Orthorexia and weight bias have been reported as high as 70% in nutrition students. Adverse Childhood Experiences (ACEs) have been linked with conditions such as eating disorders, but there is little understanding of their relationship with orthorexia and weight bias.
To explore relationships between orthorexia, ACEs, and weight bias in college nutrition students.
Study Design, Setting, Participants
Undergraduate and graduate students enrolled in a nutrition program in twelve mid-southeast states in the US were recruited to participate in an anonymous online survey.
The ORTO-R was used to measure orthorexia tendencies, ACE questionnaire for adults to measure ACEs, and the Weight Attitude Implicit Association Test to measure weight bias. Survey data was analyzed using descriptive statistics, t-tests, and chi-squared tests via Stata15 software, with a significance level of P < 0.05.
Of the 164 students who completed the survey, 92% were female, 82% were White, and 54% were found to have a moderate/strong weight bias. Around 50% identified as being from a dysfunctional family, and more than 43% experienced emotional abuse. Orthorexia tendencies (measured by each of the 6 items on the ORTO-R scale) were associated with several ACEs such as domestic abuse (P = 0.02), divorce (P = 0.03) and incarceration (P = 0.04). For weight bias, sexual abuse was the only ACE that had a statistically significant relationship (P = 0.01). No significant relationships were found between orthorexia tendencies and weight bias.
Weight bias and orthorexia remain issues for the nutrition profession, and ACEs may be an important contributor to addressing these issues. Further research is needed to explore this relationship with diverse and larger populations. Changes in the nutrition curriculum such as the inclusion of "Health at Every Size" and activities that dispel weight-based stereotypes are needed to bring awareness and prevent bias and orthorexia among nutrition students.