Orthorexia nervosa among Tunisian medical students: Relationships with self-esteem and stress

This study aimed to determine the prevalence of orthorexia nervosa (ON) in a sample of medical students and to examine the relationship between ON, self-esteem, and perceived stress. A cross-sectional study was conducted through an online survey among medical students of the Faculty of Medicine of Sfax (Tunisia). Participants completed an anonymous self-administered questionnaire. We collected their sociodemographic and clinical data. ON was assessed using the self-reported scale, ORTO-15. We used the Rosenberg’s Self-Esteem Scale and Cohen’s Perceived Stress Scale (PSS) to assess self-esteem and the level of perceived stress, respectively. Ninety-five medical students (75 [78.9%] females and 20 [21.1%] males) were included in the study. The mean age was 25.9 ± 3.3 years. A history of psychiatric disorders was reported by 17 (17.9%) of participants, 26 (27.4%) tried to control their weight, and 39 (41.1%) were physically active. We found a tendency for ON in 49 (51.6%) participants. The mean scores were 39.19 ± 4.48 for the ORTHO-15 scale, 29.74 ± 6.59 for the Self-Esteem Scale, and 21.25 ± 6.79 for the PSS. Orthorexia was significantly correlated with the use of weight control methods (P = 0.03), physical activity (P = 0.04), and history of psychiatric disorders (P = 0.04). Neither self-esteem (P = 0.1) nor the level of perceived stress (P = 0.5) was associated with ON. Our study found a high prevalence of orthorexic behaviors in medical students. No association was found between ON and self-esteem and perceived stress. Further clinical and longitudinal studies are needed to identify the risk factors of ON.