Saturday, May 28, 2011

Is it safe to go allergen free?

There's a new slew of "all in your head" diagnosis coming out.  First up, doctors have supposedly identified an eating disorder known as orthorexia.  Essentially, sufferers believe that certain foods are pure evil and begin to restrict their diet to the point that it is unhealthy and dangerous.
Next up is a spin-off of anorexia.  People with eating disorders begin to blame gluten or other food allergies as the reason that they can't eat what is put before them, or offered at parties, or why they aren't eating at social functions. 

"Whether confirmed as celiac disease through blood tests or self-diagnosed as intolerance...the condition requires treatment by way of a highly restrictive diet. ... it also requires monitoring trace elements of protein present in foods or its preparation becomes necessary lest upset stomachs, painful GI tracts or other debilitating symptoms strike." (emphasis mine)

In the article I site above, this paragraph disturbs me even more than this upsetting practice.  Because it indicates that even if one has a documented, medically rational reason for complete and total avoidance...the worst that can happen is a stomach ache (the word debilitating is in there, but I doubt most people really comprehend how debilitating physical GI symptoms can feel)  The truth is that with the (albeit relatively rare) true IgE food allergies, which are NOT limited to the top 8, even a small crumb can cause anaphylaxis.  If a peanut falls on the salad, and the cook immediately fishes it out and sends the salad out to a nut allergic individual, their throat can swell shut before the rest of the party is done commenting on how delicious the first course looks.
If someone with celiac accepts a plate with toast on it, and simply removes the toast and brushes off the crumbs...not only will they suffer from debilitating stomach issues for a few days, their intestines will sustain physical damage that can be viewed and verified by endoscopy.  This damage leads to malnutrition, along with a host of other related problems and, worst case scenario, even cancer.
I don't doubt that there are some people who are afraid of food for unhealthy reasons.  Nor do I doubt that there are people with unhealthy obsessions about food, or avoiding too many foods.  But is the best way to address that fear to label restrictive eating as a psychiatric disorder?  Or is it to do more research?
I firmly believe that most people seeking a restrictive diet are motivated by physical symptoms.  Maybe they have an intolerance or allergy.  Maybe their bodies are just fed up with soda and fried foods.  Maybe they just need a little help balancing nutrition.  Regardless, identifying the motivation should be the first step.  And then rule out causes.
And if an individual is adament about avoiding foods, then it seems likely that they may not need to reintroduce those foods.  Instead, therapy or medical support should focus on identifying what one *can* eat.  And instituting a balanced diet.  So many people these days do not know how to cook, or find vegetables...or what to do with them when they do, that if they decide to give up gluten and nightshades they feel like they're stuck with white rice and carrots.  There are a host of little known veggies out there...and others that are just scary looking.
Maybe the orthorexic would be more adventurous if they learned how to prepare and eat an artichoke, a salad, their own dressing or sauces.  Those with anorexia and other eating disorders obviously do need counseling toward reaching a healthy body image.  But it might be easier if any digestive problems (like bloating, which can make a teenager feel inexplicably "fat") were addressed at the same time. 
At any rate, when someone has a valid reason for total avoidance, their choices need to be respected.  And they will be less likely to obsess over their food choices if they weren't concerned with mental health labels.  At least in the long run.  It seems reasonable and healthy to me for someone newly diagnosed to spend a little time obsessing about food, since they quite likely have been told to drastically change their way of looking at food.
As someone with a unique allergy, I don't want to be blown off and made sick or worse because of a 'trend' in 'it's all in your head' diagnoses.  As the mother of a food allergy sufferer, I don't want her labeled as eating disordered just because a few of her peers use the word 'allergy' inappropriately.  I see her eat a wide variety of fruits, veggies, carbs and protein every day.  What we don't eat doesn't matter nearly as much as what we DO eat.  And I sincerely hope the medical practitioners diagnosing these conditions, as well as the laymen labeling them, acknowledge the difference.  

1 comment:

River Glorious said...

Thank you for writing this post. Very well stated.