Profiling orthorexia nervosa in young adults: the role of obsessive behaviour, perfectionism, and self-esteem

BACKGROUND: Orthorexia nervosa (ON) is a relatively new potential eating disorder characterized by an intense fixation on one’s eating habits and the imposition of rigid and inflexible rules on oneself. Psychological factors such as obsessive–compulsive tendencies, perfectionism and self-esteem may interact in complex ways and contribute to the development and maintenance of ON. METHODS: This cross-sectional study included 977 participants from Italy, Lebanon, and Poland. Participants completed a questionnaire consisting of socio-demographic information, the Eating Habits Questionnaire, Obsessive–Compulsive Inventory, Obsessive Beliefs Questionnaire-44, Multidimensional Perfectionism Scale, and Rosenberg Self-Esteem Scale. Cluster analysis was used to identify subgroups of individuals with common psychological characteristics associated with ON. RESULTS: Three distinct clusters were identified based on their levels of obsession-compulsive beliefs, perfectionism, and self-esteem. The first group, labeled “High Self-Mastery,” consisted of 37.0% of participants and exhibited low levels of obsession-compulsion, obsessive beliefs, and perfectionism, but high self-esteem. The second group, “Moderate Self-Mastery,” comprised 39.5% of participants and had moderate levels of these traits. The third group, “Low Self-Mastery,” consisted of 23.6% of participants and exhibited the highest levels of obsession-compulsion, obsessive beliefs, and perfectionism, but the lowest self-esteem. Additionally, a multivariable analysis revealed that being Lebanese (Beta = 3.39) and belonging to the last cluster (Beta = 4.53) were significantly associated with higher ON tendencies. CONCLUSION: Our findings show that individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies. This study emphasizes the need to have a comprehensive understanding of how cultural and psychological factors interact in the development of eating disorders.