Coronavirus Anxiety Associated With Heightened Orthorexia Nervosa Symptoms and Reduced Cognitive Flexibility

Abstract

Evidence suggests that eating behaviors changed during the COVID-19 pandemic due to fear of the virus. Within this context we sought to examine the relationship between disordered eating and coronavirus anxiety, which is debilitating anxiety about becoming ill and dying from the COVID-19 virus. We focused on orthorexia nervosa because it is an eating disorder that is characterized by an obsession with clean and healthy eating, and healthy eating is essential for healthy living. Community adults (N = 324) completed questionnaires on coronavirus anxiety (Coronavirus Anxiety Scale), orthorexia nervosa symptoms (Eating Habits Questionnaire), and cognitive flexibility (Cognitive Flexibility Inventory). Our primary hypothesis was that individuals who experienced high levels of coronavirus anxiety would also report enhanced symptoms of orthorexia nervosa. Additionally, we explored whether cognitive flexibility would mediate the relation between orthorexia nervosa and coronavirus anxiety as reduced cognitive flexibility is implicated in disordered eating. Our data supported our primary hypothesis; coronavirus anxiety was associated with enhanced symptoms of orthorexia nervosa. Individuals with high levels of coronavirus anxiety also reported high levels of orthorexia nervosa symptoms. Further, mediation regression analyses revealed cognitive flexibility partially mediated the relationship between coronavirus anxiety and problems associated with healthy eating, a key symptom of orthorexia nervosa. Individuals with higher levels of cognitive flexibility were less likely to report problems with healthy eating even if they had high levels of coronavirus anxiety. Our work suggests that coronavirus anxiety may have enhanced symptoms of orthorexia nervosa through reduced flexibility in appraising everyday challenges during the COVID-19 pandemic.