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05-06-2024 | Original Article

Food Categorization Performance and Strategies in Orthorexia Nervosa

Auteurs: Clara Lakritz, Sylvain Iceta, Jérémie Lafraire

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2025

Abstract

Background

Orthorexia nervosa (ON) is an obsession with healthy eating and is notably characterized by food hyper-selectivity with the exclusion of food considered unhealthy. The cognitive mechanisms that underlie this type of food selectivity remain poorly understood. Recent research on anorexia nervosa, which overlap with ON traits, has revealed specific categorization performance (i.e., accuracy in discriminating between food categories) and strategies (tendencies to avoid one type of error over another) as well as categorization flexibility impairments in subjects suffering from anorexia nervosa. The present study includes three experiments that investigated food categorization according to ON traits.

Methods

Experiment 1 explored subjects’ abilities to categorize foods as healthy or unhealthy according to ON traits. Experiment 2 investigated subjects’ cognitive flexibility according to ON traits in the food domain. Experiment 3 tested subjects’ strategies using the signal detection theory framework, according to ON traits. The three experiments were conducted in France and replicated in Quebec.

Results

Although the results did not allow us to conclude whether the ON scores affected the subjects' performance or cognitive flexibility, the results did reveal significant effects of ON scores on the subjects’ strategies when categorizing food as healthy or unhealthy, reflecting the fear of mistaking unhealthy foods for healthy ones when subjects exhibited high ON scores.

Conclusion

The findings challenge the standard way to define ON and pave the way for future research on emotional distress about food in subjects with high ON scores.

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Bailey, R., & Muldrow, A. (2019). Healthy Food Identification: Food Cues and Claims Affect Speeded and Thoughtful Evaluations of Food. Health Communication, 34(7), 735–746. https://doi.org/10.1080/10410236.2018.1434734

Berg, E. A. (1948). A Simple Objective Technique for Measuring Flexibility in Thinking. The Journal of General Psychology, 39(1), 15–22. https://doi.org/10.1080/00221309.1948.9918159

Blechert, J., Meule, A., Busch, N. A., & Ohla, K. (2014). Food-pics : An image database for experimental research on eating and appetite. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2014.00617CrossRefPubMedPubMedCentral

Bonin, P., Lukowski Duplessy, H., Thibaut, J.-P., & Méot, A. (2022). Norms in French for 209 images of the “food-pics” image database. Food Quality and Preference, 93, 104274. https://doi.org/10.1016/j.foodqual.2021.104274CrossRef

Bratman, S. (1997). Health food junkie. Yoga Journal, 136, 42–50.

Cardi, V., Leppanen, J., Mataix-Cols, D., Campbell, I. C., & Treasure, J. (2019). A case series to investigate food-related fear learning and extinction using in vivo food exposure in anorexia nervosa : A clinical application of the inhibitory learning framework. European Eating Disorders Review: The Journal of the Eating Disorders Association, 27(2), 173–181. https://doi.org/10.1002/erv.2639CrossRefPubMed

Carrard, I., Lien Rebetez, M. M., Mobbs, O., & Van der Linden, M. (2015). Factor structure of a French version of the eating disorder examination-questionnaire among women with and without binge eating disorder symptoms. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 20(1), 137–144. https://doi.org/10.1007/s40519-014-0148-xCrossRef

Cena, H., Barthels, F., Cuzzolaro, M., Bratman, S., Brytek-Matera, A., Dunn, T., Varga, M., Missbach, B., & Donini, L. M. (2019). Definition and diagnostic criteria for orthorexia nervosa : A narrative review of the literature. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 24(2), 209–246. https://doi.org/10.1007/s40519-018-0606-yCrossRef

Coricelli, C., Foroni, F., Osimo, S. A., & Rumiati, R. I. (2019). Implicit and explicit evaluations of foods: The natural and transformed dimension. Food Quality and Preference, 73, 143–153. https://doi.org/10.1016/j.foodqual.2018.11.014CrossRef

Crane, A. L., Brown, G. E., Chivers, D. P., & Ferrari, M. C. O. (2020). An ecological framework of neophobia: From cells to organisms to populations. Biological Reviews, 95(1), 218–231. https://doi.org/10.1111/brv.12560CrossRefPubMed

Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11(1), Article 1. https://doi.org/10.1186/1741-7015-11-126CrossRef

De Vlieger, N. M., Collins, C., & Bucher, T. (2017). What is a nutritious snack? Level of processing and macronutrient content influences young adults’ perceptions. Appetite, 114, 55–63. https://doi.org/10.1016/j.appet.2017.03.021

Dell’Osso, L., Abelli, M., Carpita, B., Pini, S., Castellini, G., Carmassi, C., & Ricca, V. (2016, juillet 7). Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum. Neuropsychiatric Disease and Treatment. https://doi.org/10.2147/NDT.S108912

