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Orthorexia, this grey area of the spectrum of relationships with food

July 12th, 2021 by Marilou Morin Dt.P., Certified Intuitive Eating Counselor, Founder of Manger en Harmonie

Well-being is a personal quest that punctuates the daily life of many and goes as far as defining their identity, their existence. Is it possible that the pursuit of well-being could, on the contrary and unbeknownst to the individuals, become unhealthy and negatively affect their overall health?

The pandemic has exacerbated the issues related to our relationship with food and with our body. Disruptions in daily life, loss of stress management strategies, decreased social interactions, isolation, increased effect of social networks and media, anxiety and the feeling of loss of control are all factors that have contributed to the development of excessive preoccupation with weight and diet.

Several health professionals report having observed an explosion in consultations related to eating disorders since the start of the pandemic, especially among young people. However, we will have to wait a little longer before we have more data and studies on the subject.

© Kolya Korzh, Unsplash

About one million people living in Canada meet the diagnostic criteria for an eating disorder (anorexia nervosa, bulimia, binge-eating, avoidant/restrictive food intake disorder, muscle dysmorphia). However, the data is inaccurate as many people suffering from their relationship to food do not receive a diagnosis or treatment.

Beyond the eating disorder itself, the quest for well-being can also lead a person to adopt behaviours that are socially encouraged and perceived as healthy, but which, in fact, negatively affect their physical, mental, social and emotional health, without these behaviours necessarily meeting the diagnostic criteria. The person thus finds themself somewhere in the shades of grey of the spectrum of the relation to food. The stakes are no less and deserve to be considered.

On one side of this spectrum is a healthy relationship with food. On the other hand, an eating disorder that meets diagnostic criteria. In between: a grey area that can be disabling and have an impact on the proper functioning of a person on a daily basis.

In this grey area is orthorexia, defined as “neurotic behaviour characterized by an obsession with healthy eating” according to the Office Québécois de la langue française. The term “orthorexia” first appeared in the early 2000s thanks to Dr. Steven Bratman (MD, MPH), but the concept is not recognized as an eating disorder according to the DSM-V, the fifth edition of the Diagnosis and Statistical Manual of Mental Disorders. Before exploring and better understanding this ambiguous area, it is important to define the extremes of the spectrum.

From healthy behaviour…

A person demonstrates a healthy relationship to food when they are able to observe with curiosity their body needs and to meet them according to their capacities and the circumstances of the moment. It’s about eating enough of the foods that please our taste buds and that do us good emotionally, psychologically and physically. In a relationship that is healthy, shame and guilt are usually absent, as well as the need for compensation or control. Self-compassion, respect, trust and kindness are the dominant feelings.

It is important to note that systemic issues unfortunately hamper the development of this healthy relationship for many. We just have to think about food insecurity, racism, an environment of grossophobia and the pervasiveness of diet culture. It is therefore not just an individual responsibility, but a collective one.

… to troubled

The opposite of a healthy relationship to food and your body comes in the form of an eating disorder; an all too frequent manifestation which is rather the symptom of a deep suffering. To find out if you are likely to develop an eating disorder, the ANEB organization (Anorexia and Bulimia Québec) offers a short questionnaire.

COMPLETE THE QUESTIONNAIRE

But when do good behaviours, such as exercising and eating a varied and balanced diet, become harmful to our physical and mental health? When the preoccupation with eating well or exercising takes up too much space and leads to distress, affecting our quality of life.

In today’s society, our health and weight (the two being closely related in popular belief) are presented as dependent on these behaviours and it is argued that the achievement of an ideal is only a matter of will. Christy Harrison, American nutritionist and author of the book Anti-Diet: Discover Intuitive Eating and Make Peace with Your Body, calls these phenomena the diet culture and the wellness diet. In other words: the normalization of a troubled relationship to food.

When adopting seemingly healthy behaviours is motivated by fear or a desire to gain weight, or when healthy eating becomes obsessive, one can afford to ask questions.

