Predictors of orthorexia nervosa: Health and death anxiety, obsessive-compulsive personality traits, and somatization

In this study, it was aimed to investigate the variables that predict orthorexia nervosa tendencies. The sample consisted of 401 individuals, aged between 18 and 65, residing in Turkey, whose native language is Turkish and who are literate. Data collection was conducted through Google Forms and questionnaires were distributed via social communication channels. Participants filled out the Demographic Information Form, Teruel Orthorexia Scale, Health Anxiety Scale, Death Anxiety Scale, Somatization subscale of Brief Symptom Inventory and Obsessive Compulsive Personality Traits subscale of Personality Beliefs Questionnaire-Short Form. An Independent Sample T Test was conducted to assess the effects of demographic variables on orthorexia nervosa scores. As a result of the analysis, it was determined that orthorexia nervosa tendencies significantly differ according to factors such as dieting, exercising, and following healthy eating and exercise-related web pages. Groups that diet, exercise, and follow such web pages were found to have higher orthorexia nervosa tendencies compared to other groups. Pearson Product-Moment Correlation Analysis was conducted to examine the relationships among the variables. Subsequently, Hierarchical Multiple Regression Analysis was performed to identify the variables predicting orthorexia nervosa. The results indicated that obsessive-compulsive personality traits, health anxiety, and death anxiety were positively associated with orthorexia nervosa. However, no direct relationship was found between somatization and orthorexia nervosa. The regression analysis revealed that only obsessive-compulsive personality traits and health anxiety have a predictive role in orthorexia nervosa, whereas death anxiety did not exhibit a predictive effect. These findings suggest that a part of the tendency toward orthorexia nervosa can be explained by obsessive-compulsive personality traits and health anxiety. To analyze the mediating effect of health and death anxiety in the relationship between obsessive-compulsive personality traits and orthorexia nervosa PROCESS Macro Analysis Model 4 was used. The findings revealed that health anxiety partially mediates the relationship between obsessive-compulsive personality traits and orthorexia nervosa. These findings indicated that individuals with high obsessive-compulsive personality traits also experience higher levels of health anxiety, and the increase in health anxiety may contribute tendency towards orthorexia nervosa. In other words, obsessive-compulsive personality traits explain the tendency toward orthorexia nervosa partially through the effect of the increase in health anxiety. Individuals with high obsessive-compulsive personality traits may feel the need to do things perfectly and maintain control in many areas of their lives. This need may manifest in some individuals as an attempt to control their health, which could be related to increased health anxiety. The person's efforts to be healthy may also lead to a strict regulation of their eating habits. It has been suggested that health anxiety, which emerges along with these personality traits, could increase the tendency toward orthorexia nervosa by leading to the strict regulation of even the smallest details of nutrition. In the conducted mediation analysis, it was found that death anxiety did not have any mediating effect. The findings have been discussed under the light of the relevant literature.