Misinformation, thin-ideal internalization, and resistance to treatment: an interpretive phenomenological analysis of th
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ORIGINAL ARTICLE
Misinformation, thin‑ideal internalization, and resistance to treatment: an interpretive phenomenological analysis of the experience of orthorexia nervosa Kristen DeBois1 · Sheryl L. Chatfield1 Received: 16 July 2020 / Accepted: 6 October 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Orthorexia nervosa (ON) is an emerging pattern of disordered eating which may be driven by a pathological desire to consume only highly nutritious foods, absent concern over body weight, as is noted in anorexia nervosa (AN). This study seeks to clarify the development and progression of ON and add to researchers’ understanding of this potential disorder. Method Utilizing Interpretive Phenomenological Analysis to guide data collection and analysis, interviews were conducted with 18 individuals who self-identified as having ON. Results Participants described a clear distinction between orthorexia nervosa and clinically recognized eating disorders, with which they had prior experience. In addition, they demonstrated patterns of inflexible thinking that guided their perceptions of themselves and others. As a result, participants rapidly integrated newly acquired nutritional information, which led to escalations in restriction, social isolation, and physical symptoms of malnutrition. While prior findings on the relationship between ON and weight are conflicting, previously proposed criteria for ON emphasize an absence of weight-related concerns. The results of the present study suggest that weight control is a primary motivating factor in the escalating pattern of restriction. Conclusion The nuanced results from this work evidence the value of interpretive qualitative approaches to improve understanding of ON. In particular, participants’ described inflexible thinking with respect to eating behaviors may help inform or revise screening instruments and provide important insights for treatment of ON. Level of evidence Level V, qualitative descriptive research. Keywords Orthorexia nervosa · Eating disorders · Interpretive phenomenological analysis · Qualitative methodology
Introduction The term orthorexia nervosa (ON) was introduced in 1997 by physician Steven Bratman to characterize pathologically disordered eating motivated primarily by concerns over food quality, rather than quantity [1]. Bratman later suggested that ON has two stages, beginning with the initiation of thoughtful diet choices aimed at improving health, followed by escalating dietary restriction accompanied by obsessive thinking [2].
This article is part of the topical collection on orthorexia nervosa. * Kristen DeBois [email protected] 1
Kent State University College of Public Health, Moulton Hall, 800 Hilltop Drive, Kent, OH 44242, USA
Bratman’s subsequent book, Health Food Junkies [3] further described the condition and introduced a ten-item self-test for readers to assess whether they were developing ON. Ultimately referred to as Bratman’s Orthorexia Test (BOT; [4]), the instrument was not developed from empirical research a
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