Higher orthorexia tendency among female fashion models: an empirical international study.

PURPOSE: Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on assessing whether female models are more prone to report orthorexia nervosa signs and symptoms than non-models. METHODS: Female fashion models (n = 179, mean age: 25.9 SD = 4.40 years) and an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years) were selected by snowball sampling. Participants filled out an online survey containing anthropometric questions and the 18-item Eating Habits Questionnaire. RESULTS: According to BMI, fashion models were underweight (mean BMI = 18.1 SD = 1.68) while control participants' BMI was in the normal range (mean = 22.1 SD = 4.23, p < 0.001). On all three of Eating Habits Questionnaire subscales fashion models showed significantly higher average value (Knowledge subscale: M = 2.42 among models versus M = 2.08 in the control group, p < 0.01, Cohen's d = 0.52; Problems subscale: M = 1.93 among models versus M = 2.61 in the control group, p < 0.01, Cohen's d = 0.49; Feelings subscale: M = 3.20 among models versus M = 2.96 in the control group, p < 0.01, Cohen's d = 0.38). Orthorexic tendencies were reported by 35.1% of the models versus 20.2% of controls. CONCLUSION: Fashion models are at risk for the development of eating disorders. Even though not yet included in the DSM-5, the assessment of orthorexia nervosa among fashion models seems to be important. It is suggested to take appropriate measures to prevent the spread of disordered eating habits among models as they can lead to the development of anorexia nervosa or bulimia nervosa. LEVEL OF EVIDENCE: Level III, well-designed cohort study.

Frequency of disordered eating habits among fashion models.

OBJECTIVE: Sociocultural influences, including an increasing pressure for fashion models to maintain a thin body frame may be crucial in the development of eating disorders. The present study aimed to establish whether fashion models are more likely than non-models to develop eating disorders. METHODS: Female fashion models were selected by snowball sampling (n = 179, mean age: 25.9 SD = 4.70 years). They were compared with an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years). Participants completed an online questionnaire containing the Eating Disorder Inventory. RESULTS: The average BMI of the fashion models was in the underweight range (mean BMI = 18.1 SD = 1.68). The BMI of the control group was significantly higher (mean = 22.1 SD = 4.23, p < 0.001). The frequency of simulated anorexia nervosa was 3.9% among the fashion models and 1.1% in the control group (p = 0.057). 14.6% of the models showed subclinical anorexia nervosa symptoms versus 2.7% in the control group (p < 0.001). The ratio of bulimia nervosa and subclinical bulimia nervosa showed no significant difference between the two groups. CONCLUSION: Female fashion models showed no significant difference from the control group in the frequency of anorexia nervosa and bulimia nervosa but had a significantly higher frequency of the subclinical form of anorexia nervosa.

The applicability of the Eating Disorder Inventory in pregnancy.

PURPOSE: The aim of our study was validating Eating Disorder Inventory (EDI) among pregnant women, who are vulnerable to eating disorders (EDs). METHODS: In 2012-2013, 1146 women (aged 18-47 years) completed a questionnaire including EDI during the first 3 days after delivery. We checked factorial validity of three diagnostic subscales of EDI with confirmative factor analysis and internal validity by Cronbach's alpha and item-total correlation. We also tested discriminative validity by comparing average of the three subscale of EDI in case of ED and non-ED groups. RESULTS: When applying the EDI to pregnant women, it seems necessary to exclude five items on three diagnostic subscales: on the Drive for Thinness subscale, 4 items remain (out of 7); on the Bulimia subscale, 6 items remain (out of 7); the Body Dissatisfaction subscale decreases from 9 to 8 items. Cronbach's alpha and item-total correlation values meet the requirements defined by Garner et al. The internal consistency of the EDI has proved to be appropriate, indicating that it is a reliable screening tool. CONCLUSIONS: Thinking, attitudes, and behaviors connected to eating, along with the relation to altering body weight change during pregnancy. Vomiting usually accompanies pregnancy; body weight gain within wide limits is also regarded as normal during pregnancy. These behaviors and changes are not feasible to use for measuring ED symptoms. These aspects cannot be neglected when screening eating disorders in pregnant women. LEVEL OF EVIDENCE: Level IV evidence obtained from multiple time series with or without an intervention.

Eating disorder characteristics among Hungarian medical students: Changes between 1989 and 2011.

BACKGROUND AND AIMS: There are contradictory findings on time changes in the prevalence of eating disorders (EDs). The first epidemiological studies in Hungary were carried out in the late 1980s. The objective of the present study was to follow the changes in the prevalence of EDs in medical students after a period of 22 years. METHODS: A questionnaire survey was conducted in 1989 and in 2010. The sample comprised medical students: 538 subjects (248 males and 290 females) in 1989 and 969 subjects (261 males and 708 females) in 2010. The questionnaire contained sociodemographic and anthropometric items, the Eating Behaviour Severity Scale, the General Health Questionnaire, the Anorexia Nervosa Inventory for Self-Rating, and the Eating Disorder Inventory (EDI). In the second wave, three subscales of the EDI-2 and the SCOFF questionnaire were added. RESULTS: Current and desired body mass index were significantly higher in the second study. Binge eating at least once a week was reported less frequently (2.7% vs 6.8% in males, 6.1% vs 13% in females) in 2010. The proportion of subclinical anorexia nervosa was higher among females in 2011 (2.5% vs 0.3%, P < 0.01). Among males, the proportion of counterregulatory behaviours increased significantly (from 8.9 to 14.6%). DISCUSSION AND CONCLUSIONS: The increase of the proportion of subclinical anorexia nervosa and that of male EDs may relate to the importance of the changes in the sociocultural background. Further representative studies are proposed in other countries of Central and Eastern Europe among medical students and in the general population.

