RELATIONSHIPS BETWEEN ORTHOREXIA NERVOSA TENDENCY, MINDFUL EATING, AND BODY MASS INDEX IN YOUNG ADULTS (19-32 AGED): A CROSS-SECTIONAL STUDY BASED ON GENDER DIFFERENCES

Öz

Objective: This cross-sectional study investigated the associations between Orthorexia Nervosa (ON), mindful eating, and body mass index (BMI) among young adults, and explored gender-based differences in ON tendencies and mindful eating. Method: The research was conducted between October and December 2024 in Elazığ, Türkiye, and included 757 healthy participants. Data were collected using face-to-face questionnaires assessing sociodemographic characteristics, the Orthorexia Nervosa-11 Scale (ORTO-11), and the Mindful Eating Questionnaire (MEQ). Anthropometric measurements were obtained to calculate BMI, and a p-value of <0.05 was considered statistically significant. Results: The findings revealed that 54.9% of participants exhibited a tendency toward ON. The prevalence of ON tendency was significantly higher in females (57.3%) than in males (46.9%) (p=0.019). While no significant gender differences were observed in overall MEQ scores, some sub-factors (thoughtless eating, emotional eating, eating control, conscious eating) showed statistically significant variation (p<0.05). Similarly, no differences in total ON scores were found across BMI categories. However, significant differences were identified in MEQ total scores and certain sub-factors (thoughtless eating, eating control, eating discipline and conscious eating) between BMI categories(p<0.05). No statistically significant association was found between total MEQ score and ON tendency. Nevertheless, ON tendency was negatively associated with the thoughtless eating and positively associated with the eating control, eating discipline, and conscious eating sub-factors of the MEQ. These findings suggest that while overall mindful eating may not directly predict ON tendency, particular aspects of mindful eating play a meaningful role. Conclusion: This study demonstrates that ON tendency may be observed at higher levels in young adult females compared to males. Although BMI was not found to be associated with ON risk, significant associations were identified with several subdimensions of mindful eating. These findings underscore the importance of gender-sensitive and subdimension-focused interventions in the assessment and prevention of orthorexic tendencies

Anahtar Kelimeler

• Orthorexia Nervosa
• Mindful Eating
• BMI

Destekleyen Kurum

None

Etik Beyan

14.10.2024-28030. Fırat University Non-Interventional Research Ethics Committee

Teşekkür

None

GENÇ YETİŞKİNLERDE (19-32 YAŞ) ORTOREKSİYA NERVOZA EĞİLİMİ, YEME FARKINDALIĞI VE BEDEN KÜTLE İNDEKSİ ARASINDAKİ İLİŞKİLER: CİNSİYET FARKLILIKLARINA DAYALI KESİTSEL BİR ÇALIŞMA

Öz

Amaç: Bu kesitsel çalışmada, genç yetişkinlerde Ortoreksiya Nervoza (ON), yeme farkındalığı ve beden kütle indeksi (BKİ) arasındaki ilişkiler incelendi ve ON eğilimleri ile yeme farkındalığının cinsiyete dayalı farklılıkları değerlendirildi. Yöntem: Araştırma Ekim-Aralık 2024 tarihleri arasında Türkiye'nin Elazığ ilinde yürütüldü ve 757 sağlıklı katılımcıyı kapsadı. Veriler yüz yüze uygulanan anketler aracılığıyla toplandı; sosyodemografik özellikler, Ortoreksiya Nervoza-11 Ölçeği (ORTO-11) ve Yeme Farkındalığı Ölçeği (YFÖ) değerlendirildi. Antropometrik ölçümler alınarak BKİ hesaplandı ve istatistiksel anlamlılık düzeyi p<0.05 olarak kabul edildi. Bulgular: Çalışma, katılımcıların %54.9’unun ON eğilimi gösterdiğini ortaya koydu. ON eğiliminin prevalansı kadınlarda (%57.3), erkeklere (%46.9) kıyasla istatistiksel olarak anlamlı düzeyde daha yüksek bulundu (p=0.019). Genel MEQ puanlarında cinsiyete bağlı anlamlı bir fark saptanmamış olsa da bazı alt boyutlarda (düşünmeden yeme, duygusal yeme, yeme kontrolü, farkındalık) istatistiksel olarak anlamlı farklılıklar tespit edildi (p<0.05). Benzer şekilde, BKİ kategorileri arasında toplam ON puanları açısından bir farklılık bulunmadı. Bununla birlikte, BKİ kategorileri arasında MEQ toplam puanlarında ve belirli alt boyutlarında (düşünmeden yeme, yeme kontrolü, yeme disiplini ve farkındalık) anlamlı farklılıklar belirlendi (p<0.05). Toplam MEQ puanı ile ON eğilimi arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. Bununla birlikte, ON eğilimi MEQ’in düşünmeden yeme alt boyutu ile negatif; yeme kontrolü, yeme disiplini ve farkındalık alt boyutları ile ise pozitif yönde ilişkili bulundu. Bu bulgular, genel yeme farkındalığı düzeyinin ON’u doğrudan öngörmeyebileceğini, ancak yeme farkındalığının belirli boyutlarının anlamlı bir rol oynadığını gösterdi. Sonuç: Bu çalışma, genç yetişkin kadınlarda ON eğiliminin erkeklere kıyasla daha yüksek düzeyde görülebildiğini ortaya koymaktadır. BKİ’nin ON riski ile ilişkili olmadığı görülse de yeme farkındalığının çeşitli alt boyutları ile anlamlı düzeyde ilişkili bulundu. Bu bulgular, ortoreksiya eğilimlerinin değerlendirilmesi ve önlenmesinde cinsiyete duyarlı ve alt boyut odaklı müdahalelerin önemini vurgulamaktadır.

