Zusammenfassung. Theoretischer Hintergrund: Orthorektisches Ernährungsverhalten bezeichnet eine Fixierung auf gesunde Ernährung, die mit psychischen, körperlichen und sozialen Beeinträchtigungen einhergehen kann. Fragestellung: Konstruktion und Evaluation eines Messinstruments zur Erfassung orthorektischen Ernährungsverhaltens. Methode: Konstruktion der Düsseldorfer Orthorexie Skala (DOS, 10 Items) in einem mehrstufigen item- und faktorenanalytischen Selektionsprozess, Evaluation an einer Stichprobe von 1 340 Probanden. Ergebnisse: Reliabilität (Cronbachs α = .84) sowie Retest-Reliabilität (r = .79) liegen im guten Bereich. Hinweise zur Validität der Skala liefern Korrelationen mit Selbsteinschätzung des Essverhaltens als gesund (r = .21) und mit subjektiver Bedeutsamkeit gesunder Ernährung (r = .42). Schlussfolgerungen: Die ermittelte Prävalenz orthorektischen Ernährungsverhaltens fällt in der untersuchten Stichprobe mit 3 % deutlich niedriger aus als Prävalenzschätzungen in früheren Untersuchungen.

Purpose: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. Methods: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A–Definition, Clinical Aspects, Duration; B–Consequences; C–Onset; D–Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. Results: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. Conclusions: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. Level of evidence: Level V: opinions of expert committees

Purpose: To analyze body dissatisfaction in relation to orthorexic eating behavior in a sample of young females to further investigate characteristic features of orthorexic eating behavior and its association with other eating disorders. Methods: N = 197 young females (age: M = 29.59, SD = 10.85 years) completed an online survey with the following questionnaires: the Düsseldorf Orthorexia Scale to measure orthorexic eating behavior, the Eating Disorder Inventory-2 (EDI-2), measuring psychopathological aspects of disordered eating behavior, the Dresden Body Image Questionnaire (DKB-35) to measure five components of body image, and the Body Shape Questionnaire (BSQ), measuring body dissatisfaction. Results: In the total sample, Pearson correlations revealed that orthorexic eating behavior was positively associated with drive for thinness and body dissatisfaction. An independent samples t-Test revealed that females with elevated levels of orthorexic eating behavior (n = 35) displayed higher levels of drive for thinness and body dissatisfaction and lower levels of self-acceptance in comparison to a randomized sample from the remaining females with low levels of orthorexic eating behavior (n = 35). According to a multiple regression analysis, drive for thinness and body dissatisfaction measured by the BSQ served as positive predictors for orthorexic eating behavior, whereas bulimia and body dissatisfaction measured by the EDI-2 served as negative predictors. Conclusions: Results reveal that orthorexic eating behavior is more closely related to psychopathological aspects of other eating disorders than previously assumed. Body dissatisfaction as another major feature of orthorexia nervosa should be taken into account in future studies. Level of evidence: III, case–control analytic study.