Relationship between Exercise Addiction, Orthorexia Nervosa, and Sports Supplement Attitude in Turkish Fitness Participants


  • Caner Özgen Faculty of Sports Sciences, Eskişehir Technical University, Eskisehir, Turkey
  • Hüseyin Köse Faculty of Sports Sciences, Eskişehir Technical University, Eskisehir, Turkey
  • Servet Reyhan School of Physical Education and Sports, Siirt University, Siirt, Turkey



Exercise addiction, Orthorexia nervosa, Sports supplement attitude


Study Objectives: There is not enough evidence in the literature for a causal relationship between ON, which is generally expressed as an obsession with healthy eating, and EA, which is expressed as an individual's loss of control over exercise behavior. The aim of this research is to determine the causal relationships between ON, EA, and SSA (Sports Supplement Attitude) in individuals who do fitness. Method: Within the scope of the research, 204 people who are doing fitness were reached by convenience sampling method. The obtained data were analyzed within the scope of structural equation modeling. Results: As a result, of the analyzes of the hypotheses put forward within the scope of the structural model, it has been determined that EA is an important antecedent of ON within the scope of individuals doing fitness. While it has been empirically proven that SSA is an important precursor of EA, ON has no significant effect on SSA. Conclusion: The results revealed that ON behavior is not only related to maintaining a healthy lifestyle, but also has aesthetic concerns within the scope of individuals who do fitness. In addition, the significant positive effect of SSA on EA is an important evidence among the risks that affect the formation of EA behavior. Finally, the finding that ON has no significant effect on SSA has opened the door to new research that will point to the difference between ON and other eating disorders.


Download data is not yet available.


Almeida, C., Borba, V. V., & Santos, L. Orthorexia nervosa in a sample of Portuguese fitness participants. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 2018: 23(4), 443-451.

Brytek-Matera A, Rogoza R, Gramaglia C, & Zeppegno P. Predictors of orthorexic behaviours in patients with eating disorders: a preliminary study. BMC Psychiatry 2015: 15, 1–8.

Vandereycken W. Media hype, diagnostic fad or genuine disorder? Professionals’ opinions about night eating syndrome, orthorexia, muscle dysmorphia and emetophobia. Eat Disord. 2011: 19, 145–155.

Bratman, S. Health food junkie. Yoga J September. 1997: 42-50.

McComb, S. E., & Mills, J. S. Orthorexia nervosa: A review of psychosocial risk factors. Appetite, 2019: 140, 50-75.

Brytek-Matera, A., Fonte, M. L., Poggiogalle, E., Donini, L. M., & Cena, H. Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 2017: 22, 609-617.

Varga M, Thege BK, Dukay-Szabó S, Túry F, van Furth EF, Bratman S, et al. When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry. BioMed Central. 2014: 14-59.

Varga M, Dukay-Szabó S, Túry F, van Furth EF, van Furth Eric F. Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord. 2013: 18, 103–11.

Cena, H., Barthels, F., Cuzzolaro, M., Bratman, S., Brytek-Matera, A., Dunn, T., et al. Definition and diagnostic criteria for orthorexia nervosa: A narrative review of the literature. Eating and Weight Disorders. 2019: 24, 209-246.

Strahler, J., Hermann, A., Walter, B., & Stark, R. Orthorexia nervosa: A behavioral complex or psychological condition? Journal of Behavioral Addictions. 2018: 7, 1143–1156.

Hayles, O., Wu, M. S., De Nadai, A. S., & Storch, E. A. (). Orthorexia nervosa: An examination of the prevalence, correlates, and associated impairment in a university sample. Journal of Cognitive Psychotherapy. 2017: 31(1), 124–135.

Barnes, M. A., & Caltabiano, M. L. The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eating and Weight Disorders, 2017: 22, 177–184.

Parra-Fernandez, M.-L., Rodriguez-Cano, T., Onieva-Zafra, M.-D., Perez-Haro, M. J., Oberle, C. D., Fernandez-Martinez, E., et al. Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry, 2018: 18, 1–8.

Stutts, L. A. It's complicated: The relationship between orthorexia and weight/shape concerns, eating behaviors, and mood. Eating Behaviors. 2020: 39, 1-4.

Rudolph, S. The connection between exercise addiction and orthorexia nervosa in German fitness sports. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2018: 23(5), 581-586.

Zeulner B, Ziemainz H, Beyer C et al. Disordered eating and exercise dependence in endurance athletes. Adv Phys Educ. 2016: 6, 76–87.

Brytek-Matera A Orthorexia nervosa: an eating disorder, obsessive-compulsive disorder or disturbed eating habit? Arch Psychiatry Psychother. 2012: 1, 55–60

Barnes, M. A., & Caltabiano, M. L. The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eating and Weight Disorders. 2017: 22(1), 177–184.

Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med, 2004: 14, 25–32.

Oberle, C. D., Watkins, R. S., & Burkot, A. J. (2). Orthorexic eating behaviors related to exercise addiction and internal motivations in a sample of university students. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2018: 23(1), 67-74.

Köse, H., & Özgen, C. Fit or Nothing! University Students' Exercise Addiction, Eating Disorders and Mediator Effect of Sports Supplement Use. African Educational Research Journal. 2020: 8(2), 381-386.

