The association of perfectionism, health‐focused self‐concept, and erroneous beliefs with orthorexia nervosa symptoms: A moderated mediation model

• Published in: The International journal of eating disorders 2022-07, Vol.55 (7), p.892-901
• Main Authors: Yung, Jayson J., Tabri, Nassim
• Format: Article
• Language: English
• Subjects: disordered eating; Eating disorders; erroneous beliefs; orthorexia nervosa; perfectionism; self‐concept
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.23719

Objective Orthorexia nervosa (ON) is a putative eating disorder linked to perfectionism among people who eat healthily (or who want to eat healthily). However, little is known about the process by which perfectionism fosters ON symptoms. Like the Transdiagnostic Cognitive‐Behavioral Theory of Eating Disorders, we hypothesized that perfectionism among people who eat healthily (or who want to eat healthily) fosters ON symptoms indirectly by cultivating a health‐focused self‐concept (i.e., placing overriding importance on health for self‐definition and self‐worth). We also hypothesized that a health‐focused self‐concept would be associated with ON symptoms among people who have erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. Method To test this moderated mediation model, a sample of people following a healthy eating diet plan and/or who believe they are leading a healthy eating lifestyle (N = 456) were recruited from Amazon's Mechanical Turk and completed measures that assessed perfectionism, health‐focused self‐concept, ON symptoms, and erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. They also completed a measure of appearance‐focused self‐concept. Results Health‐focused and appearance‐focused self‐concepts were empirically distinct. As expected, perfectionism was indirectly and positively associated with ON symptoms via a health‐focused self‐concept. Importantly, the indirect association was only observed among participants high, but not low, in erroneous beliefs. Discussion The findings support the role of perfectionism in ON. The findings also advance knowledge by identifying a health‐focused self‐concept and erroneous beliefs as potential factors in the etiology and maintenance of ON.