Orthorexia Nervosa: Validation of the Teruel Orthorexia Scale and Relationship to Health Anxiety

Abstract

The instruments most commonly used to assess orthorexia in the extant literature have been shown to have significant psychometric limitations. A promising new measure of orthorexia called the Teruel Orthorexia Scale (TOS) was published in 2018 (Barrada & Roncero). This study was the first to investigate the psychometric properties of the English version of the TOS, which was originally administered in Spanish. Although results of confirmatory factor analyses did not yield the hypothesized two-factor structure found in the TOS development study, exploratory factor analyses provided support for a 15-item, two-factor model. Correlations between the TOS subscales and measures of disordered eating, obsessive-compulsive disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS. This study also examined the long-hypothesized relationship between orthorexia and health anxiety. There was a moderate positive correlation between the Orthorexia Nervosa subscale of the TOS and the Short Health Anxiety Inventory (SHAI). Implications of these findings and proposed directions for future research are discussed. Overall, this research suggests that the TOS demonstrates psychometric properties arguably superior to those of the measures most commonly used to assess the construct. In addition, findings support the consideration of health anxiety as a possible predictor of orthorexia.