© Bianca Des Jardins

Statistics speak for themselves

  • 80% of Canadian women want to lose weight;
  • 67% think about their weight regularly;
  • 56% say they are worried about their weight and that it is a source of stress;
  • 28% find that managing their weight dominates their life;
  • In Québec, more than one in two young people is dissatisfied with their physical appearance.

And we’re only talking about cisgender women in these statistics. According to the organization ÉquiLibre, nearly one in five men are dissatisfied with their weight. Little data is available on non-binary and transgender people in Canada. Excessive preoccupation with weight and diet does not discriminate (although some groups, including those who have been socialized as women, are at greater risk) and has major impacts on physical and mental health. Age, gender identity, weight, height, neurodiversity, sexual orientation, skin colour, disability… Eating disorders can affect people with very different characteristics. It is also important to note that intersectionality, or the accumulation of different forms of discrimination experienced by an individual, can affect their experience.

Healthism

We live in a society where being in good health seems to be a moral obligation and where healthy people deserve more respect and resources than unhealthy ones. We congratulate their will, their tenacity, their dedication, but at what cost? The stress, guilt and shame of not being healthy enough are therefore all the more damaging.

© Bianca Des Jardins

Strategies to put in place

Finding harmony with your body and reframing your own relationship to food for your overall well-being is possible. We invite you now to explore and experience these five strategies.

  1. Go through your social media subscriptions: replace accounts that promote weight loss or make you feel bad about yourself with accounts that promote body diversity.
  2. Break up with the scale. Put it away, give it away or throw it away. Goodbye!
  3. Observe your tastes and food preferences in order to better satisfy your taste buds.
  4. Practice self-compassion: talk to yourself as one would talk to a close friend, with gentleness, empathy and kindness.
  5. Explore what your body allows you to do and try to be grateful for it.

Becoming aware of the biological, emotional and psychological needs of the human body and honouring them as much as possible, regardless of weight, by rejecting the rules, thoughts and beliefs that prevent us from connecting to them with curiosity and benevolence is not a linear learning. The road can be long and arduous, but the freedom that the journey brings is worth the effort.

Several organizations can support you if you have an eating disorder: ANEB, Maison L’Éclaircie and Arrimage Estrie. The team at Manger en Harmonie is also available to assist you in your efforts to find well-being in a healthy way.

Discover the resources

ANEB : Go to website

Maison l’Éclaircie : Go to website

Arrimage Estrie : Go to website

Manger en Harmonie : Go to website


EDAC-ATAC, EDFC, NEDIC, NIED, La Stratégie canadienne en matière de troubles de l’alimentation : 2019 à 2029, [En ligne], Novembre 2019, [https://nedic.ca/media/uploaded/Canadian_Eating_Disorders_Strategy_2019-2029_-_dps_-_FRE.pdf].
ÉquiLibre. Pour une image corporelle positive, [En ligne], 1991. [https://equilibre.ca/].
GORDON, Aubrey. « We Have to Stop Thinking of Being ‘Healthy’ as Being Morally Better », SELF, [En ligne], 7 août 2020, [https://www.self.com/story/healthism].
HARRISSON, Christy. « Intuitive eating coach & Anti-diet dietitian », 2017, [En ligne], [https://christyharrison.com/].
SHAH, M., SACHDEVA, M., et JOHNSTON, H. « Eating disorders in the age of COVID-19 », Psychiatry research, vol. 290, août 2020. doi :  https://doi.org/10.1016/j.psychres.2020.113122
SIMPSON, Sean. « Managing a Healthy Weight: Canadian Women Speak Out », Ipsos Reid, [En ligne], 11 février 2008, [https://www.ipsos.com/en-ca/managing-healthy-weight-canadian-women-speak-out].
STANWORTH-BELLEVILLE, Karah. « Mise sur ce que ton corps peut faire, pas sur ce qu’il a l’air! », ÉquiLibre, [En ligne], 22 novembre 2020, [https://equilibre.ca/mise-sur-ce-que-ton-corps-peut-faire-pas-sur-ce-quil-a-lair/].
TOUYZ, S., LACEY, H., et HAY, P. « Eating disorders in the time of COVID-19 », Journal of Eating Disorders, 20 avril 2020. doi : https://doi.org/10.1186/s40337-020-00295-3

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