Adverse childhood experiences and profiles of healthy orthorexia versus orthorexia nervosa: towards an explanatory model of orthorexia as a multidimensional eating style.

Background: Orthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours.

Objectives: This study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association.

Methods: A representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale.

Results: Cluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed.

Conclusions: Our study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.