(If you're reading this, you've likely already read Part 1 of the "4 Things Counselors Should Know About Food Allergies" series. If not, I'd suggest you read that one first).
In Part 1, we explored some basic concepts about food allergy-related anxiety. We bridged the path between anxiety and its impact on quality of life. We touched on how the anxiety is different than generalized anxiety, as it's clearly connected to continual perceived and actual health threats.
There's something else that tends to cause an additional layer of anxiety for those managing food allergies: reading (and trusting) food labels.
#2 - Food Labeling Laws Often Create An Additional Layer of Fear
It's often assumed that food products will have clear and consistent labeling, highlighting not only the ingredients, but also whether the food was manufactured on the same line or in the same facility as allergens. Unfortunately, it's not that cut and dry, which often adds an additional layer of fear and anxiety for those managing food allergies.
Per this article on Kids With Food Allergies,
As stated, thanks to the Food Allergen Labeling and Consumer Protection Act of 2004, there are some guidelines for food labeling, but there's still lots of grey area for food allergic people to navigate. To begin with, in the US, only the top eight major allergens are required to be clearly listed if they're an ingredient, leaving those with allergies to other foods potentially unsure if it's in that food item. Additionally, given the fact that there's no requirement or standard language to use when a company *voluntarily chooses* to disclose that an allergen was used in or near the preparation of the item, that uncertainty continues to grow.
Imagine if you already had fight-or-flight levels of stress due to day-to-day food allergy navigation, and then were tasked with trying to buy foods for your child that were deemed safe, despite the current labeling laws. It might feel like trying to solve a Rubix Cube without any directions - doable, but extremely challenging! With labeling laws that aren't required to be completely forthcoming, consistent and transparent, those uncertainties just get piled on top of the already high levels of anxiety, and that's where the work is needed.
Here's what some people managing food allergies say on this topic:
Essentially, for those managing food allergies, buying food can feel a bit like playing Russian Roulette, especially for those that are newly diagnosed and may be feeling overwhelmed with most decisions. Most people don't know how much of their allergen their body can handle before reacting (this is also known as their allergen threshold). For some, reactions start by just touching the allergen (especially if they then touch their eyes, nose, or mouth), or by ingesting even trace amounts.
It's important to know that all people with food allergies have varying degrees of comfort with their allergen. That comfort level is typically based on a combination of things - information from their allergist, any previous reaction experiences, and how much risk they're willing to take. Therefore, some of your clients may not pay much attention to the voluntary "may contain" labels and likely won't find food shopping as stressful. But for those that do avoid items with a "may contain" warning, expect the stress levels to be higher. It will be essential to help these clients assess potential risk levels when buying foods (or eating out), learn to navigate the intrusive fearful thoughts surrounding food choices, and establish their comfort zones with a variety of foods. Additionally, as is the case in working with anyone with a food allergy, it will be crucial to help them learn to accept that no matter what, there will be a degree of uncertainty in *all* choices, but that it doesn't always mean something is unsafe.
It's important to understand how current food labeling laws impact those managing food allergies, how it may present an increased risk of reaction, and how this combination of factors often adds an additional layer of anxiety. Without understanding this aspect of the food allergy puzzle, you'll be putting it together without all of the pieces in play.
June 2020 Update:
Due to the COVID-19 pandemic, the U.S. Food & Drug Administration (FDA) issued an announcement in May 2020 that they were allowing temporary flexibility in food labeling requirements to decrease supply chain disruptions. To learn more about these temporary changes and how they may impact those managing food allergies, the resources below may be helpful:
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"4 Things Counselors Should Know About Food Allergies" series!
If you're working with a client who has food allergies and feel you need more information to educate yourself, check out the following resources, in addition to the links within this post:
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