Severe allergies and the allergy pretenders

Severe allergies…

I’ve talked previously about how best to describe my son’s peanut allergy in conversation, so other people understand the severity. I’ve fallen into the habit of saying he is “severely allergic”, for fear that saying “allergic” might make the listener think “hmm, yeah, isn’t everybody these days” and saying “anaphylactic” might not be understood.

In recent months, I have read on several occasions that there is no such thing as a “mild” allergy: as any allergy has the potential to result in a severe allergic reaction. You can’t predict with absolute certainty whether an allergic person will have a mild or severe reaction on coming into contact with their allergen. They might have hives on one occasion, but anaphylaxis on another. So I am probably undermining the term “allergic” by qualifying it with the word “severely”. Simply saying “allergic” SHOULD be enough.

… and the allergy pretenders

Then I heard a story that left me somewhat aggravated and which also made me realise there is a need to spell out to people that, not only is my son’s allergy severe, it is also very “real”.

A friend of a friend said he had an allergy to chillies. One evening, whilst at a rugby club social, my friend realised a spicy dish had been taken to the “allergic” man’s table by mistake. She panicked, rushed over to warn him  … only to be met with a mumbled “erm, I think this will probably be alright” and then to see him continue eating it. Turns out, he was pretending to have an allergy, to make sure people didn’t serve him chilli-laden food.

I’ve also heard talk of people feigning allergies or intolerances to certain foods, so they don’t have to confess to counting their calories. Obviously, this all takes a far more worrying turn if someone is claiming an allergy to mask an eating disorder, and I am in no way qualified to pass comment on that. However, the woman who goes out for a meal with friends and, to save face when ordering a salad, pretends to have an intolerance? Unnecessary, unhelpful, and for goodness sake, how unassertive?

It would appear faux food allergies have been in vogue for some years, with the Washington City Paper reporting on the trend back in 2008.  The article quotes restaurant owner Jeff Black, who says of the “ingredient-averse” who feign an allergy:

“When people fake disease, it’s just like people who fake to get handicap plates… It’s ethically and morally wrong.”

Absolutely. So, why do diners do it? Is it an expression of control freakery where they otherwise don’t trust a restaurant to make a meal to their taste (or within their budgeted calorie allowance?). Is it a form of attention seeking, so that they are fussed over by the restaurant or receive sympathy from friends? Or is it simply a cowardly way of ensuring you get the meal you want, and these people haven’t realised the disservice they are doing to real allergic diners?

The problem of pretend allergies may even be rife amongst school children. It seems some parents are not above claiming that their child “can’t eat” something, when the truth is they “won’t eat” a certain food. During my recent spate of primary school tours (sussing out which were allergy savvy before my son starts this September), one headmaster stressed to me the need for a doctor’s letter confirming that D had a diagnosed allergy. Apparently, this proof is required so the school can differentiate the children with genuine dietary requirements from those who are merely picky eaters.

This approach is also recommended the School Food Plan, where the section dealing with allergies in the Q&A for headteachers states:

“Make sure that dietary needs are backed up with a medical certificate or letter from the doctor, so you ensure you are only altering your catering for those who are medically certified – or those who have special diets for religious or cultural reasons.”

I find the whole notion of pretend allergies quite incredible. It may seem like a harmless white lie, but the more allergy pretenders there are, the more catering establishments and the general public will be cynical about the claims of those with real allergies. So… men who can’t handle hot food, dieting ladies and pandering parents, please think twice before turning allergy pretender. It really doesn’t help those with the real medical condition.

Further information

Severe allergies

The Allergy UK site contains information on an allergic person’s chance of having anaphylaxis. It states this is:

“a little more likely in someone who has:

  • had a previous anaphylactic reaction
  • moderate-severe asthma
  • underlying cardiovascular disease”

Factors such as “exercise, heat, alcohol, the amount of allergen taken, and, for food, how it is prepared and consumed” can also influence the severity of the reaction. (For full details, see Allergy UK, Anaphylaxis and Severe Allergic Reactions).

Allergy pretenders

4 comments

  1. I haven’t come across anyone like this but I’ve come across people who don’t seem to take their child’s (Non-Ige) allergy very seriously and that makes me feel sad for the poor kid – whose insides must become very uncomfortable at times!

    This happened at a birthday party I went to recently. A boy who had a milk allergy was allowed to eat whatever he liked at the party. Obviously he wasn’t anaphylactic, but he soon had a red rash around his mouth. I could only suppose his mum was prepared to put up with the possible consequences of a very sore tummy/disturbed sleep/diarrhea etc.

    I don’t think this approach helps others who are taking it seriously, as we all get tarred with the same brush! People end up thinking that we switch it on and of as we please! They are then less likely to be as careful about ‘may contains’ and cross-contamination.

  2. I haven’t heard of fake allergies before either, the idea is a worrying one. However, I teach in a secondary school and there are many children who claim to have a nut allergy but have no medical back up. I also do know of a mum who has a daughter with a peanut allergy who was attending the same party as my tree nut allergic daughter and she was allowed to eat all the foods even those that ‘may contain’ which made it hard to explain why we don’t taker that risk. I wonder why people would bother to go to the effort of avoiding things if they don’t need to.

