Introducing ORTO-R: a revision of ORTO-15 : Based on the re-assessment of original data

Eat Weight Disord. 2021 Apr;26(3):887-895. doi: 10.1007/s40519-020-00924-5. Epub 2020 May 20.


Background: Orthorexia nervosa has attracted significant attention in the field, however, alongside increasing knowledge, more and more gaps are being identified. One of the fundamental problems concerns measurement of orthorexia nervosa. The most commonly used self-report measure, the ORTO-15, demonstrated an unstable factorial structure across different populations. Therefore, one might question whether the knowledge obtained from past research using ORTO-15 is valid or not. The aim of the present paper is to re-analyse original data used for the validation of ORTO-15 to assess its factorial structure and propose its revision, the ORTO-R.

Methods: The description of the sample and procedure corresponds to the one reported in Donini et al. (Eat Weight Disord 10:28-32, 2005). N = 525 subjects were enrolled. To evaluate whether the factorial structure of ORTO-15, we used confirmatory factor analysis. The results revealed that the ORTO-15 indeed does not capture the structure of orthorexia nervosa adequately and revision is needed. The ORTO-R contains six items from ORTO-15, which were identified as the best markers of orthorexia nervosa.

Discussion and conclusion: In the current paper, we present a refined measure of orthorexia nervosa-the ORTO-R. It is based on a frequently used ORTO-15, overcoming its main limitations. We strongly believe that the current work will act as a bridge, linking past with the future research, and that alongside a new measure, the field of research on orthorexia nervosa will move forward.

Level of evidence: Level V, descriptive study.

Keywords: Measurement; ORTO-15; ORTO-R; Orthorexia nervosa.

MeSH terms

  • Factor Analysis, Statistical
  • Feeding Behavior*
  • Feeding and Eating Disorders* / diagnosis
  • Health Behavior
  • Humans
  • Self Report
  • Surveys and Questionnaires