The Impact of Nutrition Education, Strength Training, and Body Image Perception on Orthorexia Nervosa Risk: A Cross-Sectional Study in Women.

Background: The increasing focus on healthy eating and achieving an ideal physique can lead to the development of disordered eating patterns, including orthorexia nervosa. The relationship between body image perception, self-esteem, and the risk of orthorexia nervosa is multifaceted, with negative body image and low self-esteem often acting as contributing factors. This study aimed to assess the risk of orthorexia nervosa and analyze body image perception among women engaged in strength training and dietetics students.

Methods: The study was conducted using a Computer-Assisted Web Interview with 190 women aged 18 and older, divided into four groups: dietetics students engaged in strength training, dietetics students not engaged in strength training, non-dietetics women engaged in strength training, and non-dietetics women not engaged in strength training. The study utilized the Düsseldorf Orthorexia Scale to assess the risk of orthorexia nervosa and the Body-Esteem Scale to evaluate body image perception.

Results: The highest orthorexia nervosa risk was observed in dietetics students who do not engage in a strength training group (60.9%), followed by dietetics students who engage in a strength training group (37.5%). In contrast, women who are not studying dietetics and do not engage in a strength training group exhibited the lowest orthorexia nervosa risk (13%), emphasizing the protective role of physical activity and reduced focus on nutritional rigidity. Regression analysis revealed that low appearance self-esteem ( = 0.011) and high social attribution ( = 0.043) significantly predicted higher orthorexia nervosa risk. Group affiliation also influenced orthorexia nervosa risk, with dietetics students showing higher Düsseldorf Orthorexia Scale scores. However, weight-related self-esteem ( = 0.082) did not significantly impact orthorexia nervosa scores.

Conclusions: Dietetics education and physical activity independently and collectively affect orthorexia nervosa risk. Students in dietetics, particularly those not engaged in strength training, are at a higher risk due to the dual influence of academic pressures and heightened nutritional awareness. The findings underscore the need for interventions targeting body image perception, promoting flexible dietary approaches, and addressing external validation pressures to mitigate orthorexia nervosa risk in high-risk groups.