Anahtar Kelimeler

• Ortoreksiya Nervoza
• Yeme Farkındalığı
• BKİ

Kaynakça

1. Horovitz O, Argyrides M. Orthorexia and orthorexia nervosa: a comprehensive examination of prevalence, risk factors, diagnosis, and treatment. Nutrients. 2023;15(17):3851.
2. Liu K, Gao R, Kuang H, Zhang C, Guo X. Global, regional, and national burdens of eating disorder in adolescents and young adults aged 10–24 years from 1990 to 2021: a trend analysis. J Affect Disord. 2025;388:119596.
3. Brytek-Matera A, Sacre H, Staniszewska A, Hallit S. The prevalence of orthorexia nervosa in Polish and Lebanese adults and its relationship with sociodemographic variables and BMI ranges: a cross-cultural perspective. Nutrients. 2020;12(12):3865.
4. Costa CB, Hardan-Khalil K, Gibbs K. Orthorexia nervosa: a review of the literature. Issues Ment Health Nurs. 2017;38(12):980-988.
5. Strahler J. Trait mindfulness differentiates the interest in healthy diet from orthorexia nervosa. Eat Weight Disord. 2021;26(3):993-998.
6. Im S, Stavas J, Lee J, Mir Z, Hazlett-Stevens H, Caplovitz G. Does mindfulness-based intervention improve cognitive function?: a meta-analysis of controlled studies. Clin Psychol Rev. 2021;84:101972.
7. González-Martín AM, Aibar-Almazán A, Rivas-Campo Y, Castellote-Caballero Y, Carcelén-Fraile MDC. Mindfulness to improve the mental health of university students: a systematic review and meta-analysis. Front Public Health. 2023;11:1284632.
8. Köse G, Tayfur M, Birincioğlu İ, Dönmez A. Adaptation study of the mindful eating questionnaire (meq) into turkish. J Cogn Behav Psychother Res. 2016;3(1):125-134.