  3. I have never seeb fake allergies in action either fortunately but people vary in the advice given. We were told as stated that you can’t describe an allergy as mild or severe as it depends on the factors you pointed out. However we have been told he may eat may contains products so I may appear negligent if allowing my son to eat these but he has (and I have for 30 odd years as I am also allergic to a few specific nuts) and neither of us has had a problem. We were advised by a specialist immunologist in a top children’s hospital that may contains is ok. He is not prescribed an epi-pen based on the fact all his reactions have been mild. I wonder at this sometimes if it could be that a future reaction might be anaphylactic. It is confusing. In addition to his medically diagnosed ige allergies I have found him intolerant to dairy and gluten. With the wheat/gluten we discussed this with immunologist as I had tried without and re-introduced and he seemed to have vomiting and respiratory problems. He showed a slight reaction on skinprick to wheat so did a wheat challenge. The challenge was negative so we were told to reintroduce. We did but half way through the meal he asked for his reflux medicaytion (he was just under 3!). I observed him to cough consistent with reflux symptoms. He wouldn’t sleep and was hyper. So I left it out and I tried again a week later. Same result. Same result each time I tried so I left it out again and discussed it. He mentioned testing for coeliacs in the future as I am not prepared to have him eating something for 6 weeks and see him deteriorate so much for a test. So this leaves us with a quandary. He is not medically diagnosed intolerant or allergic or coeliac but eating wheat produces very undesirable symptoms. It sets his reflux off and renders him wild! Literally wild erratic behaviour and unable to sleep. So where does this leave us in terms of the school food plan? Should wheat be forced on my son when it has such undesirable effects? It would affect his school work. Indeed at a restaurant he was wrongly served a wheat item and it was hurriedly reatracted but he’d had some. His writing the next day was dreadful. It would badly affect his school work! I totally agree that allergy pretenders do allergic children no use at all. But we aren’t pretending and I am not spending twice as much on gluten free products for nothing! Fortunately in preparing his care plan the school nurse was happy to add this and his undiagnosed dairy intolerance. Cutting dairy out eradicated his not inconsiderable eczema and improved his reflux. I have done this myself. I have researched calcium alternatives and arranged a calcium test through the paediatrician he sees for other problems so I have removed dairy responsibly from his diet. Again I would not be paying through the nose for milk alternatives and going to such great lengths for no gain. It was hard in the beginning to get him to go without cheese and yogurt which he loved. But they did not love him and his health improved so much. The thing I will say is I got quite a lot of hassle from a paediatrician about the wheat / gluten thing (despite the immunologist being on board) so I have learnt to just not bother mentioning these things knowing I have improved his health. What worries me about the school food plan is schools enforcing school lunches. No one is going to enforce dairy or gluten on my son as I will not stand by and see him suffer eczema, reflux, and a whole host of other symptoms but sadly the medical profession can be skeptical about intolerances. I have a foot in both camps as he is diagnosed ige and I do not want to see pretenders but at the same time some times there might be more behind it than meets the eye. We are certainly not pretenders with gluten and dairy. But there is no formal diagnosis. When I spoke to the head about it I was greeted by a wonderful common sense approach. “Well if it makes him ill or uncomfy we certainly would not want to give it him”. Thank the lord for common sense. However she can see it all goes with a range of various health issues. Actually, my story backs up all the more why pretenders are a nuisances as if everyone like my head trusted parents to make decisions then it would be helpful to me. I wonder how cultural reasons will be defined. What about people who wish to follow a vegan diet or a paleo diet? Should they be allowed to be excused from compulsory meals or should we force them to eat foods that their parents don’t want them to? I wouldn’t follow those diets but I believe people have the rights to choose them. Anyway, a very very good post. I don’t like the pretenders any more than you do either, but there is room for some parental trust. I will, if necessary, go to the GP and explain myself in the way I have here and I defy anyone to give him those foods and not notice how badly they serve him. I am no pretender. Thanks for posting this 🙂

  4. We have the same woollyness in this house too.

    I have very undesirable effects when I eat wheat and dairy and cannot eat a slice of bread without feeling instant effects. However, if at a service station and starving I might eat something like a crunchie bar that has milk chocolate on it as I am an adult and understand that I can manage a headache, etc later to stave off hunger at that time. Neither are recognised medically as doc’s couldn’t be bothered after I failed a coeliac test (not done properly I now know) and skin prick tests. But, I couldn’t eat pasta carbonara without being very unwell. Not medical back-up though and never quite sure how to explain it as no one has to me so it often comes across as a diet choice.

    Recently the dermatologist looked at MyItchyBoy’s records on her computer and said that it shows he is fine with X,Y & Z. Well, yes, it’s true, he doesn’t have an ‘allergic’ reaction – no sudden rash, breathing problems or anaphylaxis but the day after his eczema will be flared up. The impact of that can be sleeplessness for the family for a week, lots of medication for MyItchyBoy and general discomfort and grumpiness/lack of concentration for him until it clears up. Some he doesn’t react to on blood test or skin prick test – it’s just an intolerance (I think) when he ingests the food. I tend to write on school forms as an allergy to make sure he avoids the relevant foods but the NHS would probably not support it as an allergy. True, he can ‘tolerate’ them in the way I can ‘tolerate’ dairy but is that enough for the school to not feed them to him? No idea.

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