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Jump to Key Points Adults with food allergies were more likely to have a history of an eating disorder, according to new research published in Nutrients.
The findings may have implications for how clinicians assess eating behaviors in patients with food allergies, according to the study’s senior author, Christina Jones, PhD.
“The key is not to pathologize appropriate allergy management but equally not to assume that increasing restriction or distress is simply part of living with food allergy,” said Jones, a professor of clinical health psychology in the School of Psychology at the University of Surrey in Guildford, England. “A simple question about both current eating difficulties and previous eating disorder history alongside routine allergy care could open the door to identifying problems earlier.”
In the British cross-sectional study of more than 371 adults (86% women; 76% White), more than a third of participants with food allergies reported having had an eating disorder in their lifetime compared with about one fifth without allergies (36.4% vs 20.7%; P = .001). Those with food allergies were also more likely to report having received eating disorder treatment (17.9% vs 10.1%; P = .032).
- Adults with food allergy had higher lifetime ED history: 36.4% vs 20.7%.
- ED treatment history also ↑ with food allergy: 17.9% vs 10.1%.
- Current ED screen positivity was similar with vs without food allergy.
- Prior ED in food allergy patients tripled odds of current positive ED screen.
- Allergy management behaviors can mimic disordered eating; assess rigidity/anxiety.
Food allergies were not associated with screening positive for a current eating disorder (37.3% vs 37.1%; P = .972).
Jones said one possibility is that patients may be more vulnerable to eating disorders earlier in the food allergy journey, maybe closer to diagnosis.
“Eating disorders are very complicated and sneaky,” said Shari Rogers, LCSW, therapist at The Family Institute at Northwestern University in Evanston, Illinois, who was not associated with the study. “A lot of times, the way an eating disorder starts is not intentional.”
Rogers said that while avoiding allergens may be an initial trigger, the behavior can evolve into increasingly rigid, fearful, or obsessive thinking about food and lead to restriction beyond what is medically necessary.
The Study
The group’s most commonly reported allergens were tree nuts (36.6%), peanuts (33.6%), fruit (19.4%), cow’s milk (16.4%), gluten-containing cereals (14.9%), eggs (13.4%), and crustaceans (10.4%). Food allergy duration ranged from 1 to 64 years, with an average of about 19 years. Among those with medically diagnosed allergies, 63.7% reported having an epinephrine autoinjector.
The study took place between 2025 and 2026. Participants were English-speaking adults recruited through posters, word of mouth, and social media. Of the participants, 134 reported a food allergy — 90 medically diagnosed and 44 self-reported. Participants provided demographic and food allergy information and completed the Eating Attitudes Test-8 and Sick, Control, One, Fat, Food eating disorder screening tools; a positive screen required meeting the cutoff on both measures. They also reported whether they had ever had an eating disorder, whether it was current or resolved, and whether they had received treatment.
Among participants with food allergies, those with a previous eating disorder had about three times the odds of screening positive for a current eating disorder (OR, 3.07; 95% CI, 1.42-6.61). Shorter food allergy duration was also associated with positive screening, but because participants with shorter allergy duration tended to be younger, researchers could not determine which factor accounted for the association.
Jones pointed to the overlap between behaviors associated with disordered eating and those used to manage food allergies.
“Food allergy management can look a lot like disordered eating from the outside — for example, checking labels, avoiding allergenic foods, and feeling anxious around meals,” Jones said. “That overlap makes it easy for genuine warning signs to be dismissed as ‘just good allergy management,’ and equally easy for appropriate allergy-related caution to be mistaken for an eating disorder.”
Rogers said clinicians treating patients with food allergies should look for anxiety, rigidity, fear, and increasingly restrictive eating, such as eliminating foods or food groups beyond those necessary to manage their allergies.
Rogers reported no conflicts of interest. Jones reported receiving research funding from the National Institute for Health and Care Research (NIHR), Innovate UK, Food Standards Agency, Aimmune Therapeutics, the National Peanut Board, and Novartis; honoraria from the NIHR, Nutricia, Mead Johnson, DBV Technologies, Allergy UK, The Milk Allergy Dietitian, and Siemens Healthineers; and membership on the Allergy UK Health Advisory Board, the British Society for Allergy & Clinical Immunology Psychology Special Interest Group (SIG), and the British Psychological Society Paediatric Allergy SIG.
Brittany Vargas is a journalist covering medicine, mental health, and wellness.
