Uniwersyteckie Czasopisma NaukoweExploring the relationship between orthorexia nervosa, mindful eating and guilt and shame
Słowa kluczowe:
orthorexia nervosa, guilt and shame, mindful eatingAbstrakt
Background
Orthorexia nervosa (ON) is an under-researched maladaptive eating behaviour which focuses on the quality and purity of food. Mindful eating refers to being aware of what we eat by making conscious food choices. Guilt and shame are negative self-evaluative emotions which have been associated with maladaptive eating behaviours. This study explores the relationships between ON, mindful eating, and feelings of guilt and shame.
Participants and procedure
Two hundred and fifty-two participants were recruited from various online platforms, such as Facebook, Twitter, and Instagram. They were asked to complete self-report questionnaires on ON, mindful eating, and guilt and shame.
Results
The findings suggested that ON was significantly negatively associated with the mindful eating subscales focused eating, hunger and satiety, and eating with awareness and significantly positively associated with guilt and shame. In addition, guilt was significantly negatively associated with focused eating, whilst both guilt and shame were significantly negatively associated with hunger and satiety and eating with awareness. Further investigation suggested that guilt and shame mediated the association between mindful eating and ON.
Conclusions
It was concluded that guilt and shame could explain the association between mindful eating and ON. Limitations and future directions are discussed.
Downloads
Bibliografia
Albohn-Kühne, C., & Rief, W. (2011). Shame, guilt and social anxiety in obesity with binge-eating disorder. Psychotherapy, Psychosomatics, Medical Psychology, 61, 412–417. https://doi.org/10.1055/s-0031-1284334.
Allirot, X., Miragall, M., Perdices, I., Baños, R. M., Urdaneta, E., & Cebolla, A. (2018). Effects of a brief mindful eating induction on food choices and energy intake: External eating and mindfulness state as moderators. Mindfulness, 9, 750–760. https://doi.org/10.1007/s12671-017-0812-0.
Anixiadis, F., Wertheim, E. H., Rodgers, R., & Caruana, B. (2019). Effects of thin-ideal Instagram images: The roles of appearance comparisons, internalization of the thin ideal and critical media processing. Body Image, 31, 181–190. https://doi.org/10.1016/j.bodyim.2019.10.005.
Barthels, F., & Pietrowsky, R. (2012). Orthorectic eating behaviour-nosology and prevalence rates. Psychotherapie, Psychosomatik, Medizinische Psychologie, 62, 445–449. https://doi.org/10.1055/s-0032-1312630.
Barthels, F., Barrada, J. R., & Roncero, M. (2019). Orthorexia nervosa and healthy orthorexia as new eating styles. PloS One, 14, e0219609. https://doi.org/10.1371/journal.pone.0219609.
Blythin, S. P., Nicholson, H. L., Macintyre, V. G., Dickson, J. M., Fox, J. R., & Taylor, P. J. (2020). Experiences of shame and guilt in anorexia and bulimia nervosa: a systematic review. Psychology and Psychotherapy: Theory, Research and Practice, 93, 134–159. https://doi.org/10.1111/papt.12198.
Bottera, A. R., Kambanis, P. E., & De Young, K. P. (2020). The differential associations of shame and guilt with eating disorder behaviors. Eating Behaviors, 39, 101427. https://doi.org/10.1016/j.eatbeh.2020.101427.
Bratman, S. (1997). Health food junkie. Yoga Journal, 136, 42–50. Bratman, S. (2017). Orthorexia vs. theories of healthy eating. Eating and Weight Disorders, 22, 381–385. https://doi.org/10.1007/s40519-017-0417-6.
Brewer, J. A., Ruf, A., Beccia, A. L., Essien, G. I., Finn, L. M., van Lutterveld, R., & Mason, A. E. (2018). Can mindfulness address maladaptive eating behaviors? Why traditional diet plans fail and how new mechanistic insights may lead to novel interventions. Frontiers in Psychology, 9, 1418. https://doi.org/10.3389/fpsyg.2018.01418.
Chard, C. A., Hilzendegen, C., Barthels, F., & Stroebele-Benschop, N. (2019). Psychometric evaluation of the English version of the Düsseldorf Orthorexia Scale (DOS) and the prevalence of orthorexia nervosa among a U.S. student sample. Eating and Weight Disorders, 24, 275–281. https://doi.org/10.1007/s40519-018-0570-6.
Chen, X., Luo, Y., & Chen, H. (2020). Body Image Victimization experiences and disordered eating behaviors among Chinese female adolescents: The role of body dissatisfaction and depression. Sex Roles, 83, 442–452. https://doi.org/10.1007/s11199-020-01122-4.
