Table 2 Diagnostic criteria according to Barthels, Meyer and Pietrowsky [15] and the corresponding questions used in the interview to evaluate the displayed orthorexic eating behavior
| Â | Criterion | Interview questions |
|---|---|---|
A | Enduring and intensive preoccupation with healthy nutrition, healthy food and healthy eating | (1) How much time do you spend on an average day with your nutrition (including planning, purchasing, preparing, research etc.)? |
(2) Do you neglect your daily duties due to your preoccupation with your eating behavior? Or do you have difficulties concentrating on them? | ||
B | Pronounced anxieties about food as well as extensive avoidance of foods considered unhealthy according to subjective beliefs | (3) Are there any foods you are afraid of because you consider them to be really unhealthy? |
(4) Do you have any strategies that help you to avoid these foods? | ||
C(1) | At least two overvalued ideas concerning the effectiveness and potential health benefits of foods | (5) What do you think that your healthy nutrition does to your body? |
AND/OR | ||
C(2) | Ritualized preoccupation with buying, preparing and consuming foods, which is not due to culinary reasons but stems from overvalued ideas. Deviation or impossibility to adhere to nutrition rules causes intensive fears, which can be avoided by a rigid adherence to the rules | (6) Do you have established nutritional rules? |
(7) Do you have any rituals, e.g. regarding the preparation or the purchasing of your foods, which you use to make your food even healthier? | ||
D(1) | The fixation on healthy eating causes suffering or impairments of clinical relevance in social, occupational or other important areas of life and/or negatively affects children (e. g. feeding children in an age-inappropriate way) | (8) Has your diet ever led to problems or arguments with friends/family? |
(9) To what extent do you feel affected by your diet? | ||
AND/OR | Â | |
D(2) | Deficiency syndrome due to disordered eating behavior. Insight into the illness is not necessary, in some cases the lack of insight might be an indicator for the severity of the disorder | (10) Have you ever been diagnosed with nutrient deficiencies, malnutrition or obesity? |
E | Intended weight loss and underweight may be present, but worries about weight and shape do not dominate the syndrome | What is the primary purpose of your diet? (promote health, prevent illness, reduce weight)* |