The relationship between food allergies and eating disorders is complex and is a growing topic of interest for research. Not everyone who has food allergies, intolerances, or sensitivities has an eating disorder. While comorbid food allergies and eating disorders can and do occur, an illegitimate, self-proclaimed food allergy can serve as a cover for a disordered relationship with food.
by: Enchi Dai
Eating disorders are among the deadliest mental health disorders and affect people of all genders, classes, ages, races, and sizes. Today, we are going to talk about food allergies and eating disorders, focusing on the difficulty in having food allergies in eating disorder recovery and how to navigate food sensitivities in treatment.
Food Allergies/Intolerances in Eating Disorder Recovery
Food allergies are common. According to health organization Food Allergy Research & Education (FARE), food allergies affect approximately 15 million people in the United States. Research has also found that approximately 20 percent of the general population reported having a negative reaction to one or more foods (Teufel, 2007).
You may be wondering, “What do eating disorders have to do with food allergies?”
Food allergies may trigger eating disorder behaviors and obstruct eating disorder recovery. Below are some common examples of the negative impact that food allergies can have on the recovery process.
First of all, food allergies can significantly impair one’s quality of life and lead to higher levels of anxiety and fear toward certain foods or food groups. Anxiety interacts negatively with eating disorders and is often a barrier to recovery.
Secondly, the disordered eating patterns prompted by self-diagnosed food allergies may trigger the onset of eating disorders. A common concern for individuals who must avoid certain food groups due to allergies is inadequate calorie consumption, leading to a restrictive diet pattern. Additionally, individuals with food allergies may also avoid eating in public, leading to isolation, a common indicator of disordered eating.
Thirdly and most importantly, while it is entirely possible to have a co-existing eating disorder and food allergy or intolerance, it is also common for individuals with eating disorders to have self-reported or improperly diagnosed allergies or intolerances (Bearden, n.d.). In this case, food allergies serve as a way to justify extreme food behaviors and restriction of whole food groups, like dairy. One of the red flags is reporting allergies to uncommon allergens, like chocolate, or other foods they do not want to consume because they’re considered “bad foods.” Terr (1986) conducted a research study with six individuals who had a long history of multiple food allergies with subjective but not typical allergy symptoms. He found that in these cases, longstanding abnormal eating behaviors and weight problems preceded the diagnosis of the reported “food allergies” when weight reduction diets were not effective. As a result, in any patient with a history of “food allergies” toward unusual foods, allergy tests need to be conducted carefully and the underlying disordered eating needs to be thoroughly investigated.
Is it Possible to Navigate Food Allergies in Recovery?
To navigate food allergies in eating disorder recovery, one should first consult with an allergist who is also aware of the eating disorder in order to decide whether the self-reported food allergies are legitimate. If food allergies do exist, it is imperative for patients to have a dietitian who can offer appropriate meal planning and support to ensure adequate food intake, avoid malnutrition, and monitor disordered eating patterns. If food allergies are not legitimate, one needs to focus on nutrient intake stabilization and recognize that negative food responses, such as adverse gastrointestinal (GI) effects, are a physical response to a psychological stressor, not a result of the specific foods they eat. Instead, what is really happening is that the food issues are more closely related to their disordered food patterns, creating physical discomfort, and then specific foods are incorrectly ‘blamed’ for those issues.
With the support of eating disorder treatment and allergy professionals educating and building trust with individuals suffering from food allergies and eating disorders, they have the potential to remove an additional barrier to developing a healthy relationship with food.
Looking for eating disorder treatment programs or services in the New York City area? Learn more about our options at BALANCE eating disorder treatment center here or contact us here.
This post was written by BALANCE Blog Intern, Enchi Dai.
Enchi is a Bachelor’s-Master’s student at New York University, majoring in Psychology. After her recovery from disordered eating, Enchi became passionate about spreading ED awareness, advocating for intuitive eating, and promoting Health at Every Size. Enchi is also an ACE Certified Personal Trainer and Registered Yoga Teacher (RYT 200). Her goal is to help people become healthier both physically and mentally, instead of encouraging them to pursue a certain body image. Along with her internship at BALANCE, Enchi works as a Research Assistant and Crisis Counselor to prepare herself for the future career as a Clinical/Counseling Psychologist.
References
Terr, A. I. (1986). Food allergy: A manifestation of eating disorder? International Journal of Eating Disorders, 5(3), 575–579. https://doi.org/10.1002/1098-108X(198603)5:3<575::AID-EAT2260050315>3.0.CO;2-1
Teufel, M., Biedermann, T., Rapps, N., Hausteiner, C., Henningsen, P., Enck, P., & Zipfel, S. (2007). Psychological burden of food allergy. World Journal of Gastroenterology : WJG, 13(25), 3456–3465. https://doi.org/10.3748/wjg.v13.i25.3456
When Food Allergies & Eating Disorders Collide: A Resource for Health Professionals – Managing Peanut Allergies. (n.d.). Retrieved July 30, 2020, from https://peanutallergyfacts.org/2018/03/15/when-food-allergies-eating-disorders-collide-a-resource-for-health-professionals/