Dondzilo, L., Phillipou, A., Miles, S., Jonker, N., Jeffery, E., & MacLeod, C. (2024). Cognitive biases involving readiness to categorise food in terms of calorie content in anorexia nervosa. Cognitive Therapy and Research. https://doi.org/10.1007/s10608-023-10462-wCrossRef

Donini, L. M., Barrada, J. R., Barthels, F., Dunn, T. M., Babeau, C., Brytek-Matera, A., Cena, H., Cerolini, S., Cho, H., Coimbra, M., Cuzzolaro, M., Ferreira, C., Galfano, V., Grammatikopoulou, M. G., Hallit, S., Håman, L., Hay, P., Jimbo, M., Lasson, C., & Lombardo, C. (2022). A consensus document on definition and diagnostic criteria for orthorexia nervosa. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity. https://doi.org/10.1007/s40519-022-01512-5CrossRef

Donini, L., Marsili, D., Graziani, M., Imbriale, M., & Cannella, C. (2005). Orthorexia nervosa: Validation of a diagnosis questionnaire. Eating and Weight Disorders: EWD, 10, e28-32. https://doi.org/10.1007/BF03327537CrossRefPubMed

Fairburn, C. G., & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? The International Journal of Eating Disorders, 16(4), 363–370.CrossRefPubMed

Finger, H., Goeke, C., Diekamp, D., StandvoB, K., & Konig, P. (2017). LabVanced : A unified JavaScript framework for online studies. [JavaScript]. In International Conference on Computational Social Science.

Foroni, F., Esmaeilikia, M., & Rumiati, R. I. (2022). What makes a food healthy? Sex differences in what is associated to healthiness evaluations. Food Quality and Preference, 96, 104438. https://doi.org/10.1016/j.foodqual.2021.104438CrossRef

Foroni, F., Pergola, G., Argiris, G., & Rumiati, R. I. (2013). The FoodCast research image database (FRIDa). Frontiers in Human Neuroscience. https://doi.org/10.3389/fnhum.2013.00051CrossRefPubMedPubMedCentral

Gleaves, D., Graham, E., & Ambwani, S. (2013). Measuring “Orthorexia.” Development of the Eating Habits Questionnaire. The International Journal of Educational and Psychological Assessment, 12.

Goddard, E., Carral-Fernández, L., Denneny, E., Campbell, I. C., & Treasure, J. (2014). Cognitive flexibility, central coherence and social emotional processing in males with an eating disorder. The World Journal of Biological Psychiatry, 15(4), 317–326. https://doi.org/10.3109/15622975.2012.750014CrossRefPubMed

Godefroy, V., Trinchera, L., & Dorard, G. (2021). Optimizing the empirical assessment of orthorexia nervosa through EHQ and clarifying its relationship with BMI. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity, 26(2), 649–659. https://doi.org/10.1007/s40519-020-00909-4CrossRef

Green, D. M., & Swets, J. A. (1966). Signal detection theory and psychophysics. Wiley.

Hayatbini, N., & Oberle, C. D. (2019). Are orthorexia nervosa symptoms associated with cognitive Inflexibility? Psychiatry Research, 271, 464–468. https://doi.org/10.1016/j.psychres.2018.12.017CrossRefPubMed

Hayatbini, N., Oberle, C. D., & Ali, M. N. (2020). Are orthorexia nervosa symptoms associated with deficits in inhibitory control? Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity. https://doi.org/10.1007/s40519-020-00979-4CrossRef

Hoenig, K., Sim, E.-J., Bochev, V., Herrnberger, B., & Kiefer, M. (2008). Conceptual flexibility in the human brain : Dynamic recruitment of semantic maps from visual, motor, and motion-related areas. Journal of Cognitive Neuroscience, 20(10), 1799–1814. https://doi.org/10.1162/jocn.2008.20123CrossRefPubMed

Hu, S. (2007). Akaike Information Criterion. Center for Research in Scientific Computation, 93.

Keegan, E., Tchanturia, K., & Wade, T. D. (2021). Central coherence and set-shifting between nonunderweight eating disorders and anorexia nervosa : A systematic review and meta-analysis. The International Journal of Eating Disorders, 54(3), 229–243. https://doi.org/10.1002/eat.23430CrossRefPubMed

Koven, N. S., & Abry, A. W. (2015). The clinical basis of orthorexia nervosa : Emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385–394. https://doi.org/10.2147/NDT.S61665CrossRefPubMedPubMedCentral

Koven, N. S., & Senbonmatsu, R. (2013). A neuropsychological evaluation of orthorexia nervosa. Open Journal of Psychiatry. https://doi.org/10.4236/ojpsych.2013.32019CrossRef

Lakritz, C., Iceta, S., Duriez, P., Makdassi, M., Masetti, V., Davidenko, O., & Lafraire, J. (2023). Measuring implicit associations between food and body stimuli in anorexia nervosa : A Go/No-Go Association Task. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity, 28(1), 93. https://doi.org/10.1007/s40519-023-01621-9CrossRef

Macmillan, N. A., & Creelman, C. D. (2005). Detection theory : A user’s guide (2nd ed.). Lawrence Erlbaum Associates.

