TY - JOUR

T1 - Obsessed with healthy eating: A systematic review of observational studies assessing orthorexia nervosa in patients with diabetes mellitus

AU - Grammatikopoulou, Maria G

AU - Gkiouras, Konstantinos

AU - Polychronidou, Georgia

AU - Kaparounaki, Chrysi

AU - Gkouskou, Kalliopi K

AU - Magkos, Faidon

AU - Donini, Lorenzo Maria

AU - Eliopoulos, Aristides G

AU - Goulis, Dimitrios G

N1 - This article belongs to the Special Issue Advances in the Nutrition of Diabetes and Gestational Diabetes.

PY - 2021

Y1 - 2021

N2 - Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Typical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the evidence on the prevalence of ON symptomatology among patients with DM. PubMed, Web of Science, Scopus, and grey literature were searched, and relevant observational studies were screened using the Rayyan software. The quality of the studies was assessed using the appraisal tool for cross-sectional studies (AXIS) and the Newcastle–Ottawa scale (NOS). Out of 4642 studies, 6 fulfilled the predefined criteria and were included in the qualitative synthesis. Most studies relied on the ORTO-15 or its adaptations to identify ON among patients with DM. No apparent sex or age differences exist regarding the prevalence of ON symptoms. None of the studies compared the prevalence of ON in patients with type 1 and type 2 DM. Most of the research was of average to good methodological quality. In conclusion, patients with DM often exhibit ON tendencies, although research is still limited regarding the etiology or mechanistic drivers behind ON and the characteristics of patients with a dual ON–DM diagnosis.

AB - Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Typical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the evidence on the prevalence of ON symptomatology among patients with DM. PubMed, Web of Science, Scopus, and grey literature were searched, and relevant observational studies were screened using the Rayyan software. The quality of the studies was assessed using the appraisal tool for cross-sectional studies (AXIS) and the Newcastle–Ottawa scale (NOS). Out of 4642 studies, 6 fulfilled the predefined criteria and were included in the qualitative synthesis. Most studies relied on the ORTO-15 or its adaptations to identify ON among patients with DM. No apparent sex or age differences exist regarding the prevalence of ON symptoms. None of the studies compared the prevalence of ON in patients with type 1 and type 2 DM. Most of the research was of average to good methodological quality. In conclusion, patients with DM often exhibit ON tendencies, although research is still limited regarding the etiology or mechanistic drivers behind ON and the characteristics of patients with a dual ON–DM diagnosis.

KW - Anorexia nervosa

KW - Binge eating disorder

KW - Bulimia nervosa

KW - Diet

KW - Disordered eating

KW - Eating behavior

KW - Eating disorders

KW - Healthism

KW - Metabolic control

KW - Psychology

KW - Purging

U2 - 10.3390/nu13113823

DO - 10.3390/nu13113823

M3 - Review

C2 - 34836080

AN - SCOPUS:85117914319

VL - 13

JO - Nutrients

JF - Nutrients

SN - 2072-6643

IS - 11

M1 - 3823

ER -