Making the leap from healthy to disordered eating: the role of intuitive and inflexible eating attitudes in orthorexic behaviours among women

Purpose Orthorexia Nervosa (ON) has been a research focus in recent years. Despite the lack of consensus on its definition and classification as a psychiatric disorder, research has shown that ON is linked to certain behaviours (orthorexic behaviours, e.g.: obsessive thinking and compulsive behavior, guilt and self-punishment, restriction), associated with disordered eating. However, very little is known about this relationship. The aim of this study was to explore the eating-related processes inherent to the relationship between orthorexic behaviours and disordered eating, and understand if it is through the adoption of a more inflexible and less intuitive eating approach, that an interest in healthy eating develops into a pathological one, while controlling the effect of age and BMI. Additionally, this relationship was explored for two different groups: Omnivores and Non-omnivores. Methods Four hundred fifty-one women (281 Omnivores and 170 Non-omnivores) from the Portuguese population participated in this study, by answering a set of self-report measures. Results Non-omnivores presented significant higher levels of orthorexic behaviours and inflexible eating. In both groups, orthorexic behaviours and disordered eating were linked positively to inflexible eating and negatively to intuitive eating. A path model analyses showed that the preferred eating approach mediated the relationship between orthorexic behaviours and disordered eating, explaining 51% of the variance of disordered eating. A multigroup analysis confirmed the model invariance between Omnivores and Non-omnivores. Conclusions Our findings contribute to the better understanding of the relationship between orthorexic behaviours and disordered eating and its eating-related processes. Future research regarding the clinical intervention and prevention of ON in women should focus on encouraging a more intuitive eating approach.