Perfectionism, obsessive-compulsive symptoms, and health-thinness-cleanliness motivations as primary correlates of orthorexia nervosa.

Abstract

Purpose: Orthorexia Nervosa (ON) is characterized by an obsessive preoccupation with eating foods perceived as healthy or clean. Despite growing research interest, risk factors and underlying motivations for ON remain poorly understood. This study examined demographic factors, psychological correlates, and dietary motivations associated with ON symptomatology, building on McComb and Mills' (2019) theoretical model.

Methods: Participants (N = 697) completed validated measures of ON, alongside assessments of demographic factors (age, gender, socioeconomic status, dietary means), psychological variables (perfectionism, obsessive-compulsive symptoms, perceived control, perceived vulnerability to disease, past eating disorder diagnosis), and dietary motivations (thinness, health, cleanliness, muscularity, feeling mentally well).

Results: Three dietary motivations: desires to be thin, healthy, and clean were significantly associated with ON symptoms across both measures. Perfectionism (specifically perfectionistic striving) and obsessive-compulsive symptoms (particularly the 'washing' subscale reflecting contamination concerns) emerged as the strongest psychological predictors of ON symptomatology. Demographic variables (age, gender, socioeconomic status) were not associated with ON symptoms, although lower perceived dietary means was associated with higher ON symptomatology. Results were largely replicated using both ON scales.

Conclusion: ON appears driven by perfectionist striving and contamination-related obsessive-compulsive symptoms, alongside complex motivations that extend beyond health to also include thinness and cleanliness concerns. These findings suggest that ON represents a convergence of multiple motivational domains and highlights potential targets for intervention, including perfectionism-based and exposure-response prevention approaches adapted from obsessive-compulsive disorder and eating disorders treatments.

Level of evidence: Level V, based on a descriptive study.