9. Nelson JB. Mindful eating: the art of presence while you eat. Diabetes Spectr. 2017;30(3):171-174.
10. Buckworth J. Be here now: mindful eating and exercise. ACSM Health Fit J. 2019;23(4):38-39.
11. Vanzhula IA, Levinson CA. Mindfulness in the treatment of eating disorders: theoretical rationale and hypothesized mechanisms of action. Mindfulness. 2020;(11):1090-1104.
12. Hernando A, Pallas R, Cebolla A, García-Campayo J, Hoogendoorn CJ, Roy JF. Mindfulness, rumination, and coping skills in young women with eating disorders: a comparative study with healthy controls. PLoS One. 2019;14(3):e0213985.
13. Yücel ÜÖ. Evaluation of the relationship between eating behaviors and orthorexia nervosa in adults. J Contin Med Educ. 2014;33(6):420-426.
14. Hamurcu P. Social media addiction and usage purposes as predictors of eating behaviors, eating disorders and orthorexia nervosa: a study on young adults. J Dependence. 2023;24(2):133-145.
15. Asil E, Yılmaz M, Ayyıldız F, Yalçın T. The effect of social media use on orthorexia nervosa: a sample from turkey. Nutr Hosp. 2023;40(2).
16. Sünbül S, Bayrak E. Eating attitudes and orthorexia nervosa tendencies in a sample of turkish university students: a cross-sectional study. Prog Nutr. 2021;23(4):1-9.
17. Shensa A, Escobar-Viera CG, Sidani JE, Bowman ND, Marshal MP, Primack BA. Problematic social media use and depressive symptoms among US young adults: A nationally-representative study. Soc Sci Med. 2017;182:150-157.
18. Miley M, Egan H, Wallis D, Mantzios M. Orthorexia nervosa, mindful eating, and perfectionism: an exploratory investigation. Eat Weight Disord. 2022;27(7):2869-2878.
19. World Health Organization. Obesity: preventing and managing the global epidemic. WHO Technical Report Series 894. Geneva: WHO; 2000.
20. Donini LM, Marsili D, Graziani MP, et al. Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord. 2004;9:151-157.
21. Arusoğlu G, Kabakçı E, Köksal G, Merdol TK. orthorexia nervosa and adaptaɵ on of orto-11 into Turkish. Turk J Psychiatry. 2008;19(3):283-291.
22. Framson C, Kristal AR, Schenk JM, Littman AJ, Zeliadt S, Benitez D. Development and validation of the mindful eating questionnaire. J Am Diet Assoc. 2009;109(8):1439-1444.
23. Lumley T, Diehr P, Emerson S, Chen L. The importance of the normality assumption in large public health data sets. Annu Rev Public Health. 2002;23:151-169.
24. Staśkiewicz-Bartecka W, Masłoń K, Kołodziejczyk A, et al. Nutritional knowledge, insulin resistance, and the risk of orthorexia nervosa: a comparative cross-sectional study among polish women. Front Public Health. 2025;(13):1562866.
25. Yeşil E, Turhan B, Tatan D, Şarahman C, Saka M. The effect of gender to orthorexıa nervosa tendency ın adults. J Ankara Health Sci. 2018;7(1):1-9.
26. Uzdil Z, Kayacan AG, Özyıldırım C, et al. Investigation of orthorexia nervosa presence and eating attitude in adolescents. J Samsun Health Sci. 2019;4(1):8-13.
27. Pehlivan E, Mete B, Fırıncı B, Doğan E. Prevalence of orthorexıa nervosa and ıts relatıons with health lıteracy in unıversıty students. ESTUDAM Public Health J. 2019;4(2):166-175.
28. Köse G, Tayfur M. BMI, physical activity, sleep quality, eating attitudes, emotions: which one is affected by mindful eating? Prog Nutr. 2021;23(1).
29. Karaca V, Rakıcıoğlu N. The relationship between mindful eating and portion amounts of daily foods consumed in adults. J Nutr Diet. 2024;52(2):37-47.
30. Aras HK, Delen İ. Evaluation of dietary habits and mindful eating status of university students. CBU-SBED. 2023;10(3):265-274.
31. Athanasaki D, Lakoumentas J, Milani GP, et al. Maternal bonding as a protective factor for orthorexia nervosa risk in dietetics students. Nutrients. 2023;15(16):3577.
32. Anderson LM, Reilly EE, Schaumberg K, Dmochowski S, Anderson DA. Contributions of mindful eating, intuitive eating, and restraint to BMI, disordered eating, and meal consumption in college students. Eat Weight Disord. 2016;21(1):83-90.
33. Demirer B, Yardımcı H. Is mindful eating higher in individuals with orthorexia nervosa? A cross-sectional study. J Public Health. 2024;32(3):455-460.
34. Bayram HM. The role of mindful eating, and intuitive eating on the relationship with orthorexia nervosa in university students: a cross-sectional study. Rev Nutr. 2024;37:e230219.
35. Köse G, Çıplak M. Does mindful eating have a relationship with gender, body mass index and health promoting lifestyle? Prog Nutr. 2020;22(2):1-8.
36. Urhan M, Cengisiz C, Türk M, Akanalçı C. Can mindful eating be a psycho-marker of obesity in bipolar disorder? Nutr Hosp. 2024;41(5):1082-1090.
37. Alberts HJEM, Mulkens S, Smeets M, Thewissen R. Coping with food cravings: investigating the potential of a mindfulness-based intervention. Appetite. 2010;55(1):160-163.
38. Christodoulou E, Markopoulou V, Koutelidakis AE. Exploring the link between mindful eating, instagram engagement, and eating disorders: a focus on orthorexia nervosa. Psychiatry Int. 2024;5(1):27-38.
39. 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.