Celiac Disease: Neither a Food Allergy nor an Eating Disorder

I was surprised to discover the opinion piece, “Food Allergies are the New Eating Disorder,” published this week by the Huffington Post. The author of the article, Charlotte Hilton Andersen, reveals her past struggle with eating pathology and the ways she justified food avoidance. She goes on to state that a current trend in popular culture is to feign food allergies in order to avoid eating. She specifically identifies celiac disease as one of the allergies notoriously used to disguise disordered eating and sites the increasing prevalence of celiac disease as evidence of this claim.

The purpose of this post is to correct the misinformation about celiac disease contained within Ms. Andersen’s article, whether or not it is centrally related to the conclusions she has drawn. First, celiac disease is not a food allergy; it is an autoimmune disorder. This is an important distinction. Individuals with celiac disease do not experience anaphylactic shock the way some individuals with peanut allergies do. Instead, ingesting gluten causes an immune response, the target of which is the individual’s small intestine. The important distinction between allergies and autoimmune disorders like celiac disease is that there is no gradation of severity. No one with celiac disease can consume a little gluten and be ok. A little gluten causes the full autoimmune response.

Second, the alarming increase in the prevalence of celiac disease over the last 50 years is not a result of changing trends in methods to disguise eating pathology. The recent research on the growing rates of undiagnosed celiac disease was based on diagnostic blood tests, not self-reported allergies. The whole point of that study was that everyone was undiagnosed; no one even knew that they even had celiac disease, which means that it was not a guise for closeted eating pathology.

Third, and perhaps most important, if someone is avoiding food and provides allergies as the reason, it is usually best to take the person at their word. It is nearly impossible for a layperson to tell the difference between someone with celiac disease, an allergy, and an eating disorder. The one exception: if you are a close friend or relative of the individual, he or she has experienced extreme weight fluctuations or adverse health consequences as a result of dieting, you care about the person, and you are concerned for his or her health or well-being. Then, you may decide to express your concern and recommend that he or she discuss said allergies and diet with a physician, registered dietician, or mental health provider.

It is irresponsible to imply that everyone who claims to have food allergies should be suspected of having an eating disorder. Eating disorders are a significant mental health concern and should be addressed with compassion and understanding, not suspicion and rejection. In addition, I suspect that most people who claim to have food allergies do have genuine food allergies, and it is possible to have both celiac disease and an eating disorder.

Finally, adjusting to the gluten-free diet is hard enough without feeling like everyone suspects that you have an eating disorder. Celiac disease is a real autoimmune disorder, and it should be regarded as such.

For more information about eating disorders, please visit the Academy of Eating Disorders website.

For more information about the symptoms, diagnosis, and treatment of celiac disease, please visit our Resources page.

Photo credit: BartmanSA

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