Anxiety, Social Struggles, Coping Strategies in Adults with Food Allergies

A recent study demonstrated food allergies’ profound effect on adult lives, with many unable to access support to manage their allergies and accompanying anxiety.1

“It is clear that [food allergy] affects the psychosocial lives of adults and this should be considered by healthcare professionals, in particular the anxiety and fear of [food allergies],” wrote investigators, led by Caity Roleston, from the University of Oxford.

Research has linked food allergies to poor quality of life and psychological distress in patients and caregivers.2 However, recent food allergy well-being studies have only focused on children—not adults. Investigators sought to assess the lived experiences of adults aged ≥ 18 years in the UK with a medically diagnosed food allergy.1

The team recruited 22 participants as part of the Global Access to Psychological Services for Food Allergy (GAPS) study. The sample was 82% White, 73% women, and 82% with an undergraduate degree or more.

Most (86%) reported ≥1 food allergy, 50% were diagnosed during childhood, 81% had a history of anaphylaxis, and 62% had no allergic reactions in the past year. Food allergens included peanut (n = 10), tree nuts (n = 15), dairy (n = 7), fish (n = 5), crustaceans/mollusks (n = 7), fruits (n = 3), cereals (n = 2), and other (n = 5).

Investigators identified 2 main themes: the influence of food allergy on psychological and social well-being and the strategies participants used to cope. Participants employed avoidance, control, and self-monitoring to manage both their allergies and anxiety.

The study showcased food allergies’ profound impact on adults’ well-being.

“You get really worried that you’re going to eat the wrong thing and die,” one participant said.

Another participant ordered fish and chips and disclosed a nut food allergy. The employee responded, “Well you can’t have anything we serve here; we fry stuff in the chip oil which has got hazelnut in it.”

Those who had experienced anaphylaxis in childhood remained cautious and nervous around food. Many struggled with transitioning into adulthood, relying on avoidant behaviors and social isolation.

One participant described how food allergy-related swelling in her face impacted her self-confidence and self-esteem, making it difficult to maintain eye contact, FaceTime family, or join photographs.

The study highlighted that while food allergies have a psychological impact, the social challenges were the hardest to manage. Many withdrew from social situations due to food anxieties, leading to loneliness and isolation.

“I suppose it’s people that I’ve just met for the first time or some people even that I’m friends with can be kind of like brush it aside like ‘oh it’s not that big a deal’ or ‘if you eat this, nothing will probably happen.’ I don’t think they realize that it is deadly,” a participant said.

Most reported that people do not take their allergies seriously, often calling them picky. Some felt embarrassed about their differences, the follow-up questions, or situations like when a waiter brought out a catering-size ice cream box so she could check the ingredients herself.

Although many felt supported by their friends and families, tension arose. One participant was worried her partner was annoyed about avoiding small independent restaurants. However, no fights resulted due to a food allergy.

Avoidance was the main coping strategy, which was easier at home. Many avoided specific cuisines such as Indian, Asian, and Thai due to the frequent peanut content. Participants checked ingredients diligently, kept allergen-free homes, and used advanced planning when eating out—viewing menus beforehand, carrying emergency food, and selecting safe options.

Constant vigilance sometimes turned into obsessive label-checking, resembling OCD. Many preferred accommodations with kitchens while traveling to cook their own meals.

“Where necessary, adults with [food allergy] should be referred for further support to help them manage their [food allergy] distress,” investigators concluded. “Planning and positive adaptation should be encouraged so that adults with [food allergy] can maximize their quality of life.”

References

1. Roleston C, Protudjer JLP, Herbert LJ, Jones CJ, Warren C, Brough HA, Miah M, O'Donnell N, Marchisotto MJ, Knibb RC. "It's a Permanent Struggle to Manage It Really": Psychological Burden and Coping Strategies of Adults Living With Food Allergy. Qual Health Res. 2025 Mar 17:10497323251320839. doi: 10.1177/10497323251320839. Epub ahead of print. PMID: 40096850.

2. Westwell-Roper C, To S, Andjelic G, Lu C, Lin B, Soller L, Chan ES, Stewart SE. Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatr Allergy Immunol. 2022 Jan;33(1):e13695. doi: 10.1111/pai.13695. Epub 2021 Dec 11. PMID: 34779046.