Parental eating attitudes and adolescent eating disorder severity: preliminary findings on orthorexic tendencies

Introduction: Eating disorders (EDs) often emerge in adolescence and are influenced by family factors. Parental eating attitudes, including orthorexic tendencies, may be associated with adolescent ED severity. We examined parental orthorexic tendencies, cognitive rigidity, and nutritional knowledge in relation to adolescents' ED symptoms. Methods: The sample comprised 59 adolescents (93.2% female; mean age = 18.34 ± 3.78 years) and their parents (36 dyads; 23 single parents). Parents completed measures of orthorexia (ORTO-R), cognitive rigidity (D-FLEX), and an ad hoc nutritional knowledge questionnaire; adolescents completed the EDE-Q. Analyses were conducted in the full sample and repeated in anorexia nervosa (AN). Results: In the full sample, higher maternal ORTO-R scores were associated with greater EDE-Q restraint (β = 0.29, p = 0.042) and shape concern (β = 0.31, p = 0.030). In fathers, older age was associated with adolescents' shape (β = 0.32, p = 0.037) and weight concerns (β = 0.36, p = 0.018), whereas paternal ORTO-R was not significant. Mothers showed higher nutritional knowledge than fathers (U = 821.0, p = 0.013). No parent-child concordance emerged for BMI or eating psychopathology. Associations were no longer significant in AN-only analyses. Conclusion: Parental orthorexic tendencies showed small associations with adolescent ED severity in the full sample, with limited robustness in AN. Findings are preliminary and warrant replication in larger diagnostically stratified cohorts. Level of evidence: Level III, observational analytic study; cross-sectional design.