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Purpose <p>The lives of people with eating disorders (EDs) habitually revolve around food and diet, and they exhibit disturbances in attitudes and feelings about their bodies and appearance. Both aspects are also described in people at risk of orthorexia nervosa (ON). Social support plays an important role in the treatment of EDs, but less is known about the role of social support in ON. Therefore, the study aimed to estimate the levels of ON risk, perceived social support, body esteem (BE), and diet quality among students by biological sex, body mass index (BMI) group, and current education stage and program; and evaluate the associations between the levels of ON risk, perceived social support, BE, and diet quality.</p> Methods <p>Data were collected from 2022 to 2025 through a cross-sectional quantitative survey among 261 Polish high school students (aged 16–19&#xa0;years) and university students (aged 18–23&#xa0;years). Students completed the Polish version of the Düsseldorf Orthorexia Scale (PL-DOS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Body Esteem Scale for Adolescents and Adults (BESAA), and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). Pearson Chi-squared test, the Mann–Whitney U test, the Kruskal–Wallis rank ANOVA, and quantile regression analysis were used for further analyses.</p> Results <p>Females exhibited a significantly higher ON risk than males. University students from nutrition-related majors demonstrated a significantly higher ON risk than those from non-nutrition-related majors. No significant association was found between ON risk and BMI. An increased risk of ON was significantly associated with lower social support from friends, lower BE weight, and a lower intensity of harmful dietary characteristics for health. Meanwhile, higher BE attribution and a higher intensity of beneficial dietary characteristics for health were significantly associated with increased ON risk.</p> Conclusions <p>Overall, the findings suggest that ON risk is associated with selected psychosocial characteristics, such as perceived social support and body weight-related self-esteem. These findings highlight the need for greater integration of psychological aspects of eating and body image into school and university education programs, as well as interventions aimed at enhancing support from friends to reduce the risk of ON and EDs.</p> <p><i>Level of evidence</i>: Level III. Evidence obtained from a cross-sectional quantitative study.</p>

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Exploring orthorexia nervosa risk in high school and university students: associations with perceived social support, body esteem, and diet quality

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月20日

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  • Marta Plichta,
  • Nanette Stroebele‐Benschop

摘要

Purpose

The lives of people with eating disorders (EDs) habitually revolve around food and diet, and they exhibit disturbances in attitudes and feelings about their bodies and appearance. Both aspects are also described in people at risk of orthorexia nervosa (ON). Social support plays an important role in the treatment of EDs, but less is known about the role of social support in ON. Therefore, the study aimed to estimate the levels of ON risk, perceived social support, body esteem (BE), and diet quality among students by biological sex, body mass index (BMI) group, and current education stage and program; and evaluate the associations between the levels of ON risk, perceived social support, BE, and diet quality.

Methods

Data were collected from 2022 to 2025 through a cross-sectional quantitative survey among 261 Polish high school students (aged 16–19 years) and university students (aged 18–23 years). Students completed the Polish version of the Düsseldorf Orthorexia Scale (PL-DOS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Body Esteem Scale for Adolescents and Adults (BESAA), and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). Pearson Chi-squared test, the Mann–Whitney U test, the Kruskal–Wallis rank ANOVA, and quantile regression analysis were used for further analyses.

Results

Females exhibited a significantly higher ON risk than males. University students from nutrition-related majors demonstrated a significantly higher ON risk than those from non-nutrition-related majors. No significant association was found between ON risk and BMI. An increased risk of ON was significantly associated with lower social support from friends, lower BE weight, and a lower intensity of harmful dietary characteristics for health. Meanwhile, higher BE attribution and a higher intensity of beneficial dietary characteristics for health were significantly associated with increased ON risk.

Conclusions

Overall, the findings suggest that ON risk is associated with selected psychosocial characteristics, such as perceived social support and body weight-related self-esteem. These findings highlight the need for greater integration of psychological aspects of eating and body image into school and university education programs, as well as interventions aimed at enhancing support from friends to reduce the risk of ON and EDs.

Level of evidence: Level III. Evidence obtained from a cross-sectional quantitative study.