Conradt, M., Dierk, J. M., Schlumberger, P., Rauh, E., Hebebrand, J., & Rief, W. (2007). Development of the Weight- and Body-Related Shame and Guilt scale (WEB-SG) in a nonclinical sample of obese individuals. Journal of Personality Assessment, 88, 317–327. https://doi.org/10.1080/00223890701331856.
Costa, C. B., Hardan-Khalil, K., & Gibbs, K. (2017). Orthorexia nervosa: a review of the literature. Issues in Mental Health Nursing, 38, 980–988. https://doi.org/10.1080/01612840.2017.1371816.
Craven, M. P., & Fekete, E. M. (2019). Weight-related shame and guilt, intuitive eating, and binge eating in female college students. Eating Behaviors, 33, 44–48. https://doi.org/10.1016/j.eatbeh.2019.03.002.
Cruz-Sáez, S., Pascual, A., Wlodarczyk, A., & Echeburúa, E. (2020). The effect of body dissatisfaction on disordered eating: The mediating role of selfesteem and negative affect in male and female adolescents. Journal of Health Psychology, 25, 1098– 1108. https://doi.org/10.1177/1359105317748734.
Dąbal, A. K. (2020). Characteristics and nosological separation of orthorexia nervosa. Psychiatria i Psychologia Kliniczna, 20, 32–42. https://doi.org/10.15557/PiPK.2020.0004.
Depa, J., Barrada, J. R., & Roncero, M. (2019). Are the motives for food choices different in orthorexia nervosa and healthy orthorexia? Nutrients, 11, 697. https://doi.org/10.3390/nu11030697.
Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: a review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11–17. https://doi.org/10.1016/j.eatbeh.2015.12.006.
Egan, H., Keyte, R., Nash, E. F., Barrett, J., Regan, A., & Mantzios, M. (2021). Mindfulness moderates the relationship between emotional eating and body mass index in a sample of people with cystic fibrosis. Eating and Weight Disorders, 26, 1521– 1527. https://doi.org/10.1007/s40519-020-00969-6.
Gaebel, W., Zielasek, J., & Reed, G. M. (2017). Mental and behavioural disorders in the ICD-11: Concepts, methodologies, and current status. Psychiatria Polska, 51, 169–195. https://doi.org/10.12740/PP/69660.
Godsey, J. (2013). The role of mindfulness-based interventions in the treatment of obesity and eating disorders: an integrative review. Complementary Therapies in Medicine, 21, 430–439. https://doi.org/10.1016/j.ctim.2013.06.003.
Gramaglia, C., Brytek-Matera, A., Rogoza, R., & Zeppegno, P. (2017). Orthorexia and anorexia nervosa: two distinct phenomena? A cross-cultural comparison of orthorexic behaviours in clinical and non-clinical samples. BMC Psychiatry, 17, 1–5. https://doi.org/10.1186/s12888-017-1241-2.
Heiss, S., Hormes, J. M., & Timko, C. A. (2017). Vegetarianism and eating disorders. In F. Mariotti (Ed.), Vegetarian and plant-based diets in health and disease prevention (pp. 51–69). Academic Press.
Hong, P. Y., Lishner, D. A., & Han, K. H. (2014). Mindfulness and eating: an experiment examining the effect of mindful raisin eating on the enjoyment of sampled food. Mindfulness, 5, 80–87. https://doi.org/10.1007/s12671-012-0154-x.
Hussain, M., Egan, H., Keyte, R., & Mantzios, M. (2021). Mindful construal reflections: Reducing unhealthier eating choices. Mindfulness, 12, 1757–1767. https://doi.org/10.1007/s12671-021-01638-0.
Kalika, E., Egan, H., & Mantzios, M. (2022). Exploring the role of mindful eating and self-compassion on eating behaviours and orthorexia in people following a plant-based diet. Eating and Weight Disorders. https://doi.org/10.1007/s40519-022-01407-5.
Keng, S. L., & Ang, Q. (2019). Effects of mindfulness on negative affect, body dissatisfaction, and disordered eating urges. Mindfulness, 10, 1779–1791. https://doi.org/10.1007/s12671-019-01146-2.
Koven, N. S., & Abry, A. W. (2015). The clinical basis of orthorexia nervosa: Emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385–394. https://doi.org/10.2147/NDT.S61665.