Dell'Arte, S., & Lenzo, V. (2021). Personality, exercise addiction and orthorexia. A research contribution. Journal of Clinical & Developmental Psychology. 2021: 3(2), 63-83.

Aubrey J.S. Looking good versus feeling good: an investigation of media frames of health advice and their effects on women’s body-related self-perceptions. Sex Roles. 2010: 63, 50-63.

Leit, R.A., Pope, H.G. & Gray, J.J. Cultural expectations of muscularity in men: The evolution of Playgirl centerfolds. International Journal of Eating Disorders. 2001: 29, 90-93.

Lee J. & Macdonald D. “Are they just checking our obesity or what?” The healthism discourse and rural young women. Sport Education and Society, 2010: 15, 203-219.

Baekeland F. Exercise deprivation. Sleep and psychological reactions. Arch Gen Psychiatry. 1970: 22, 365–369.

Adams J., & Kirkby R. J. Excessive exercise as an addiction: A review. Addiction Research and Theory. 2002: 10(5), 415-437

Hausenblas H.A. & Downs, D.S. Exercise dependence: A systematic review. Psychology of Sport and Exercise. 2002: 3(2), 89-123.

Farrell PA, Gates WK, Maksud MG, Morgan WP. Increases in plasma beta-endorphine/betalipotropin immunoreactivity after treadmill running in humans. Journal of Applied Physiology. 1982: 52(5), 1245-1249.

Szabo A, Griffiths MD. Exercise addiction in British sport science students. Int J Ment Health Addict. 2007: 5, 25–28.

Lichtenstein MB, Jensen TT. Exercise addiction in CrossFit: prevalence and psychometric properties of the exercise addiction inventory. Addict Behav Rep. 2016: 3, 33–37.

Haman L, Lindgren E. C. & Prell H. “If it’s not Iron it’s Iron f*cking biggest Ironman”: personal trainers’ views on health norms, orthorexia and deviant behaviors. International Journal of Qualitative Studies on Health and Well-being. 2017: 12(2), 1-9.

Atalay D, Erge HS. Dietary supplements and their effects on health. Food Health. 2018: 4(2), 98‐111.

Selçuk, K. T., Çevik, C., Sarıoğlu, N., Bilen, Ç., Gencer, N., Kökçü, Ö. D., ... & Eser, E. (2020). Use of dietary supplements among nursing students in Turkey in the last 12 months and its relation with orthorexia nervosa. Perspectives in psychiatric care, 56(4), 885-893.

Petróczi, A., Naughton, D. P., Mazanov, J., Holloway, A., & Bingham, J. Limited agreement exists between rationale and practice in athletes' supplement use for maintenance of health: a retrospective study. Nutrition journal, 2007: 6(1), 1-8.

US Food and Drug Administration. Dietary Supplement Products & Ingredients.‐supplements/dietary‐ supplement‐products‐ingredients

NBJ. Supplement Business Report. 2021.

Hurst, P., Kavussanu, M., Boardley, I., & Ring, C. Sport supplement use predicts doping attitudes and likelihood via sport supplement beliefs. Journal of sports sciences. 2019: 37(15), 1734-1740.

Hyman, S. E., & Malenka, R. C. (2001). Addiction and the brain: the neurobiology of compulsion and its persistence. Nature reviews neuroscience, 2(10), 695-703.

Robinson, T. E., & Berridge, K. C. The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain research reviews, 1993: 18(3), 247-291.

Ntoumanis, N., Ng, J. Y., Barkoukis, V., & Backhouse, S. Personal and psychosocial predictors of doping use in physical activity settings: a meta-analysis. Sports medicine, 2014: 44(11), 1603-1624.

Yurdakul, H. Ö. The Relationship Between Exercise Addiction And Beliefs in Sports Nutritional Supplements. Turkish Journal of Sport and Exercise. 2020: 22(2), 338-343.

He, J., Ma, H., Barthels, F., & Fan, X. Psychometric properties of the Chinese version of the Düsseldorf Orthorexia Scale: Prevalence and demographic correlates of orthorexia nervosa among Chinese university students. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2019: 24(3), 453-463.

Ajzen, I. The theory of planned behavior. Organizational behavior and human decision processes. 1991: 50(2), 179-211.

Griffiths, M. D., Szabo, A., & Terry, A. The exercise addiction inventory: a quick and easy screening tool for health practitioners. British journal of sports medicine. 2005: 39(6), 30-39.

Terry, A., Szabo, A., & Griffiths, M. The exercise addiction inventory: A new brief screening tool. Addiction Research & Theory. 2004: 12(5), 489-499.

Byrne, B. M. Structural equation modeling with LISREL, PRELIS, and SIMPLIS: Basic concepts, applications, and programming. Psychology Press. 2013.

Malhotra, N. K., Peterson, M., & Uslay, C. Helping marketing research earn a seat at the table for decision‐making: An assessment and prescription for the future. European Business Review. 2006: 18(4), 294-306.

Nunnally, J.C. & Bernstein, I.H. Psychometric theory (3rd ed.). 1994: New York: McGraw-Hill.






Original articles