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Background: Orthorexia nervosa (ON) represents a pathological obsession with healthy eating. While dietary self-efficacy and positive attitudes are generally considered beneficial for health, their relationship with the risk of developing obsessive eating patterns remains complex. This study aimed to investigate the relationships between dietary self-efficacy, healthy eating attitudes, and orthorexia nervosa among university students in Turkey.
Participants and Procedure: A cross-sectional study was conducted with 381 university students. Data were gathered between February and March 2024 through a structured questionnaire comprising a Sociodemographic Form, the Dieting Self-Efficacy Scale (DIET-SE), the Attitude Scale for Healthy Nutrition (ASHN), and the ORTO-11 Scale. Data were collected through voluntary sampling, where students were randomly invited to participate within the university campus. Statistical analyses were performed using SPSS v26.0, employing descriptive statistics, t-tests, Pearson correlation, and multiple linear regression to identify predictors of ON.
Results: Female students demonstrated significantly higher scores in DIET-SE (31.56 ± 8.65), ASHN (71.13 ± 10.82), and ORTO-11 (27.11 ± 4.51) compared to males (p < 0.05). Notably, the lower ORTO-11 scores in male students indicate a higher tendency toward orthorexia nervosa compared to females. BMI was negatively correlated with all scales (p < 0.05), suggesting that lower BMI is associated with higher ORTO-11 scores and thus lower orthorectic tendencies. Positive correlations were found between DIET-SE and both ASHN (r = 0.202, p < 0.001) and ORTO-11 (r = 0.129, p = 0.012). Multiple linear regression revealed that healthy eating attitudes were the strongest predictor of ON tendency (B = -0.088, p < 0.001), alongside age (B = -0.246, p = 0.028).
Conclusions: High dietary self-efficacy is linked to positive nutritional attitudes but may also increase the risk of orthorexia nervosa. These findings suggest that health interventions should focus on enhancing self-efficacy while simultaneously promoting dietary flexibility to prevent the transition from health-conscious eating to pathological obsession.
