In my clinical practice, I specialize in treating Obsessive Compulsive Disorder and the so-called OC spectrum disorders. One of the most common is health anxiety, which is better known by the older and more negatively loaded term, “hypochondriasis.” Whatever you call it, this excessive worry about illness can overtake the lives of those who have it.
I can’t say for sure if the prevalence of health anxiety has increased in the last decade, but judging from my admittedly unscientific personal experience and a cursory scan of the data, it seems to be on the rise. In the days before the Internet, a person with health worries might have read the Merck manual to assess symptoms or gone to the doctor for reassurance. Now we’re all diagnosticians, taking cell phone photos of troublesome moles to compare with online examples of cancerous lesions, typing symptoms into WebMD, and using Internet forums to share stories about medical mishaps and exotic illnesses. But without the depth and breadth of information and the context for interpreting it that comes with medical training, it’s easy to misinterpret physical sensations and overestimate the seriousness of a problem or the likelihood of its occurrence.
I thought about this as I read a story in Sunday’s New York Times Magazine about how General Mills has jumped on the gluten-free bandwagon, using the latest health fad to kick start a marketing campaign for their GlutenFreely line of products. Celiac disease, the inability to digest the gluten found in wheat and several other grains, is a serious, even life-threatening, illness. It is five times more common today than it was fifty years ago, and an estimated 18 million Americans suffer from some degree of gluten sensitivity, if not full-blown celiac disease. But the explosion of gluten-free options on supermarket shelves and restaurant menus makes it seem even more prevalent.
For those with a true gluten sensitivity, this is a welcome trend. But for those prone to health anxiety, it’s just one more trigger for unnecessary worry. As the Times article points out, athletes have embraced the gluten-free diet, claiming it gives them more energy and enhances performance. So have several celebrities, including Gwyneth Paltrow, who touts it as a weight-loss method and Jenny McCarthy, who believes it cured her son’s autism. No matter that scientists dismiss such claims because there’s no research backing them. If you’re overly attuned to your body, as people with health anxiety are, you’re likely to focus on every physical sensation and are highly suggestible. And if you buy into the celebrity endorsements—and a lot more people follow Us Weekly than the New England Journal of Medicine—going gluten-free will seem like a panacea for whatever ails you.
I’m a little embarrassed to admit to my own brief, three-day experiment with the gluten-free lifestyle. Drawn in by the promise of clear-headedness and boundless energy, I decided to test it out for myself. I replaced sandwiches with salads at lunch and pasta with potatoes at dinner. And for breakfast, I tried a great recipe I found in Bon Appetit for the Garmin cycling team’s gluten-free pancakes. My husband and I both agreed we felt less weighed down and more energized than we do after eating our usual whole wheat variety.
There was only one problem. The Garmin pancakes weren’t gluten-free. They contained spelt flour, which is a wheat product, and oat flour, which gluten-free purists eschew.
As it turned out, the regimen wasn’t for me. It made me feel deprived, which caused me to overindulge in too many inferior wheat substitutes, like peanut butter cookies made with teff flour. I’m back to eating pizza and muffins, and I feel much more satisfied, albeit a little more sluggish. But maybe that’s the result of Thanksgiving, not gluten.
Without a compelling medical reason to go gluten-free, proponents of this newest dietary trend may be showing symptoms of a sensitivity not to wheat, but to health concerns. And for that, I’d say a gluten-free diet would be contraindicated.