Kristeller, J., Baer, R., & Quilian-Wolever, R. (2006). Mindfulness-based approaches to eating disorders. In R. Baer (Ed.), Mindfulness-based treatment approaches (pp. 75–93). Academic Press.
Kristeller, J. L., & Wolever, R. Q. (2010). Mindfulnessbased eating awareness training for treating binge eating disorder: The conceptual foundation. Eating Disorders, 19, 49–61. https://doi.org/10.1080/10640266.2011.533605.
Lattimore, P. (2020). Mindfulness-based emotional eating awareness training: Taking the emotional out of eating. Eating and Weight Disorders, 25, 649– 657. https://doi.org/10.1007/s40519-019-00667-y.
MacNeill, L. P., Best, L. A., & Davis, L. L. (2017). The role of personality in body image dissatisfaction and disordered eating: Discrepancies between men and women. Journal of Eating Disorders, 5, 44. https://doi.org/10.1186/s40337-017-0177-8.
Mantzios, M. (2021). (Re)defining mindful eating into mindful eating behaviour to advance scientific enquiry. Nutrition and Health, 27, 367–371. https://doi.org/10.1177/0260106020984091.
Mantzios, M., Egan, H., & Asif, T. (2020). A randomised experiment evaluating the mindful raisin practice as a method of reducing chocolate consumption during and after a mindless activity. Journal of Cognitive Enhancement, 4, 250–257. https://doi.org/10.1007/s41465-019-00159-y.
Mantzios, M., Egan, H., Bahia, H., Hussain, M., & Keyte, R. (2018a). How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population? Health Psychology Open, 5, 2055102918762701. https://doi.org/10.1177/2055102918762701.
Mantzios, M., Egan, H., Hussain, M., Keyte, R., & Bahia, H. (2018b). Mindfulness, self-compassion, and mindful eating in relation to fat and sugar consumption: an exploratory investigation. Eating and Weight Disorders, 23, 833–840. https://doi. org/10.1007/s40519-018-0548-4.
Mantzios, M., & Giannou, K. (2014). Group vs. single mindfulness meditation: Exploring avoidance, impulsivity, and weight management in two separate mindfulness meditation settings. Applied Psychology: Health and Well‐Being, 6, 173–191. https://doi.org/10.1111/aphw.12023.
Mantzios, M., & Giannou, K. (2019). A real-world application of short mindfulness-based practices: a review and reflection of the literature and a practical proposition for an effortless mindful lifestyle. American Journal of Lifestyle Medicine, 13, 520–525. https://doi.org/10.1177/1559827618772036.
Mantzios, M., Skillett, K., & Egan, H. (2020). Examining the effects of two mindful eating exercises on chocolate consumption. European Journal of Health Psychology, 26, 120–128. https://doi.org/10.1027/2512-8442/a000040.
Mantzios, M., & Wilson, J. C. (2015). Mindfulness, eating behaviours, and obesity: a review and reflection on current findings. Current Obesity Reports, 4, 141–146. https://doi.org/10.1007/s13679-014-0131-x.
Marek, R. J., Ben‐Porath, D. D., Federici, A., Wisniewski, L., & Warren, M. (2013). Targeting premeal anxiety in eating disordered clients and normal controls: a preliminary investigation into the use of mindful eating vs. distraction during food exposure. International Journal of Eating Disorders, 46, 582–585. https://doi.org/10.1002/eat.22152.
McComb, S. E., & Mills, J. S. (2019). Orthorexia nervosa: a review of psychosocial risk factors. Appetite, 140, 50–75. https://doi.org/10.1016/j.appet.2019.05.005.
Neff, K. D. (2003). Development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250. https://doi.org/10.1080/15298860309027.
Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007). Selfcompassion and adaptive psychological functioning. Journal of Research in Personality, 41, 139–154. https://doi.org/10.1016/j.jrp.2006.03.004.
Nelson, J. B. (2017). Mindful eating: The art of presence while you eat. Diabetes Spectrum, 30, 171– 174. https://doi.org/10.2337/ds17-0015.
Oberle, C. D., De Nadai, A. S., & Madrid, A. L. (2021). Orthorexia Nervosa Inventory (ONI): Development and validation of a new measure of orthorexic symptomatology. Eating and Weight Disorders, 26, 609–622. https://doi.org/10.1007/s40519-020-00896-6.
Özkan, N., & Bilici, S. (2021). Are anthropometric measurements an indicator of intuitive and mindful eating? Eating and Weight Disorders, 26, 639– 648. https://doi.org/10.1007/s40519-020-00904-9.
