title: Prevalence of orthorexia nervosa is less than 1 %: data from a US sample.
abstract: OBJECTIVE
  Orthorexia nervosa, or pathological dieting based on being "healthy," has been of growing interest. Clinical data are limited to less than a half-dozen case studies reporting instances of medical problems due to healthful eating. However, more than a dozen studies using a measure to identify orthorexia, the ORTO-15, report very high prevalence rates in non-clinical samples. Point prevalence rates are reported from 6 % to nearly 90 %. Such variability could be due to cultural issues or psychometric problems with the instrument. This study examines prevalence rate of orthorexia in a US sample.
  
  
  METHODS
  The ORTO-15 was administered to 275 US college students along with other questions regarding diet, exercise, and health.
  
  
  RESULTS
  While the ORTO-15 indicated a prevalence rate of 71 %, only 20 % of the sample endorsed a dietary practice of removing a particular food type (e.g. meat) from their diet. Those who endorsed following a vegan diet had the highest (less pathological) mean ORTO-15 score. Further, when classifying participants based on their seriousness about healthy eating and whether their diet had led to impairment in everyday activities and medical problems, less than 1 % of the sample fell into such a category.
  
  
  CONCLUSIONS
  As in other countries, a large proportion of a non-clinical US sample scored in the orthorexia range on the ORTO-15. However, this instrument is likely unable to distinguish between healthy eating and pathologically healthful eating. Our estimate is that orthorexia nervosa like anorexia nervosa and bulimia nervosa, is not a common condition.
authors.affiliation: School of Psychological Sciences, University of Northern Colorado, Campus Box 94, Greeley, CO, 80639-0094, USA. thomas.dunn@unco.edu.|Behavioral Health Service, Denver Health Medical Center, Denver, USA. thomas.dunn@unco.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Dunn
authors.affiliation: School of Psychological Sciences, University of Northern Colorado, Campus Box 94, Greeley, CO, 80639-0094, USA.
authors.forename: Josh
authors.initials: J
authors.lastname: Gibbs
authors.affiliation: School of Psychological Sciences, University of Northern Colorado, Campus Box 94, Greeley, CO, 80639-0094, USA.
authors.forename: Noelle
authors.initials: N
authors.lastname: Whitney
authors.affiliation: Behavioral Health Service, Denver Health Medical Center, Denver, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Starosta
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D015995:Prevalence; D055815:Young Adult
keywords: Eating disorders; ORTO-15; Orthorexia nervosa; Pathological healthful eating