Associations Between Social Appearance Anxiety, Disordered Eating Attitudes, and Orthorexia Nervosa: A Cross-Sectional Study.

OBJECTIVE: Disordered eating attitudes and orthorexia nervosa (ON) represent important public health concerns. Social appearance anxiety may constitute a key psychological factor underlying these patterns. This study aimed to examine social appearance anxiety as associated with disordered eating attitudes and ON in a large adult sample. METHOD: This cross-sectional study was conducted using an online questionnaire. A total of 827 adults (614 female [74.2%] and 213 male [25.8%]) were included in this study, with a mean age of 30.1 ± 7.6 years. Data were collected using the Eating Attitudes Test-26 (EAT-26), the Orthorexia Nervosa Inventory (ONI), and the Social Appearance Anxiety Scale (SAAS). Group comparisons were performed using independent samples t-tests and one-way analysis of variance, and linear regression analyses were conducted to assess the predictive role of social appearance anxiety. RESULTS: Social appearance anxiety scores were significantly higher among females, single individuals, and participants with lower physical activity levels (p < 0.05). Participants at risk for disordered eating and those with higher ON tendencies exhibited significantly elevated SAAS scores (p < 0.01). Linear regression analyses indicated that social appearance anxiety was independently associated with both disordered eating attitudes and orthorexia nervosa after adjustment for sociodemographic variables (p < 0.001). DISCUSSION: Social appearance anxiety appears to be a significant psychological factor associated with both disordered eating attitudes and ON. These findings underscore the importance of addressing appearance-related concerns in the prevention and management of maladaptive eating behaviors.