Nguyen, S. P., & Murphy, G. L. (2003). An apple is more than just a fruit : Cross-classification in children’s concepts. Child Development, 74(6), 1783–1806. https://doi.org/10.1046/j.1467-8624.2003.00638.xCrossRefPubMedPubMedCentral

Niedzielski, A., & Kaźmierczak-Wojtaś, N. (2021). Prevalence of orthorexia nervosa and its diagnostic tools—A literature review. International Journal of Environmental Research and Public Health, 18(10), Article 10. https://doi.org/10.3390/ijerph18105488CrossRef

Peirce, J., Gray, J. R., Simpson, S., MacAskill, M., Höchenberger, R., Sogo, H., Kastman, E., & Lindeløv, J. K. (2019). PsychoPy2: Experiments in behavior made easy. Behavior Research Methods, 51(1), 195–203. https://doi.org/10.3758/s13428-018-01193-yCrossRefPubMedPubMedCentral

Pergola, G., Foroni, F., Mengotti, P., Argiris, G., & Rumiati, R. I. (2017). A neural signature of food semantics is associated with body-mass index. Biological Psychology, 129, 282–292. https://doi.org/10.1016/j.biopsycho.2017.09.001CrossRefPubMed

Pini, S., Abelli, M., Carpita, B., Dell’Osso, L., Castellini, G., Carmassi, C., & Ricca, V. (2016). Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum. Neuropsychiatric Disease and Treatment, 12, 1651–1660. https://doi.org/10.2147/NDT.S108912CrossRefPubMedPubMedCentral

Raybaut, P. (2009). Spyder-documentation. [Logiciel]. pythonhosted.org

Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8(3), 271–276. https://doi.org/10.2466/pms.1958.8.3.271CrossRef

Roque, J., Lafraire, J., & Auvray, M. (2020). Audiovisual crossmodal correspondence between bubbles’ size and pouring sounds’ pitch in carbonated beverages. Foods, 9(8), Article 8.CrossRef

Roth, R. M., Isquith, P. K., & Gioia, G. A. (2005). Behavior Rating Inventory of Executive Function for Adults. Psychological Assessment Resources. https://www.parinc.com/Products/Pkey/25

RStudio Team. (2021). RStudio : Integrated Development Environment for R. [RStudio]. http://www.rstudio.com/

de Saint Pol, T., & Hébel, P. (2021). Practices and representations of snacking in a highly standardized food culture : The scenario in France. Food Quality and Preference, 93, 104245. https://doi.org/10.1016/j.foodqual.2021.104245CrossRef

Stanislaw, H., & Todorov, N. (1999). Calculation of signal detection theory measures. Behavior Research Methods, Instruments, & Computers, 31(1), 137–149. https://doi.org/10.3758/BF03207704CrossRef

Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18(6), 643–662. https://doi.org/10.1037/h0054651CrossRef

Urdapilleta, I., Mirabel-Sarron, C., Eiber, R., & Richard, J.-F. (2005). What categorization tells us about food representation. Current Psychology Letters. Behaviour, Brain & Cognition, 3, 17.

van Eeden, A. E., van Hoeken, D., & Hoek, H. W. (2021). Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 34(6), 515–524. https://doi.org/10.1097/YCO.0000000000000739CrossRefPubMedPubMedCentral

Wentura, D., & Degner, J. (2010). Guide to Sequential Priming 1 Running head : GUIDE TO SEQUENTIAL PRIMING A Practical Guide to Sequential Priming and Related Tasks. In Handbook of implicit social cognition : Measurement, theory, and applications. (B. Gawronski, B. K. Payne). Guilford Press.

Yue, L., Tang, Y., Kang, Q., Wang, Q., Wang, J., & Chen, J. (2020). Deficits in response inhibition on varied levels of demand load in anorexia nervosa : An event-related potentials study. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 25(1), 231–240. https://doi.org/10.1007/s40519-018-0558-2CrossRef

Titel: Food Categorization Performance and Strategies in Orthorexia Nervosa
Auteurs: Clara Lakritz
Sylvain Iceta
Jérémie Lafraire
Publicatiedatum: 05-06-2024
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 2/2025
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-024-10495-9

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Food Categorization Performance and Strategies in Orthorexia Nervosa

Abstract

Background

Methods

Results

Conclusion

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