I’m three and half years into a lifelong diet. It’s not to lose weight or build muscle, and there are no cheat days—no, not even for a freshly-baked chocolate croissant that I can smell a block away. I get a metal probe put down my throat every year so my doctor can confirm that I’m really, truly, 100 percent adhering to my diet. As if that wasn’t awesome enough, I also get to pay anywhere from 30-500 percent more for basic food.
If you haven’t figured it out yet, I have celiac disease. My diet is that eye-roll-inducing, clichéd trope that comedians have been making the same joke about for the last few years: gluten-free. Since I live in the United States, I swallow the extra cost of gluten-free food. We have a tax deduction system that might (or might not) help me, but it’s not worth the hundreds of calculations that I’d have to perform just to pay a little less in taxes. If I lived in the United Kingdom, I’d get a lot of my dietary staples through my pharmacy via a prescription I’d get from my doctor. My insurance would cover that cost, and all I’d be out is time. But the U.K.’s healthcare system is looking to cut costs, and right now they’re eyeing gluten-free bread as a possible cutback—even though it takes up just 0.3 percent of the budget.
Before we get into the gritty details, let’s get the technical stuff out of the way. Celiac disease is an autoimmune disorder in which eating gluten causes a person’s immune system to attack the small intestines. Those attacks cause damage to the villi—the waggling, tiny, finger-like things that absorb nutrients from your food. Damaged villi can’t absorb nutrients properly and can take months to years to fully heal. The only treatment: a gluten-free diet. Gluten is a protein found in wheat, barley, and rye, so my doctor-prescribed diet cuts out all of those.
Let me translate for you. This means no bread, cake, cookies, pizza, crackers, oatmeal, granola, beer, and pasta—a.k.a. the backbones of my diet—unless they’re specially-made to be gluten-free. Meat is gluten-free, as are plenty of other important food groups like dairy, but a whole chunk of my daily food intake now comes from rice and corn substitutes for delicious wheat products.
As gluten-free diets have become trendy, more grocery stores have started stocking gluten-free alternatives. You have your Whole Foods and your Wegmans if you live on the East Coast. Shop-Rite has some good options, and some Acme’s have a whole gluten-free section. If you’re just a passerby of these aisles—that person who rolls their eyes at the gluten-free cookies in my cart, perhaps, or that lady who told me that “gluten isn’t good for you anyway”—you probably think that gluten-free items are easy to find.
Or maybe you’re James Cave, a general practice physician who wrote in the British Medical Journal on Tuesday that if U.K. celiac patients were no longer provided with gluten-free prescribed food, market prices in grocery stores would fall and “people with coeliac disease who currently struggle with the logistics of a lifelong gluten-free diet and a cumbersome and antiquated supply system, would have the convenience and choice we all enjoy.”
No, James, they wouldn’t. It might seem to you, a general practitioner who feels inconvenienced by being forced to “behave as a grocer” and having to deal with “the time consuming bureaucracy,” that gluten-free products are everywhere. They’re not. And for the people who need the most financial help buying their food, they’re even harder to come by.
If you walk around a Whole Foods, you’ll find lots of gluten-free options. If you walk around a Shop-n-Stop in a poor neighborhood, though? Good luck. Grocery stores stock products that a significant portion of their customers will buy, so celiacs living in neighborhoods filled with wealthy people on fad diets are usually good to go. When I go to my local store, I can find options for almost all of my cooking needs, including baking (though I still order plenty of ingredients on Amazon). The key is that I can afford to live in a neighborhood with those options. I actually chose to live there because it had those options. I pay higher rent to live 10 blocks away from a grocery store that has frozen gluten-free bread, because more affordable neighborhoods in my city would have me ordering all my food online.
And frankly, I don’t care if my doctor and I find a prescription system “stressful and confusing.” It’s stressful and confusing to figure out where to buy my staple foods. It’s stressful and confusing to read the ingredient list on every item I buy to make sure I’m not accidentally poisoning myself. And I don’t care if I have to buy my food in bulk. I already do that—because if the one grocery store that carries my morning bagels is out of stock, I’m screwed until they reorder.
So please, if you don’t want your prescription system, send it over to us. I’d love to be stressed and confused about a system that actually cares about me.
