A cross-sectional study to determine factors associated with orthorexia nervosa, healthy orthorexia, and intuitive eating

This study examined the relationships between sociocultural attitudes toward appearance, orthorexia (including orthorexia nervosa and healthy orthorexia), and intuitive eating in adults. It also explored whether body appreciation and body functionality appreciation mediated these links. Participants ( N = 630; M age = 34.82, SD = 10.15; 62.4% females, 37.6% males) completed the Teruel Orthorexia Scale, Intuitive Eating Scale-2, Sociocultural Attitudes Toward Appearance Questionnaire-4-Revised, Body Appreciation Scale-2, and Functionality Appreciation Scale. Findings from two structural models indicated that stronger sociocultural attitudes toward appearance were associated with higher levels of orthorexia nervosa, with this relationship mediated by lower body functionality appreciation. Moreover, greater sociocultural pressures were linked to lower levels of healthy orthorexia and intuitive eating, with reduced body appreciation mediating these associations. Overall, the findings highlight the influence of sociocultural attitudes on both adaptive and maladaptive eating behaviors and emphasize the role of body-related constructs in shaping individuals’ eating patterns.