Food allergy has long been one of the few life-threatening medical conditions that society still treats as entertainment. For years, it has been the punchline in comedies. More recently, it has appeared as a convenient murder weapon in television dramas and thrillers. Now, in a recent comedy series, viewers are presented with something arguably just as dangerous: a storyline built around nearly every major misconception the public holds about food allergy and anaphylaxis.
After watching Episode 3 of Not Suitable for Work on Hulu, I was struck not by a single inaccurate scene, but by the accumulation of misinformation packed into one storyline. The episode involves a young man with a shellfish allergy who is invited to dinner by a female coworker he hopes to impress. Early in the episode, she casually remarks that she hates when men have allergies and asks whether he has any. Rather than disclose his condition, he stays silent and jokes that he does not.
The audience is meant to laugh. I did not.
Hiding a food allergy is not merely a television trope. It is a documented behavior with potentially dangerous consequences.
The character conceals his allergy because he wants acceptance. He does not want to be seen as different. He does not want to be a burden. He wants the woman he likes to view him as “normal.”
That may sound absurd in the context of a television comedy, but it mirrors a reality that many people with food allergies face every day. Over the years, I have documented reports of passengers being mocked, ridiculed, denied pre-boarding, and treated as though a life-threatening medical condition was merely an inconvenience. When people repeatedly receive the message that their allergy makes them difficult, burdensome, or unwelcome, some inevitably choose silence.
The pressure to remain silent is real. In the largest global survey of food-allergic air travelers conducted by researchers at Northwestern University’s Center for Food Allergy and Asthma Research, 31 percent of respondents reported concealing their allergy from an airline or others while traveling.
Think about that for a moment. Nearly one-third of respondents reported hiding a potentially life-threatening medical condition. That is not a failure of those passengers. It is evidence of the stigma that continues to surround food allergy.
We know that silence can have consequences. I think of a college student who experienced an allergic reaction while at a gathering with friends. Rather than tell anyone what was happening, he attempted to drive himself to the emergency room. He died in the hospital parking lot. Those who knew him said he had experienced bullying related to his food allergy in the past.
We cannot know exactly what influenced his decision that day. But we do know that stigma surrounding food allergy is real, and that embarrassment can be deadly.
When the character on Hulu eventually consumes shellfish, he begins experiencing symptoms and immediately reaches for Benadryl, swallowing it dramatically like a shot of liquor. Again, the audience is invited to laugh.
The problem is that Benadryl is not a treatment for anaphylaxis. This remains one of the most persistent and dangerous myths in food allergy. Antihistamines may help relieve some symptoms, but they do not stop anaphylaxis. They do not reverse airway swelling. They do not halt cardiovascular collapse. They do not replace epinephrine. Yet generations of patients have absorbed the message that Benadryl is enough.
I think of another young college student who delayed using her epinephrine auto-injector after ingesting an allergen. By the time epinephrine was administered, it was too late. We know from decades of clinical experience and research that epinephrine works best when used early. Delayed administration has repeatedly been associated with worse outcomes and fatalities.
But perhaps the most dangerous message arrives later. As the character continues eating shellfish, continues reacting, and continues administering epinephrine, he ultimately collapses and is later diagnosed with “adrenaline poisoning.”
Think about the message viewers are left with. The shellfish allergy did not nearly kill him. The epinephrine did.
For families living with food allergy, this narrative is painfully familiar. We already battle widespread fear of epinephrine. Parents hesitate. Patients hesitate. Bystanders hesitate. Some people are more afraid of administering epinephrine than they are of the reaction itself.
That hesitation can be deadly. Epinephrine is the first-line treatment for anaphylaxis and remains the only FDA-approved medication capable of stopping the progression of a severe allergic reaction.
The episode also creates the impression that someone can repeatedly consume shellfish, repeatedly self-treat, and simply continue on with the evening. Real life is not nearly so forgiving.
I think of a young boy with a severe shellfish allergy who died after inhaling shrimp being cooked by his grandmother. He never sat down to eat shellfish. He never intentionally took a bite. Yet the reaction was severe enough to take his life.
That tragedy underscores a reality that people outside the food allergy community often fail to appreciate: Shellfish reactions can be sudden, severe, and unforgiving. Anaphylaxis is not a condition that can be negotiated with, laughed off, or repeatedly pushed through for the sake of a joke or a romantic storyline.
Perhaps what frustrates me most is that these portrayals do not exist in a vacuum. They reinforce the same dismissive attitudes that people with food allergies encounter every day. We see it when students are bullied. We see it when passengers are mocked for requesting accommodations. We see it when people are told to “just take Benadryl.” And we see it in the fact that, after more than a decade of advocacy, families are still waiting to learn whether commercial aircraft will be required to carry modern, easy-to-use epinephrine for medical emergencies.
Food allergy is one of the few diseases that can kill in minutes and still be treated as a joke. Until that changes, we should not be surprised when misinformation thrives, accommodations are questioned, and lifesaving interventions are delayed. The problem is not a single television episode. The problem is a culture that continues to view food allergy as something less serious than it is.
Entertainment shapes public perception. What people see on screen influences what they believe in real life. When viewers are taught that hiding an allergy is romantic, that Benadryl can stop anaphylaxis, or that epinephrine is more dangerous than the reaction itself, those messages do not disappear when the credits roll. They become part of the public consciousness.
For the millions of people living with food allergies, and for the families who have lost loved ones to anaphylaxis, the consequences can be measured in far more than ratings or laughs. Food allergy is not a punchline. And the price of treating it like one may be far higher than we realize.
Lianne Mandelbaum is a leading advocate for airline safety measures to protect food-allergic passengers. As president of No Nut Traveler and airline correspondent for Allergic Living, she drives policy change by collecting testimonials from food-allergic families to share with lawmakers, media, and advocacy groups. She can be reached on X @nonuttraveler, Facebook, and LinkedIn.
A sought-after speaker and media source, Lianne participated in a Medscape panel on emergency medical kits on planes and contributed global data on airline travel and food allergies at the GA²LEN Anacare Anaphylaxis & Food Allergy Forum. Her travel tips were also featured by Stanford’s Sean N. Parker Center for Allergy Research. She also appeared on Bloomberg to discuss the challenges faced by food-allergic travelers and advocate for policy changes.
Her advocacy led to a Department of Transportation ruling recognizing food allergy as a disability. She co-designed a global air travel and food allergy survey with Northwestern University’s CFAAR, which was presented at AAAAI and published in The Journal of Allergy & Clinical Immunology. She is the co-author of “Understanding Experiences, Barriers, and Facilitators of Safe Airline Travel—A Global Survey of Food Allergy Patients and Caregivers” (The Journal of Allergy & Clinical Immunology). She also contributed to “10 Practical Priorities to Prevent and Manage Serious Allergic Reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto” (Clinical and Translational Allergy) and “Ever Treat a Patient on a Plane? Why Med Kits Need an Update” (Medscape). Additionally, she collaborated with stakeholders to include anaphylaxis and necessary medications in the FAA Reauthorization Act of 2024.
