Purpose: Orthorexia nervosa (ON) has garnered increasing attention in the literature as a relatively new eating disorder characterized by an excessive preoccupation with healthy eating, which can result in malnutrition and other health problems. While studies have established a link between body image and ON, the role of social physique anxiety (SPA) as a mediator in this relationship remains unclear. The present study aimed to address this gap by examining the mediating role of SPA in the relationship between body image and ON in women. Material and Methods: A total of 647 women aged 18 to 65 years were recruited from a Province in the Mediterranean Region of Turkey. The causal steps approach (Baron and Kenny method) was used in the statistical evaluation of the mediation model and the realization of the steps testing the mediation model was evaluated. The hypothesized mediation model was tested with the PROCESS macro for SPSS models in Model 4 using a bootstrapping approach to assess the significance of indirect effects. Results: After controlling for the effects of age, education, marital status, employment status, body mass index (BMI), and weight perception for consistency with BMI, the results of regression analyses supported the mediating effect of SPA on the relationship between body image and ON. Conclusion: It follows from these findings that the inclusion of strategies aimed at reducing negative body image perception and SPA may contribute to improved prevention efforts aimed at reducing ON among Turkish women.