Category: Eating Disorders

PS12- #A20 - The Orthorexia Nervosa Scale: Updated and Revised

Saturday, Nov 18
1:30 PM – 2:30 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Eating | Eating Disorders | Health Anxiety

In 2000, physician Steven Bratman coined the term Orthorexia Nervosa (ON) based on his observations that some individuals were so obsessive about healthy eating that it reached a pathological level (Bratman & Knight, 2000). He conceptualized ON as a way to describe an obsession about proper nutrition and a “fixation” on healthy eating (Bratman & Knight, 2000). Over the past 17 years, the research conducted on ON has been unexceptional and has often used methodological approaches that are unsuitable. An article as recently published as 2016 that examined the prevalence of ON among college students based its results on flawed methodology (Bundros, Clifford, Silliman, & Morris, 2016). Currently, very little is known about ON, as evidenced by lack of a formal operational definition or standard diagnostic criteria. Although, there are three existing scales that measure ON (Bratman & Knight, 2000; Donini, 2007; Gleaves et al., 2013), none of them appear adequate to capture all of the facets of ON.  This study details the development of a psychometrically valid and reliable scale, the Orthorexia Nervosa Scale (ONS) that more accurately and fully captures the construct of ON.


Initial analyses (exploratory factor analysis and confirmatory factor analysis) of a 103 item pool indicated a 10-factor solution with an adequate model fit once model modifications were made (Kramer, 2016). This led to the current study, in which the items were examined and adjustments were made (e.g. removing and revising items). An EFA and CFA were conducted (n=537 and n=465, respectively), and revealed a 6-factor structure that explained 59.2% of the variance. Additionally, the CFA revealed a good model fit, X2(650) = 1531.115, p < 0.01, CFI = 0.903, SRMR = 0.07. The 6 dimensions assessed by the 6 factors were: 1) Social Concerns, 2) Knowledge/Superiority, 3) Fulfillment/Control, 4) Pureness/Natural Quality of Food, 5) Detox, and 6) Online Forums/Blogs as social outlet. The current study provides strong evidence for the validity and reliability of the ONS, and suggests that the ONS may be a useful tool for future research and clinical work related to ON.

Melanie E. Kramer

Doctoral Student
Colorado State University
Fort Collins, Colorado

Bradley T. Conner

Associate Professor
Colorado State University
Fort Collins, Colorado

Kathryn Rickard

Colorado State University