How Does Perfectionism Affect the Relationship Between Obsessive-Compulsive and Orthorexia Nervosa Symptoms?

What you need to know

• Orthorexia nervosa involves an unhealthy obsession with eating foods perceived as healthy
• Obsessive-compulsive symptoms are more common in orthorexia nervosa than previously thought
• Perfectionism may strengthen the relationship between obsessive-compulsive and orthorexia nervosa symptoms
• Understanding these connections could help improve treatment approaches for orthorexia nervosa

What is orthorexia nervosa?

Orthorexia nervosa (ON) is a proposed eating disorder characterized by an obsessive focus on eating foods believed to be healthy. Unlike other eating disorders that focus on food quantity, people with ON are preoccupied with food quality and “purity.” This can lead to:

• Extremely restrictive diets
• Anxiety about food choices
• Social isolation due to rigid eating habits
• Malnutrition from eliminating entire food groups

While not yet officially recognized as a distinct disorder, ON shares features with both eating disorders and obsessive-compulsive disorder (OCD).

The relationship between orthorexia nervosa and obsessive-compulsive symptoms

Previous research has found mixed results when looking at the connection between ON and obsessive-compulsive (OC) symptoms. Some studies found little overlap, while others reported stronger links. This study aimed to clarify this relationship and explore factors that might influence it.

The researchers surveyed 190 adults using questionnaires that measured:

• ON symptoms
• OC symptoms
• OC beliefs (e.g., perfectionism, responsibility for harm)
• Clinical perfectionism

They found that higher levels of OC symptoms were associated with more ON symptoms. This suggests OC tendencies may play a larger role in ON than some previous studies indicated.

The role of perfectionism

An important finding was that perfectionism appeared to moderate the relationship between OC and ON symptoms. This means that perfectionism influenced how strongly OC and ON symptoms were connected.

Specifically:

• For people with high levels of perfectionism, there was a stronger link between OC and ON symptoms
• For those with low perfectionism, the connection between OC and ON symptoms was weaker

In other words, being highly perfectionistic may strengthen the relationship between obsessive-compulsive tendencies and orthorexic behaviors.

What is clinical perfectionism?

This study focused on clinical perfectionism, which involves:

• Setting extremely high personal standards
• Basing self-worth on meeting those standards
• Continuing to pursue those standards despite negative consequences

Unlike more general concepts of perfectionism, clinical perfectionism is considered an unhealthy trait that can contribute to various mental health issues.

Why perfectionism matters in orthorexia nervosa

The study’s findings suggest perfectionism may be a key factor in how ON develops and is maintained. Here’s why this matters:

1. It may help explain why some people with OC tendencies develop ON while others don’t.

2. Perfectionism could be driving the obsessive thoughts and rigid behaviors seen in ON, perhaps even more than general OC symptoms.

3. Understanding the role of perfectionism could lead to more effective treatments for ON.

Implications for treatment

Current cognitive-behavioral therapy (CBT) approaches for eating disorders and OCD may need to be adapted for ON. Based on this study’s findings, treatment for ON might benefit from:

1. Directly addressing perfectionistic thoughts and behaviors
2. Helping patients set more realistic and flexible standards around eating
3. Working on self-worth issues that aren’t tied to rigid ideas about “perfect” eating

Obsessive-compulsive beliefs in orthorexia nervosa

Interestingly, the study found that most OC beliefs (like overestimating threat or feeling overly responsible) weren’t strongly linked to ON symptoms once perfectionism was accounted for. This suggests that unlike in OCD, where various belief patterns play a role, ON may be more specifically connected to perfectionistic thinking.

How orthorexia nervosa differs from OCD

While this study found connections between ON and OC symptoms, there are important differences:

1. Ego-syntonic vs. ego-dystonic: ON behaviors often feel in line with a person’s values (ego-syntonic), while OCD behaviors typically feel unwanted (ego-dystonic).

2. Insight: People with ON often don’t recognize their behavior as problematic, whereas those with OCD usually have some awareness that their obsessions and compulsions are excessive.

3. Focus: ON obsessions and compulsions are specifically about food and health, while OCD can involve a wide range of themes.

Limitations and future research

This study provides valuable insights, but it’s important to note some limitations:

• The sample size was relatively small, which can limit the reliability of complex statistical analyses like those used here.
• The study design was correlational, so it can’t prove cause-and-effect relationships.
• The research relied on self-report questionnaires, which can be influenced by participants’ perceptions and honesty.

Future research could:

• Use larger sample sizes to confirm these findings
• Explore how different aspects of perfectionism relate to ON
• Investigate other factors (like self-esteem or health anxiety) that might influence ON symptoms
• Develop and test treatments for ON that incorporate these insights about perfectionism

Conclusions

• Obsessive-compulsive symptoms appear to be more common in orthorexia nervosa than previously thought.
• Perfectionism may play a crucial role in strengthening the relationship between obsessive-compulsive and orthorexia nervosa symptoms.
• Treatment approaches for orthorexia nervosa may need to specifically target perfectionistic thoughts and behaviors.

This research helps refine our understanding of orthorexia nervosa and its relationship to obsessive-compulsive tendencies. By highlighting the important role of perfectionism, it opens up new avenues for developing more effective treatments for those struggling with an unhealthy obsession with “clean” eating.