ORTO-Measured Orthorexia Nervosa-Related Tendencies Among Dancers Before and During the COVID-19 Pandemic: A Multivariate Analysis.

Publication date: Aug 01, 2026

This study aimed to examine the changes in orthorexia nervosa (ON) tendencies among dancers at different levels before and during the COVID-19 pandemic. This retrospective repeated-measures observational study included 128 professional, semi-professional, and amateur dancers (86 females, 42 males; 19-40 years) from various dance styles. Orthorexia nervosa tendencies before and during COVID-19 were assessed using ORTO-11 and ORTO-15. Physical activity and anthropometric data were collected for both recalled pre-pandemic and pandemic periods, while energy and macronutrient intakes were assessed using a retrospective 24-h dietary recall. Data were analyzed using paired tests, effect sizes (ES), and multivariate linear regression. During the pandemic, dancers reported approximately 50% lower weekly dance frequency and daily dance duration than recalled pre-pandemic values, with large and significant effect sizes. Significant decreases were observed in ORTO-11 and ORTO-15 scores, indicating an increase in orthorexic tendencies. Pandemic-period self-reported body weight was higher than pre-pandemic body weight, whereas BMI did not differ significantly between the recalled pre-pandemic and pandemic-period assessments. In multivariate analyses, female sex remained an independent predictor for both ORTO-11 and ORTO-15 scores. Compared with recalled pre-pandemic scores, pandemic-period ORTO-11 and ORTO-15 scores were lower, suggesting higher ORTO-measured health-oriented eating tendencies among dancers. Given the retrospective self-report design and the methodological limitations of ORTO-based instruments, these findings should not be interpreted as evidence of clinical ON prevalence or precise longitudinal change. Nevertheless, these ORTO-measured tendencies appeared to differ not only behaviorally but also in relation to nutrient intake patterns. Female sex was associated with pandemic-period ORTO scores, but this finding should be interpreted cautiously because psychological, sociocultural, and clinical variables were not assessed.

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Original Article