Rosewall, J. K., Gleaves, D. H., & Latner, J. D. (2018). An examination of risk factors that moderate the body dissatisfaction-eating pathology relationship among New Zealand adolescent girls. Journal of Eating Disorders, 6, 1–10. https://doi.org/10.1186/s40337-018-0225-z.
Segura-García, C., Papaianni, M. C., Caglioti, F., Procopio, L., Nisticò, C. G., Bombardiere, L., Ammendolia, A., Rizza, P., De Fazio, P., & Capranica, L. (2012). Orthorexia nervosa: a frequent eating disordered behavior in athletes. Eating and Weight Disorders, 17, e226–e233. https://doi.org/10.3275/8272.
Sharpe, H., Griffiths, S., Choo, T. H., Eisenberg, M. E., Mitchison, D., Wall, M., & Neumark-Sztainer, D. (2018). The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. International Journal of Eating Disorders, 51, 1168– 1175. https://doi.org/10.1002/eat.22936.
Solomon-Krakus, S., & Sabiston, C. M. (2017). Body checking is associated with weight- and bodyrelated shame and weight- and body-related guilt among men and women. Body Image, 23, 80–84. https://doi.org/10.1016/j.bodyim.2017.08.005.
Surała, O., Malczewska-Lenczowska, J., Sadowska, D., Grabowska, I., & Białecka-Dębek, A. (2020). Traits of orthorexia nervosa and the determinants of these behaviors in elite athletes. Nutrients, 12, 2683. https://doi.org/10.3390/nu12092683.
Turgon, R., Ruffault, A., Juneau, C., Blatier, C., & Shankland, R. (2019). Eating disorder treatment: a systematic review and meta-analysis of the efficacy of mindfulness-based programs. Mindfulness, 10, 2225–2244. https://doi.org/10.1007/s12671-019-01216-5.
Turner, P. G., & Lefevre, C. E. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders, 22, 277–284. https://doi.org/10.1007/s40519-017-0364-2.
Vuillier, L., Robertson, S., & Greville-Harris, M. (2020). Orthorexic tendencies are linked with difficulties with emotion identification and regulation. Journal of Eating Disorders, 8, 15. https://doi.org/10.1186/s40337-020-00291-7.
Warren, J. M., Smith, N., & Ashwell, M. (2017). A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: Effectiveness and associated potential mechanisms. Nutrition Research Reviews, 30, 272–283. https://doi.org/10.1017/S0954422417000154.
Webb, J. B., Jafari, N., Schoenefeld, S. J., & Hardin, A. S. (2013, March). Examining a model of selfcompassion, body shame, and mindful eating. Poster presented at the Society of Behavioral Medicine’s 34th Annual Meeting and Scientific Sessions, San Francisco, CA.
Westermann, S., Rief, W., Euteneuer, F., & Kohlmann, S. (2015). Social exclusion and shame in obesity, Eating Behaviors, 17, 74–76. https://doi.org/10.1016/j.eatbeh.2015.01.001.
Wildes, J. E., Marcus, M. D., Bright, A. C., & Dapelo, M. M. (2012). Emotion and eating disorder symptoms in patients with anorexia nervosa: an experimental study. International Journal of Eating Disorders, 45, 876–882. https://doi.org/10.1002/eat.22020.
Winkens, L. H. H., van Strien, T., Barrada, J. R., Brouwer, I. A., Penninx, B. W. J. H., & Visser, M. (2018). The Mindful Eating Behavior Scale: Development and psychometric properties in a sample of Dutch adults aged 55 years and older. Journal of the Academy of Nutrition and Dietetics, 118, 1277–1290. https://doi.org/10.1016/j.jand.2018.01.015.
Zagaria, A., Vacca, M., Cerolini, S., Ballesio, A., & Lombardo, C. (2022). Associations between orthorexia, disordered eating, and obsessive-compulsive symptoms: a systematic review and meta‐analysis. International Journal of Eating Disorders, 55, 295–312. https://doi.org/10.1002/eat.23654.
Zhang, Z., Robinson, L., Jia, T., Quinlan, E. B., Tay, N., Chu, C., Barker, E. D., Banaschewski, T., Barker, G. J., Bokde, A. L. W., Flor, H., Grigis, A., Garavan, H., Gowland, P., Heinz, A., Ittermann, B., Martinot, J., Stringaris, A., Penttilä, J., … Desrivières, S. (2021). Development of disordered eating behaviors and comorbid depressive symptoms in adolescence: Neural and psychopathological predictors. Biological Psychiatry, 90, 853–862. https:// doi.org/10.1016/j.biopsych.2020.06.003.
