Understanding Orthorexia Nervosa: A Systematic Review of Meta-analytical Findings

Abstract: Orthorexia Nervosa (ON) is an emerging condition marked by an obsessive focus on healthy eating, often resulting in impairments in well-being, daily functioning, and quality of life. Despite growing awareness, ON is not currently recognized in major psychiatric diagnostic systems, complicating its identification and clinical management. Objective: This umbrella review aims to synthesize evidence from existing meta-analyses on the prevalence and associated factors of ON, while critically assessing the quality of the current literature. Methods: A comprehensive review of five meta-analyses was conducted, focusing on ON prevalence rates, its psychological correlates, and the quality of the included studies. The review also evaluated heterogeneity in findings and the reliability of assessment tools used across studies. Results: Prevalence estimates of ON showed wide variability due to differences in populations and assessment instruments. ON was significantly associated with compulsive exercise, eating disorder symptoms, obsessive-compulsive traits, and perfectionism. Newer diagnostic tools reveal a stronger connection between ON and obsessive-compulsive tendencies, while distinguishing it from traditional eating disorders, due to its focus on food purity rather than weight control. Methodological limitations, such as inconsistent assessment tools and variable study designs, limit the conclusiveness of current evidence, rendering most findings suggestive rather than definitive. Discussion: The review highlights the need for standardized diagnostic criteria, validated screening instruments, and longitudinal studies to establish the clinical relevance of ON. Enhancing understanding of its psychological and behavioral foundations is crucial for improving diagnostic accuracy and developing effective interventions.