[Eating disorders and pregnancy - a review of literature]. / Az evészavarok és a terhesség összefüggései - irodalmi áttekintés.

Eating disorders are psychosomatic disorders affecting primarily women, and influence reproductive functions as well. They have an impact on ovarial cyclem fertility, course of pregnancy, process of delivery, post partum period. Moreover, some data show that they can influence the adult health status. Extensive research from the last three decades call the attention to the fact that besides the classical eating disorders (anorexia nervosa and bulimia nervosa) the newer types (e.g., orthorexia nervosa), and subclinical disorders also occur in a subgroup of pregnant women. For this reason it is of key importance that the personnel working in the territory of obstetrics and gynecology have a solid knowledge about the symptoms, screening and therapeutical opportunities, and outcome of these disorders. The review summarizes the recent research data about the relationship of eating disorders and pregnancy.

When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary.

BACKGROUND: For a better differential diagnosis of eating disorders, it is necessary to investigate their subtypes and develop specific assessment tools to measure their specific symptoms. Orthorexia nervosa is an alleged eating disorder in which the person is excessively preoccupied with healthy food. The ORTO-15, designed by Donini and colleagues, is the first and only at least partially validated instrument to measure this construct. The aims of the present study were to examine the psychometric properties of its Hungarian adaptation (ORTO-11-Hu), and to investigate its relationship to food consumption and lifestyle habits in order to contribute to a better description of the phenomenon. METHODS: The ORTO-11-Hu, a lifestyle habits questionnaire, a food choice list indicating foods the participants choose to consume, and ten additional orthorexia-related questions were administered to a group of 810 Hungarian participants (89.4% female) aged between 20 and 70 (M = 32.39 ± 10.37 years). RESULTS: Confirmatory factor analysis suggested a single factor structure for the 11-item shortened version of the instrument. Internal consistency of the measure was adequate (Cronbach's alpha = 0.82). No significant differences were found between males and females on the ORTO-11-Hu. Age and body mass index were significantly associated with a tendency towards orthorexia nervosa. Additional orthorexia-related features were significantly correlated with ORTO-11-Hu scores: orthorexia nervosa tendency was associated not only with healthier food choices (eating more whole wheat cereals, less white wheat cereals, more fruit and vegetables) but with shopping in health food stores, as well as with some healthy lifestyle habits (more sports activity, specific dietary behaviors, and less alcohol intake). Individuals with higher orthorexia nervosa tendency also reported a greater tendency to advocate their healthy diet to their friends and family members. CONCLUSIONS: These results provide evidence for the reliability of ORTO-11-Hu and some support for the construct validity of the instrument. The present study also contributes to the establishment of (diagnostic) criteria for this new subtype of eating disorders.

[Orthorexia nervosa and it's background factors]. / Orthorexia nervosa és háttértényezoi.

The place of orthorexia nervosa (ON)--described by Bratman in 1997--is not clearly defined in the diagnostic systems. However, the increasing number of clinical experiences and research data gives us more and more information about the epidemiology, and the social and individual characteristics of ON. The general population shows a 6.9% prevalence of ON; healthcare professionals are at high risk of ON with the prevalence rate of 35-57.6%. Education, the choice of profession, socioeconomic status and the internalization of the ideals of society are significant factors in the development of ON, while sex, age and body mass index do not seem to be determining variables in this respect. The lack of common criteria and proper research results on ON makes it impossible to generalize data on the general population. Further studies with larger representative samples and assessment instruments with good psychometric properties are necessary to make research data on ON comparable.

Evidence and gaps in the literature on orthorexia nervosa.

AIM: To review the literature on the prevalence, risk groups and risk factors of the alleged eating disorder orthorexia nervosa. METHODS: We searched Medline and Pubmed using several key terms relating to orthorexia nervosa (ON) and checked the reference list of the articles that we found. Attention was given to methodological problems in these studies, such as the use of non-validated assessment instruments, small sample size and sample characteristics, which make generalization of the results impossible. RESULTS: Eleven studies were found. The average prevalence rate for orthorexia was 6.9 % for the general population and 35-57.8 % for high-risk groups (healthcare professionals, artists). Dieticians and other healthcare professionals are at high risk of ON. Risk factors include obsessive-compulsive features, eating-related disturbances and higher socioeconomic status. Relevant clinical experience, published literature and research data have increased in the last few years. DISCUSSION: The definition and diagnostic criteria of ON remain unclear. Further studies are needed to clarify appropriate diagnostic methods and the place of ON among psychopathological categories.