Restaurants Can Be Hell for People with Food Allergies

For most of us, the decision to order take-out Chinese is a respite from the dreaded task of cooking. That plastic tub of gooey orange chicken and unidentifiable chunks of what might be broccoli are your signal to skip grocery shopping, cooking, or cleaning. It's instant gratification drenched in MSG.

Unless you have allergies.

I frequently dine with a significant other who has allergies to shellfish and dairy and who also cannot eat seeds (this includes everything from tomatoes to fancy mustards) due to Crohn's disease. And I've learned that how a server first responds to special requests can completely shape how my partner will feel about the meal. Promising signs? A server who appears to pay attention, jots things down if necessary, and checks in to see if a certain related ingredient is okay.

In Asian restaurants, for example, we'll often be asked if sesame oil is okay, since we always mention that sesame seeds are a no-go (the oil is actually fine, but the simple clarification itself sends us a message that the kitchen is actually paying attention to the allergen, which is a huge anxiety-reliever). Even FAQs like "So, like…is butter okay?" in response to a clearly stated dairy allergy aren't that annoying, because it clears up any potential miscommunication about what is and isn't a part of a restriction. The server doesn't want us to swell up or die, and I appreciate that.

When you choose to let anyone else cook for you, you're trusting their ability to make you food that not only adheres to hygiene and safety regulations, but also (hopefully) leaves you feeling good. As someone who suffers from allergies, that trust dynamic is intensified, especially if there are potential reactions that can become life-threatening at play.

"There are many fears and anxieties that exist for a food allergic patient especially when eating out," says Purvi Parikh, an allergist/immunologist and clinical instructor of medicine at NYU Langone, who frequently observes feelings of anxiety and guilt in patients who allergy-related dietary restrictions. "There's the chance that the waitstaff won't take your restriction seriously or won't appropriately convey the information to the kitchen. "The other possibility is human error and despite the best efforts and communication someone may forget and accidentally the allergen can come in contact with the patient's food. Since allergic reactions can be life threatening, this constant fear and anxiety can be really debilitating for a [person]."

Farah Joan Fard of Cambridge, Massachusetts learned about her cinnamon allergy less than a year ago, and says she initially tried to make do by asking restaurants if a dish contained the spice, as a way of protecting herself from her allergen. "I would read the menu and try to figure out if the dish could possibly have cinnamon in it instead of just telling the waiter that I had a cinnamon allergy," Fard says. She describes feeling anxious about the stigma around trendy food sensitivities and dieting as a key reason why she initially chose not to disclose her allergy in a straightforward way (even though cinnamon does not suffer from the same rep as, say, gluten).

Unfortunately, she found that cinnamon makes its way into enough dishes in such subtle ways (many Indian and Thai sauces, for example) that it was no longer feasible to just play guess-and-check. Fard is also a vegetarian, which she says contributes to the guilt she feels about disclosing various aversions and allergies when eating out. "I went out to breakfast not long ago, and it turns out the dish I ordered wasn't vegetarian. They brought me a replacement dish that was vegetarian, but had cinnamon sprinkled all over it," she says. "I felt so guilty because I didn't want to burden them another time, and just took the whole thing home for my fiancé to eat."

Lauren Wolf, psychologist and associate training director of the health psychology program at California Pacific Medical Center and co-founder, works with allergy patients who also experience frequent social anxiety. They often "struggle to publicly alert waiters of their allergies, choosing instead to forgo disclosure and risk of significant health effects." Wolf describes how a number of her clients have had success navigating eating at restaurants by creating a food allergy card to hand to a waiter. "People with food allergies have to vigilantly protect themselves from food contamination," she says. "They may have to avoid certain environments, such as airplane travel. They may even have to avoid affection from a partner who may have accidentally eaten a forbidden ingredient."

For some patients, the trust dynamic between patient and restaurant is so fraught with anxiety that letting someone else cook for them simply stops being worth it. Jillian Rodriguez and her partner both suffer from celiac disease, and in the past two to three years, she says they have almost completely stopped dining out in their hometown of Detroit. "People always give you a heavy sigh and the eye roll when you say you can't have gluten," she tells me. "That's why I had to start disclosing that I had celiac, so waitstaff would actually take my allergy seriously."

Rodriguez recalls a recent experience at a hibachi restaurant, in which the grillmaster insisted on cooking their food on a grill that everything else—including things she was allergic to—is prepared on (versus a special grill they and most restaurants have that avoids cross contamination). He felt the larger grill created better flavors. "We [my partner and I] were really anxious because cross-contamination poses a serious challenge for us. We eventually gave in because the grillmaster was so pushy and we didn't want to keep making a scene, but the whole meal was impacted as a result." Despite Rodriguez's difficult experience, some chefs have figured out the value of making patrons with allergies feel welcome, instead of like a burden.

Jamie Bissonnette is a chef and co-owner at three of Boston's most popular restaurants, Toro, Coppa, and Little Donkey. "As a chef who has had allergies of my own, I wanted to instill the severity of the issue to the team, not just for the health and safety, but for the hospitality." His team says that guests notice when servers go the extra mile to accommodate an allergy or a restriction in ways that don't make it seem like it's a burden to the restaurant––this TLC pays back in Yelp and Google reviews, which we all know can make or break a restaurant's reputation.

The equation for making eating out a more enjoyable experience for people with allergies isn't simple; it depends on servers being able to own their roles in ensuring the safety of their patrons, and also depends on folks with allergies feeling comfortable enough to disclose their allergens, and speak up despite the anxiety or guilt of asking about (or even sending back) a dish that could potentially be harmful. After all, everyone deserves to indulge in the mindless joy of clicking "Place Order" on GrubHub or ordering the greasiest burger on the menu without worrying about getting shade from the server or spending a night in the ER.

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