title: The prevalence of orthorexia nervosa among eating disorder patients after treatment.
abstract: BACKGROUND
  The pursuit for healthy food consumption is considered a laudable habit. This attitude can turn into pathological when cognitions and worries about healthy nutrition lead to such an accurate food selection that correct diet becomes the most important part of one's own life leading to important dietary restrictions, stereotyped eating or impairment in important areas of functioning. This behaviour is coined orthorexia nervosa (ON) and can share common characteristics with anorexia nervosa (AN) and bulimia nervosa (BN). The purpose of the present study was to examine the frequency of ON among women with eating disorders (EDs) and to evaluate if it changed after treating the ED.
  
  
  METHODS
  Thirty-two patients with AN or BN were evaluated by means of the ORTO-15, the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) and the Eating Attitude Test (EAT-26) before (t0) and 3 years after the treatment of their ED (t1), and compared to 32 female healthy controls (HC) matched by gender, age, and BMI at t1.
  
  
  RESULTS
  A significantly higher percentage of patients either at t0 (28 %) or t1 (58 %) resulted positive to ORTO-15 compared to controls (6 %). YBC-EDS and EAT-26 scores were higher among ED patients than in HC, but they decreased from t0 to t1.
  
  
  CONCLUSIONS
  Orthorexia nervosa symptoms are highly prevalent among patients with AN and BN, and tend to increase after treatment. ON seems associated both with the clinical improvement of AN and BN and the migration towards less severe forms of EDs. It is necessary to clarify if ON residual symptomatology can be responsible for a greater number of relapses and recurrences of EDs.
authors.affiliation: Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, Località Germaneto, 88100, Catanzaro, Italy, segura@unicz.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Segura-Garcia
authors.forename: Carla
authors.initials: C
authors.lastname: Ramacciotti
authors.forename: Marianna
authors.initials: M
authors.lastname: Rania
authors.forename: Matteo
authors.initials: M
authors.lastname: Aloi
authors.forename: Mariarita
authors.initials: M
authors.lastname: Caroleo
authors.forename: Antonella
authors.initials: A
authors.lastname: Bruni
authors.forename: Denise
authors.initials: D
authors.lastname: Gazzarrini
authors.forename: Flora
authors.initials: F
authors.lastname: Sinopoli
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Fazio
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy; D052018:Bulimia Nervosa / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult