthorexia nervosa a non-specific eating disorder or a disease in the spectrum of obsessive-compulsive disorder?. Cureus. 2023;15(5):e38451.
  • Barthels F, Meyer F, Pietrowsky R. Orthorexic eating behavior. A new type of disordered eating. Ernahrungs Umschau. 2015; 62(10):156-161.
  • Barnes MA, Caltabiano ML. The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eat Weight Disord. 2017;22:177-184.
There are 54 citations in total.

Details

Primary Language English
Subjects Public Health Nutrition
Journal Section Original Article
Authors

Fatma Elif Eroğlu 0000-0003-0394-4640

Nevin Şanlıer 0000-0001-5937-0485

Publication Date September 27, 2024
Submission Date July 6, 2024
Acceptance Date August 25, 2024
Published in Issue Year 2024 Volume: 7 Issue: 5

Cite

AMA Eroğlu FE, Şanlıer N. A structural modeling approach to determine the effects of orthorexia nervosa and social appearance anxiety on healthy lifestyle behaviors in young adults. J Health Sci Med / JHSM. September 2024;7(5):529-537. doi:10.32322/jhsm.1502373
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