Prevalence of Orthorexia nervosa among college students based on Bratman's test and associated tendencies.

Disordered eating is prevalent among college student populations, and Orthorexia nervosa (ON) is being explored as a new type of eating disorder. There is currently no standardized ON diagnostic tool, and the majority of ON research has been conducted among European populations. The present study explored the Bratman Orthorexia Test (BOT) for ON diagnosis, and its relationship to validated tools for assessing disordered eating, body dysmorphic, and obsessive-compulsive tendencies among college students attending a western university. A convenience sample of 448 college students with a mean age of 22 years was recruited to complete an online survey that included the BOT, Eating Attitudes Test-26 (EAT-26), Body Dysmorphic Disorder Questionnaire (BDDQ), Obsessive Compulsive Inventory, Revised (OCI-R) and demographics. Spearman correlation, Mann-Whitney U, Kruskal-Wallis, chi-square, and multiple linear regressions were used for analyses. The average BOT score was 4.71, near the "health fanatic" range, with Hispanic/Latino subjects and overweight/obese students having significantly higher median BOT scores. Gender, age, and college major were not significantly associated with BOT score. Significant positive correlations were observed between total BOT and EAT-26 scores (r = .47, p < 0.01), BOT and BDDQ scores (r = .25, p < 0.01), and BOT and OCI-R scores (r = .19, p < 0.01). ON tendencies may exist among college students and Hispanic/Latino and overweight/obese students may be at increased risk. Further research is needed to determine ON risk factors among diverse student populations in order to inform prevention and treatment approaches on college campuses.

Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review.

OBJECTIVE: To determine the overall effect of non-diet, weight-neutral interventions on factors such as weight, biochemical measures, food and activity behavior, body image, and mental health. DESIGN: Systematic review of intervention literature. SETTING: Group classes in community and worksite settings (14 studies), and individual counseling (1) and online education (1) in college settings. PARTICIPANTS: Eighteen research articles (representing 16 studies) evaluating non-diet interventions using quasi-experimental and randomized study designs with either a comparison or control group. MAIN OUTCOME MEASURES: Anthropometric, physiological, psychological, and dietary intake. ANALYSIS: Systematic search of 168 articles and review of 18 articles meeting inclusionary criteria. RESULTS: Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes. CONCLUSIONS AND IMPLICATIONS: Because of the long-term ineffectiveness of weight-focused interventions, the psychological improvements seen in weight-neutral, non-diet interventions warrant further investigation.