Date of Award

Fall 11-15-2025

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Food Science

First Advisor

Simone Camel

Abstract

There are indeterminate risk, prevalence, and correlation data on orthorexia nervosa (ON) as shown by current literature on disordered eating (Rodgers et al., 2021). As a roughly defined disordered eating pattern, ON may be better understood after identifying associations among other attributes in a college student sample (Abdullah et al., 2020; Mavrandrea & Gonidakis, 2023; Parra-Fernández, 2019; Rogowska et al., 2021). A cooccurrence and influence of perfectionism, food insecurity, and grade point average (GPA) with ON risk was hypothesized since current literature suggests college students exhibit each of these characteristics independently (Abdullah et al., 2020; Ambwani et al., 2019; Caferoglu & Toklu, 2022; Celik et al., 2023; Ellison et al., 2021; Kim et al., 2022; Richards et al., 2023; Slaney et al., 2001; Yanover & Thompson, 2008). By identifying co-occurring variables with ON and its risk, timely interventions may mitigate its effects. Associations between 1) ON risk and perfectionism; 2) ON risk and GPA number; 3) ON risk, perfectionism, and GPA; and 4) ON risk and food security status (FSS) were hypothesized. ON risk was measured by the Test of Orthorexia Nervosa – 17 (TON-17) tool, and perfectionism by the Almost Perfect Scale – Revised (APS-R) tool. Food security status was measured by the U.S. Adult Food Security Survey Module (USFSSM–10), and GPA was self-reported. This was a cross-sectional study with college students in the United States who were ≥ 18 years of age. Participants were obtained via convenience and network sampling. Responses were acquired via Qualtrics, an online survey software. Respondents were required to consent to participation prior to responding to questionnaire items. A sample of 257 initially accessed the questionnaire however, 32% were removed prior to analysis due to survey incompleteness or not meeting inclusion criteria. The remaining 174 responses comprised the sample for analysis. Most were female (71.8%), White, Non-Hispanic (52.3%), living off- campus (83.9%), and were in their fourth or higher years of post-secondary education (52.9%). The mean age of the sample was 23 years (SD = 4.76) and had a mean GPA of 3.50 (SD = 0.49). ON risk was determined by a score above 61 on the TON-17, 12 participants (6.97%) were deemed at ON risk. The APS-R revealed a majority of the sample reported being in the maladaptive perfectionism subtype (68.1%). The following positive correlations were found: ON risk and the APS-R "Order" subscale, [r(163) = .301, p < .001], ON risk and FSS [r(151) = .254, p = .002], and the APS-R “Discrepancy” subscale and FSS [r(152) = .367, p < .001]. GPA and FSS were negatively correlated [r(132) = -.239, p = .005]. When comparing “high” and “low” food security, as determined by the USFSSM–10, “Discrepancy” scores of the APS-R, which indicates perfectionism subtype, were higher in “low” FSS (M = 67.67, SD = 10.72) than in “high” FSS participants [(M = 49.62, SD = 17.34); t(152) = -4.302, p = .019]. These findings revealed that maladaptive perfectionism was prevalent at “low” FSS when compared to those at “high” FSS. Additionally, GPA was lower in “low” FSS (M = 3.26, SD = .73) than in “high” FSS (M = 3.54, SD = .45); t(132) = 2.095, p = .004. One-way ANOVA with post-hoc analyses revealed that ON risk was significantly higher at very low FSS (M = 53.5882, SD = 11.58) when compared to individuals at high FSS (M = 45.90, SD = 9.74), (p = .029, 95% CI = [.57-14.78]). Significant differences in individual TON-17 subscales were also found: “Control of food quality” for the “very low” FSS (M = 19.41, SD = 3.89) were statistically higher than at “high” FSS (M = 17.28, SD = 3.65), [F(3,152) = 2.662, p=.050]. Similarly, “Disorder symptoms” scores at “very low” FSS were statistically higher (M = 17.72, SD = 4.78) than at “high” FSS (M = 14.59, SD = 4.26), [F(3,150) = 4.478, p=.005]. No difference was detected in “Fixation on health and a healthy diet” subscale scores. However, caution is advised when interpreting results from TON-17 subscale data since poor reliability was detected when subscales were analyzed individually. Regression analyses finding indicated that FSS and “Order” subscale scores had significant influence in predicting the TON-17 outcome (β =.948, p =.013; β =.669, p =.002, respectively). The combination of increased ON risk and perfectionism may suggest that rigidity in controllable life factors, by choice, serves as survival or emotional coping mechanisms at low FSS. At the same time, maladaptive perfectionism and ON risk may, instead, originate out of necessity at low FSS to conserve finances, which results in disordered eating habits and a forced inability to meet self-imposed high standards. Overall, food security status appears to influence ON risk, perfectionism subtype, and GPA number. Control, meticulousness, fixation, and flawlessness, as survival or emotional coping mechanisms, appear to shape the co-occurrence and influence identified among ON risk, perfectionism, and food security status in the sample population. Further study of adaptive versus maladaptive perfectionism at different levels of food security may clarify dominant traits between attributes or variations that were not explored in the current study. Additionally, investigating the etiologies of disordered behaviors observed in maladaptive perfectionism, ON risk, and very low food security status may improve early detection, timely intervention, and understanding of risk factors for these conditions. A qualitative approach to observing food purchasing and consumption behaviors in those at very low food security status, who were significantly at risk for ON in this sample, may clarify quantitative findings in the current study. Lastly, observing other potential characteristics associated with ON risk may further refine an understanding of the disordered eating pattern.

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