What are the key features of Orthorexia Nervosa and influences on its development? A qualitative investigation?

Cheshire, A., Berry, M. and Fixsen, Alison 2020. What are the key features of Orthorexia Nervosa and influences on its development? A qualitative investigation? Appetite. 155 104798. https://doi.org/10.1016/j.appet.2020.104798

TitleWhat are the key features of Orthorexia Nervosa and influences on its development? A qualitative investigation?
TypeJournal article
AuthorsCheshire, A., Berry, M. and Fixsen, Alison
Abstract

Orthorexia nervosa (ON) – a pathological obsession with healthy eating - is an emerging eating disorder. The precise nature of ON and its causes remain unclear, yet few published research studies speak directly to those with ON tendencies or professionals working with them. Our study redresses this gap in the literature by uncovering the defining ON features and the factors influencing its development. The exploratory qualitative research design included semi-structured interviews with those self-identifying as orthorexic or obsessively preoccupied with healthy eating (n=9); professionals working with ON and eating disorders - psychologists, dieticians and a family therapist (n=7). Data were analysed thematically. ON emerged as multifactorial, with a variety of interrelated influences needing to coalesce for ‘healthy eating’ to become pathological. Key features included rigidity and control (around food choices, routines and preparation) and moral judgements around food, along with a range of negative psychosocial and physical impacts. Influences on the development of ON were organised according to their occurrence at the individual (micro) level, external/relational (meso) level and societal (macro) level. Influences on the individual included health concerns, belief in food as medicine, past trauma, personality (e.g. obsessive, perfectionist), exposure to extreme views and behaviours while growing up and moral concerns. External influences included parents, partners and relational groups (e.g. fitness or clean eating groups). Societal influences included aestheticism, moral citizenship and social media. We conclude that ON is more than an individual pathology, it is symptomatic of our ‘orthorexic society’: where hyper-reflexivity around food choices, conflicting information what is the correct diet, preoccupation with appearance, and emphasis on individual (not collective) responsibility for health combine with individual susceptibilities and ecological/moral concerns, to predispose toward pathological ‘healthy’ eating.

Keywordsorthorexia nervosa
qualitative
healthy-eating
society
Article number104798
JournalAppetite
Journal citation155
ISSN0195-6663
Year2020
PublisherElsevier
Accepted author manuscript
License
CC BY-NC-ND 4.0
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1016/j.appet.2020.104798
PubMed ID32717291
Publication dates
Published online24 Jul 2020
Published01 Dec 2020

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