Food perception in Orthorexia Nervosa: worry or craving?

Background Orthorexia nervosa (ON) is characterized by an excessive preoccupation with eating healthy foods. This disorder shares similarities with various pathological conditions, including anorexia nervosa and addictive behaviours. The current research aimed to explore whether ON is driven by a fear of unhealthy foods, similar to anorexia nervosa, or by a craving for healthy foods, akin to the patterns observed in addictive disorders. Methods In an online study (Study 1), participants (n = 166 adults, mean age = 24.8 years, SD = 7.6 years, 48.8% female) reported liking, wanting, and frequency of intake of 20 healthy and 20 unhealthy foods. Additionally, they completed the Dusseldorf Orthorexia Scale, while BMI, hunger level, and risk of eating disorders were collected. In Study 2, participants (n = 73 adults, mean age = 23.4 years, SD = 3.5 years, 37% female) completed questionnaires on ON and the risk of eating disorders, and a visual probe task with images of healthy and unhealthy foods. Eye movements were also recorded for a subset of participants in the laboratory. Results The results suggested that individuals with higher ON tendencies exhibit decreased responsiveness to rewards and demonstrate a pattern of attentional avoidance toward unhealthy foods. This indicates that ON behaviors may be driven by a fear of unhealthy foods. Conclusions These results underscore the importance of elucidating the role of attentional and motivational mechanisms in ON and their clinical implications.