Orthorexia nervosa in patients diagnosed with obsessive compulsive disorder

Objective: The term orthorexia nervosa is used to describe the pathological fixation associated with consuming healthy food. It is assumed that orthorexia nervosa shares some phenomenological features with anorexia nervosa, obsessive-compulsive disorder, obsessive-compulsive personality disorder, physical symptoms disorder, illness anxiety disorder, and other mental disorders such as psychotic disorders. In this study, we aimed to investigate the relationship of orthorexia nervosa with obsessive-compulsive symptoms, eating attitudes, and several sociodemographic features. Method: This study was conducted in The Obsessive-Compulsive Disorder Unit of the psychiatric outpatient clinic of Çukurova University Faculty of Medicine and consisted of 3 sample groups: 63 patients with OCD, 63 healthy controls who performed physical exercises at least three days a week, and 63 healthy controls who did not perform physical exercises. Sociodemographic data form, the Yale-Brown Obsessive Compulsive Scale, the ORTO-11 scale, the Eating Attitudes Test, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and DSM-5 structured clinical interview for Disorders-Clinical Version were administered to all participants. Besides, the Obsessive-Compulsive Disorder data form was applied to patients with OCD. Results: We found a statistically significant relationship between current order-symmetry obsessions and orthorexic tendencies in patients with obsessive-compulsive disorder (p<0.05). However, there was no significant relationship between other obsessive-compulsive symptoms and orthorexia nervosa (p>0.05). There was no relationship between the severity of the disorder and orthorexia nervosa in patients with obsessive-compulsive disorder (p>0.05). Orthorexic tendencies were found to increase as impaired eating attitudes increased in participants who performed physical exercises regularly and patients with obsessive-compulsive disorder (p<0.05, p<0.001, respectively). The orthorexic tendencies of participants who performed physical exercises regularly were higher than those of patients diagnosed with obsessive-compulsive disorder and healthy individuals who did not perform physical exercises. Patients with obsessive-compulsive disorder and healthy individuals who did not perform physical exercises were similar in terms of orthorexic tendencies. Conclusion: In our study, there was no significant relationship between the severity of OCD and orthorexia nervosa. Orthorexic tendencies were also found to increase as impaired eating attitude increased in patients with OCD and individuals who performed physical exercises regularly. Our findings suggest that orthorexia nervosa may be closer to the group of eating disorders than to obsessive-compulsive disorder. In order to determine the group of orthorexia nervosa belongs in classification systems, studies with larger samples and different diagnoses are needed. Keywords: Orthorexia Nervosa, Obsessive Compulsive Disorder, Eating Attitude