How a Food Allergy Resulted in an Eating Disorder: Cliff’s Story
The relationship between food allergies and eating disorders is a relatively new area of study that is very important to bring into conversation. To provide insight into this, I am going to tell Cliff’s story.
By: Marianna Mele
Disclaimer: The following is a case study by BALANCE Dietetic Intern Marianna Mele to raise awareness about the intersection between eating disorders and food allergies. This story was shared with permission of the patient and all patient names and identifying features have been changed to protect their anonymity. This story includes mentions of specific foods, weight loss, and allergic reactions. If you find yourself uncomfortable with the content please step away, and don’t hesitate to reach out to BALANCE. We are here to support you.
What are Food Allergies?
For some background, food allergies are severe immune reactions to specific proteins in a food. It is important to note that this differs from food intolerances, which are non-life-threatening inflammatory digestive system reactions to food. For the context of this article, we will only explore the relationship between food allergies and eating disorders.
Cliff’s Food Allergy Diagnosis
Cliff’s family discovered he was allergic to dairy before he started eating solid food. Cow’s milk spilled on his head, which caused a rash, and since his older brother had already been diagnosed with food allergies, his parents knew what that could mean. By the time he was two years old, he was diagnosed with not only a dairy allergy but he was also found to be allergic to eggs, peanuts, tree nuts, and sesame seeds. Allergic reactions were a significant part of Cliff’s childhood. By age ten, he had already had three reactions and witnessed his brother having a few of his own. Cliff was a known “picky eater.” He refused the majority of foods due to fear of allergic reactions or sensory issues. He took a long time to eat, and there were battles at the dinner table trying to convince him to try a new food.
From Food Allergy to Eating Disorder
One instance caused Cliff to become wary of even his “safe” foods because he had an extreme allergic reaction to foods he had safely eaten before without explanation. This reaction heightened his food anxiety and gave him a distrust of all foods. If his “safe” foods could cause a reaction, how would he trust any food?
After this extreme reaction, Cliff’s food rules and restrictions spiraled. He would take hours to complete meals, refuse to eat at restaurants, and only eat about 20 different foods, and those foods had to be a specific brand prepared in a particular way under his supervision. He began to lose weight, and his parents took him in to see a nutritionist who mentioned that Cliff may have ARFID (Avoidant Restrictive Food Intake Disorder). At the time, ARFID was a relatively new diagnosis, so treatment plans for this eating disorder were not as tried and tested as for other eating disorders. This diagnosis overwhelmed ten-year-old Cliff. To avoid the stress of continuous nutritionist visits, Cliff found enough motivation to eat bigger quantities of his few safe foods, and his weight stabilized. For the next seven years, he and his parents stuck strictly to his food rules because it seemed like the only option, and since he didn’t experience another reaction, he felt safe.
Growing Up Navigating Food Allergies and Safe Foods
By the time he was 17, Cliff seemed to be loosening some food rules and expressing interest in becoming more adventurous in his eating. At this time, he had even joined his high school football team and taken to weightlifting. Cliff even began attending team dinners with his football team each week, even though he would eat safe, allergen-free foods before attending. Despite these new experiences, Cliff still had heightened anxiety around foods, even around some foods that he had previously eaten without issues.
Over time, Cliff’s list of safe foods disappeared due to intense anxiety. He spent hours at the table trying to eat even a single bite of foods he had previously relied on to fuel his body. His eating became so dysregulated that every food he ate, even water, was giving him sensory discomfort, such as an itchy mouth and stomach pain. Cliff lost a significant amount of weight in a short time. His mom was alarmed by this drastic change and quickly got him appointments with a treatment team and got him on the waitlist for a higher level of care program. He began meeting multiple times a week with the new therapist and doing exposure therapies. Getting Cliff comfortable with his safe foods was essential to stop his rapidly dropping weight.
A Turning Point in Cliff’s Treatment
A few weeks into treatment, Cliff was only making minimal progress. However, his family had a trip planned to visit Cliff’s older brother. The prospect of having an allergic reaction on this trip - particularly on a plane - was terrifying to Cliff. Despite the standstill in his treatment progress, Cliff took the trip and made it through the flight and the visit without an allergic reaction. Luckily, this ended up being a turning point for Cliff. He began to trust some of his safe foods again, and throughout the coming weeks, he was finally able to feed himself again adequately.
After two years and lots of hard work, Cliff has a much wider range of safe foods, brands, and eating environments. He expresses more interest and less anxiety around trying new foods. Although Cliff may never be labeled as a “foodie” or an “adventurous eater,” he is very capable of nourishing his body and trusting food.
Takeaways from Cliff’s Story
Food allergies cause very real and tangible fear. People with food allergies experience higher levels of anxiety surrounding food and have more food restrictions than their peers without allergies. This heightened stress around and focus on food can potentially lead to disordered eating. Ensuring our doctors and allergist specialists are well-informed about eating disorders can help prevent situations like Cliff’s. If you or someone you know is having a similar experience with allergies and disordered eating behaviors, BALANCE is here for you.
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. If you or a loved one are struggling with diabetes and eating disorder behaviors, RSVP for our next free Virtual Eating Disorder Support group here.
Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below, or read more about our philosophy here.
This post was written by BALANCE Dietetic Intern, Marianna Mele (she/her).
Marianna is currently in her final year of Hunter College’s IPND program and will complete her Masters in Nutrition and dietetic internship. She previously completed her BS in Nutrition with a minor in psychology at Cal Poly University. Marianna is on track to becoming a registered dietitian within the next year! Marianna is passionate about food and nutrition. She believes food functions as a way to nourish the brain and body, connect with others, learn about different cultures, and bring joy to everyday life. Marianna desires to use her love of food and the values of HAES and intuitive eating in her career to help others create a more positive relationship with food and their body. In her free time, Marianna can be found doing crafts with friends, exploring New York City, or on her couch reading a book or watching a new show with her roommates and their cat, Audrey.