Background: Patients with Inflammatory Bowel Disease (IBD) believe that diet is a key factor in the pathogenesis of their disease and in worsening their symptoms; they often follow restrictive diets that can lead to malnutrition, anxiety, and stress. Recent studies have found an association between eating disorders and IBD, particularly anorexia nervosa and ARFID (Avoidant Restrictive Food Intake Disorder). None of these studies report the association with orthorexia nervosa, that is the obsession with healthy and natural foods. Aim: to assess the risk of orthorexia nervosa in patients with IBD. Methods: 158 consecutive subjects were recruited, including 113 patients diagnosed with IBD and 45 controls. The Donini standardized questionnaire ORTO-15 was administered to assess the risk of orthorexia; clinical and demographic data were also collected. Results: patients with IBD have a prevalence of orthorexia of 77%, significantly higher than the 47% observed in the control group. In patients with IBD, the risk of orthorexia is associated with lower BMI and history of previous surgery. Conclusion: Many patients with IBD develop orthorexia nervosa that impacts the patient's psychological and social sphere, exposes them to a high risk of nutritional deficiencies, and affects quality of life. Further high quality studies are warranted to evaluate the clinical impact of orthorexia and its correlation with clinical features and frank eating disorders.

Evidence points to a link between gluten-free diet or celiac disease and eating disorders, but not with orthorexia. This study is the first to examine adults with celiac disease in terms of the prevalence of risk of orthorexia. The study included 130 adults diagnosed with celiac disease. The standardized ORTHO-15 questionnaire was used to assess the risk of orthorexia. Cronbach's alpha test was used to determine the reliability of the ORTHO-15 questionnaire. Eating habits of the subjects were assessed using a questionnaire. The effect of celiac disease on diet was assessed on a 5-point scale. A risk of orthorexia was found in 69% of subjects with celiac disease. A statistically significant (p<0.005) positive correlation was observed between age and ORTHO-15 test scores (rho=0.37). In the group with orthorexia risk, meals were more often self-prepared (93.3%) compared to those without orthorexia (80%) (p=0.023). For 80% of those at risk for orthorexia versus 20% without risk, mood was a factor influencing dietary choices (p=0.001). The study observed a strong association between celiac disease and the presence of orthorexia risk. The numerous risk factors for orthorexia suggest the need for holistic care, including nutritional and psychological support among individuals with celiac disease.

Mindful Eating (ME) is an increasingly popular dietary practice that may mediate the sympto-matology of Eating Disorders (EDs). Orthorexia Nervosa (ON) is a recently proposed eating dis-order characterized by excessive concern for healthy eating and calorie control. The purpose of this study is to investigate the relationship between ME and Psychological Distress (PD) with EDs and ON. In a cross-sectional study involving 407 adults, this research explored the interplay between ME, PD, and EDs, notably ON. Utilizing validated scales for ME (MES-16), EDs (EDE-QS), ON (ORTO-R), and PD, subcategorized in depression, anxiety, and stress (DASS-21), alongside inquiries into Instagram usage, significant correlations emerged. ME demonstrated a robust negative asso-ciation with both EDE-QS (r=-0.501, p<0.001) and ORTO-R (r=-0.519, p<0.001), while EDE-Q and ORTO-R showed significant correlations with depression, anxiety, and stress (p<0.001). Variations in ORTO-R mean scores were notably distinct across different ME categories (p<0.001), emphasizing the relationship between ME and ON. Additionally, participants with extensive daily Instagram use displayed significantly higher ON scores compared to minimal users (p<0.05). These findings sug-gest a negative link between ME with EDs and ON, highlighting ME's potential role in reducing ON tendencies. Furthermore, Instagram use seems associated with PD and elevated ON levels.