Social Media Addiction and Orthorexia Nervosa Tendencies in Turkish Adults: A Cross-Sectional Study of BMI and Lifestyle Factors.

This cross-sectional study examined whether addictive-like social media use, operationalized as generalized symptom-like engagement captured by the Bergen Social Media Addiction Scale (BSMAS) rather than content-specific exposure, is associated with orthorexia nervosa tendency in Turkish adults, and whether these associations persist after adjustment for BMI and lifestyle factors. Complete-case data on n = 258 adults (age ≥ 18 years) were analyzed using validated Turkish versions of the BSMAS and the Orthorexia Nervosa Inventory (ONI). Group differences were tested using Welch's procedures with Holm-adjusted post hoc comparisons; associations were examined using Pearson correlations and HC3-robust multiple regression controlling for gender, age, education, physical activity frequency, smoking, alcohol use, and BMI. The mean age was 23.96 ± 9.36 years, and the mean BMI was 23.46 ± 4.09 kg·m-2. Men reported higher ONI total (g = 0.45) and higher BMI (g = 0.72) than women, whereas BSMAS did not differ by gender (g = 0.05). ONI total differed across BMI categories, with lower scores in the underweight category than in the overweight and obesity categories (Holm-adjusted p < 0.05). BMI showed a small positive correlation with ONI total (r = 0.136), and age was weakly negatively correlated with BSMAS (r = -0.172). BSMAS showed small correlations with ONI Impairments and ONI Emotions (r = 0.139-0.148). The bivariate association between BSMAS and ONI total was small and non-significant (r = 0.092). BSMAS was not an independent predictor of ONI total in the covariate-adjusted HC3 regression (B = 0.246, p = 0.141; adjusted R2 = 0.059). In this sample of Turkish adults, orthorexia nervosa tendency was associated with gender and BMI strata. In contrast, generalized addictive-like social media use showed no independent association with overall orthorexia after covariate adjustment. The absence of an independent BSMAS-ONI association should not be interpreted as evidence that social media is unrelated to orthorexia; rather, a generalized addiction-like measure may be insufficient to capture content- and platform-specific digital pathways. Future research should incorporate content-specific exposure and longitudinal designs to clarify mechanisms.