ArticleEating and weight disorders : EWD2021
Orthorexic tendencies moderate the relationship between semi-vegetarianism and depressive symptoms.
Article in Eating and weight disorders : EWD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- The Associations Between Vegetarian and Vegan Diets and Orthorexia Nervosa Symptoms in Adults: A Systematic Review and Meta-Analysis.The International journal of eating disorders · 2026Pooled it
- Pooled it
- Disordered eating and the meat-avoidance spectrum: a systematic review and clinical implications.Eating and weight disorders : EWD · 2022Pooled it
- Systemic lupus erythematosus is associated with an increased risk for orthorexia nervosa: a cross-sectional study.Rheumatology international · 2026Article
- Vegetarianísh-How "Flexitarian" Eating Patterns Are Defined and Their Role in Global Food-Based Dietary Guidance.Nutrients · 2025Review
- Vegan and vegetarian males and females have higher orthorexic traits than omnivores, and are motivated in their food choice by factors including ethics and weight control.Nutrition and health · 2025Article
- Orthorexia nervosa is a concern in gastroenterology: A scoping review.Neurogastroenterology and motility · 2022Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
purposeVegetarianism and semi-vegetarianism (i.e., overly vegetarian diet with rare consumption of meat) have been repeatedly linked with depression. As the nature of this association is unclear, we explored whether orthorexic (i.e., pathologically healthful eating) tendencies and ecological/ethical motives to follow a vegetarian diet may moderate the relationship between (semi-)vegetarian diets and depressive symptoms.
methodsFive-hundred eleven adults (63.4% females; 71.2% omnivores, 19.2% semi-vegetarians, 9.6% vegetarians) completed the Patient Health Questionnaire (PHQ-9) questionnaire-measuring depressive symptoms-and the Düsseldorf Orthorexia Scale (DOS)-measuring orthorexic tendencies. Based on respective questions, participants were categorized as omnivores, semi-vegetarians, and vegetarians (including vegans) and were asked to indicate whether they chose their diet based on ecological/ethical motives. Moderation analyses were carried out with PROCESS.
resultsAdjusted for age, sex, and body mass index, there was a statistically significant interaction effect between diet (omnivore vs. semi-vegetarianism vs. vegetarianism) and DOS scores when predicting PHQ depression scores. At low or medium DOS scores, diets did not differ in PHQ depression scores (all ps > 0.05). At high DOS scores, however, semi-vegetarians had higher PHQ depression scores than both omnivores (p = 0.002) and vegetarians (p < 0.001). The interaction between diet and ecological/ethical eating motives when predicting PHQ depression scores was not statistically significant (p = 0.41).
conclusionSemi-vegetarians with strong orthorexic tendencies show more depressive symptoms than omnivores and vegetarians. The complex nature of the relationship between vegetarianism and depression requires further investigation. LEVEL OF EVIDENCE: III, case-control analytic studies.
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