Food Allergies and Eating Disorders

With May dedicated to food allergy awareness, I wanted to take the opportunity to write about a more serious topic.

I’ve successfully managed and adapted to living with my multiple life threatening food allergies my entire life. The allergen list is long. There are some I’ve grown into, some I’ve grown out of, some I’ve tasted and know what I’m missing out on, but none of them are worth giving up on being me.

In life there are always waves, and sometimes you enter a rocky time but know there’s something good coming out of it. Unfortunately, I’ve had three separate occasions in the last two weeks where my allergies have come up in conversation and been met by the response of “if I were you I’d kill myself or die from starving.” It’s then usually followed by uncomfortable silence and a laugh. They continue to laugh while listing all the foods they couldn’t possibly survive a day without, while I sit there trying not to scream or get too defensive.

Mental health is a topic just gaining momentum, and the impact of food allergies is a conversation that has barely even started.

Previous research has shown that anxiety and eating disorders often co-occur in individuals. However, in food allergic individuals, the idea of anxiety leading to unhealthy eating habits has been overlooked. Individuals who have suffered from life threatening or anaphylactic reactions have so much anxiety towards eating, that it presents as an eating disorder. In reality, the individual’s unusual relationship with eating does not stem from the usual thoughts that correspond to an eating disorder, but from anxiety. If a food allergic individual were to be tested for symptoms of anxiety and eating disorders, then it would be concluded that their anxiety results in an avoidance of food without necessarily identifying the root cause of the avoidance.

Food allergies are affecting a rapidly increasing number of individuals around the world. Up to fifteen million individuals are estimated to have food allergies, including 1 in 13 children. In previous studies, a food allergy has been defined as a failure of the immune system to develop tolerance, or a breakdown of tolerance, to food proteins. The inability to break down food proteins can become evident as hypersensitivity responses occur.

Following a reaction, which may range from mild to life-threatening, some individuals suffer from this fear of allergenic exposure, which creates anxiety around eating any type of food. This anxiety could lead to individuals' development of aversions to eating anything, as they view any food as being a potential threat.

It has already been seen that individuals who have previously had a severe allergic reaction could become withdrawn and fearful, and display other symptoms of anxiety due to the allergen, as well as disordered eating.

Most research tends to focus on children, as food allergies started to become prevalent in those children born during the 1990s. People who have suffered from food allergies for their entire lives are just starting to enter adulthood, and very little research has been performed on the effects of their food allergies on them. Almost all research related to the quality of life, eating patterns, or anxiety and food allergies has to do with the effects on children with food allergies or their caretakers.

In a group of forty children with peanut allergies or diabetes, the children with the allergy reported higher levels of fear of an adverse event, more anxiety about eating, and more restrictions due to their illness.

While anxiety is acknowledged in food allergic individuals, there has not been any research done to tie anxiety to a person’s eating habits. Anxiety is likely what triggers eating disorders among food allergic people, rather than the typically manifested traits of unhappiness based upon physical appearance or the need to be in control of an aspect of their lives.

Currently, individuals with food allergies are often led to believe that they suffer from eating disorders, such as anorexia nervosa or orthorexia nervosa. They are receiving treatment for those eating disorders, but it is ineffective as their problem, in actuality, stems from anxiety due to their life threatening food allergies.

One previous study concluded that authors and researchers have not yet put forward a mechanism to conclude if a food allergic individual has an altered type of eating disorder that differs from the usual diagnoses. If it is found that food allergic people alter their eating patterns commonly, an understanding between food allergy, anxiety, and eating disorders might arise. This development would be useful for workers in both food allergy and eating disorder clinics.

Food allergic individuals come to terms with the fact that they must live with constant awareness, vigilance, and fear. Physicians often lack awareness of the psychological aspects of food allergies. There is often an interplay between the psychological and physical traits of a person, and a traumatic food event, such as an anaphylactic reaction or an initial diagnosis, which could lead to initial fear and anxiety.

Anxiety has been seen in food allergic individuals, but overlooked with respect to atypical eating habits. Medical professionals diagnose eating disorders, such as anorexia nervosa or orthorexia nervosa, but fail to notice the symptoms of anxiety playing a role.

Speaking with many food allergic individuals of all ages, it has become obvious that after an anaphylactic reaction, many people become terrified to eat anything. I believe this is a problem that needs to be addressed and many of these food allergic individuals diagnosed with eating disorders will be found to have been misdiagnosed, as their atypical eating habits stem from anxiety.