In this article, I discuss 10 reasons why the gluten-free diet is hard to stick to and why so many people fail to fully adhere to a strict, gluten-free diet. Please see my disclosures.
The gluten-free diet is the only treatment option for people with celiac disease and non-celiac gluten sensitivity, yet so few people are successful at fully adhering to the complex diet.
Gluten is a protein found in wheat, rye, barley, and sometimes oats, and ditching the sticky protein for good is the only way a person with a gluten disorder can get rid of their symptoms and improve their long-term health outcomes.
Yet, it’s common for people who need to be gluten-free for medical reasons to continually struggle with full compliance to the gluten-free diet.
In fact, researchers found that full diet compliance among people with celiac disease is low. They found that of the 123 three-year-olds with celiac disease that they followed for 10 years, only 65 percent of the patients were adhering to a strict gluten-free diet. However, they found that 11.4 percent of the patients were on a gluten-free diet but admitted to occasionally eating gluten, and 23.6 percent were no longer following a gluten-free diet altogether.
Another study found that fewer than 50 percent of the adult celiac participants on a gluten-free diet were fully adhering to the diet.
Low compliance with the diet is associated with an increase in morbidity and mortality in patients with celiac disease, as well as continued inflammation that inevitably leads to chronic disease and early death.
10 Reasons the Gluten-Free Diet Is Hard
Knowing that compliance to the gluten-free diet seems to behoove many adolescents and adults, I started to wonder why gluten is so hard to give up and came up with the following 10 reasons:
(1) Gluten is Addictive
Gluten is highly addictive and giving it up comes with a slew of unpleasant withdrawal symptoms similar to giving up nicotine or crack, according to Dr. William Davis in his bestselling book, Wheat Belly.
Dr. Davis says that 30 percent of people who stop eating wheat experience withdrawal symptoms such as fatigue, brain fog, irritability, and even depression in the first few days and weeks of implementing a gluten-free diet.
It’s tempting to eat just another “hit” of wheat in order to calm those symptoms, which leads to a vicious cycle of eating gluten, experiencing unpleasant gluten withdrawal symptoms, eating gluten again, unpleasant withdrawal symptoms, etc.
The brain is constantly sending tempting messages that encourage you to eat gluten because gluten makes the brain feel good. However, eating gluten again only serves to train the brain’s reward center to demand more of the sticky substance.
(2) Gut Imbalance
The gut plays a huge role in food cravings. That means when the gut is demanding a particular food, it’s like an annoying toddler asking for the same toy over and over again because it knows its parent will eventually cave.
A gut imbalance occurs when there are more bad bacteria in the gut than good bacteria.
This imbalance can occur due to a variety of factors, including eating too many sugary foods (sugar feeds bad bacteria and helps them proliferate), eating foods (aka gluten) that inflame and damage the gut lining and lead to leaky gut, and/or overusing antibiotics, which kill all bacteria in the gut, not just the bad bacteria.
Resolving a gut imbalance is hard to do and takes time and effort. Ways to resolve a bacteria imbalance include avoiding or reducing the consumption of sugar, including white refined grains that convert to sugar in the body, taking a good dosage of probiotics every day, and adding fermented foods to your diet, including kombucha (fermented tea), kimchi, and lacto-fermented pickles.
Read my tips on how to heal your gut.
(3) Nutritional Deficiencies
Gluten cravings might be the result of your body missing specific nutrients, which is common in people with celiac disease and gluten sensitivities.
In people with celiac disease, gluten has damaged the small intestine and impaired the organ’s ability to properly absorb nutrients. In people with non-celiac gluten sensitivity, gluten has created widespread inflammation of the gut, again impairing the small intestine from functioning properly.
When the small intestine is impaired, it cannot properly absorb nutrients from the foods you’re eating.
On top of that, once you go on a gluten-free diet, you may be eating foods that are devoid of nutrition, as many gluten-free packaged food don’t contain nearly as much fiber (whole grains) as their wheat-based counterparts.
Many grains, such as wheat and barley, are required by the U.S. government to be fortified with vitamins, but gluten-free grains, like rice and corn, are not. I wrote about the dangers associated with the gluten-free diet.
Intense cravings for gluten may actually be intense cravings for nutrients your body is missing. This is why eating a nutrient-dense, whole foods-centered diet packed with naturally gluten-free foods is essential to the healing process.
Also, consider taking supplements for celiac disease and gluten Intolerance, including a daily multivitamin, vitamin D, and vitamin B12.
(4) Lack of Lifestyle Convenience
The increasing reliance on wheat-based foods, coupled with an increasingly complex and busy lifestyle, all have contributed to greater reliance on packaged foods and take-out meals.
Plus, for people who love to travel and/or eat out, following a strict gluten-free diet can and will feel unbearable at times.
Unfortunately, however, there’s no vacation from the gluten-free diet, and that can lead people to cheat or give up on the diet altogether.
(5) Emotional Attachment to Gluten
Having an emotional connection to food is normal and makes giving up a favorite foods groups – gluten – difficult. You might have fond childhood memories of family pizza night, eating bread bowls at Panera, or noshing on your grandmother’s challah every Friday night.
While these emotions never go away, you can soften the longing by learning how to recreate your favorite childhood treats and having fun with the process. I loved creating gluten-free Pop Tarts and gluten-free Goldfish recipes. These treats helped me feel normal and brought back childhood memories.
Additionally, it’s important to make and enjoy foods that are inspiring and flavorful. There’s no need to limit yourself to boring salads when you can still enjoy so many tasty foods. Check out my gluten-free recipe gallery for ideas.
While many people wish they could see immediate improvements in their health instantly after implementing a gluten-free diet, for many – or most – people, healing from celiac disease is a long game.
Unfortunately, a lot of people begin the gluten-free diet with good intentions, but within a few days or weeks, they give up, mostly claiming that it’s not working or it’s too hard.
Sadly, most people give up right before their big breakthrough and/or right before their gluten cravings were about to subside. Patience is key to healing your body and giving up gluten for good.
(7) Difficulties Finding Gluten-Free Food
One of the largest barriers to gluten-free diet compliance comes from the fact that many people cannot find gluten-free foods near them, whether at the grocery store or local restaurants or bakeries.
The Canadian Celiac Association surveyed people on the gluten-free diet and found that 85 percent of adults and 90 percent of children said finding gluten-free foods was a major barrier to complying with a gluten-free diet.
(8) Difficulties Affording Gluten-Free Foods
In addition to experiencing difficulting finding gluten-free foods nearby, the affordability of gluten-free foods is another barrier to full compliance with the gluten-free diet among people with celiac disease and gluten intolerance. Researchers found that 33 percent of gluten-free patients cited the cost of gluten-free foods as the reason for dietary noncompliance.
And it’s with good reason. The cost of gluten-free food is outrageous, and brands are charging more for less food just because it’s labeled gluten-free. Restaurants, too, upcharge for foods like a gluten-free bun or gluten-free pizza crust.
A 2008 study found that gluten-free foods cost 242 percent more than regular foods, and another study in 2019 found that gluten-free foods cost 183 percent more than their wheat-based counterparts. This is a lot of extra dough to spend to maintain a strict gluten-free diet, making compliance more difficult.
(9) Lack of Support
Researchers found that gluten-free patients lacked quality information and support from their primary healthcare providers and gastroenterologists.
In fact, a survey found that people with celiac disease found their friends to be “better” sources of information and support about celiac disease than their primary care doctors, once again highlighting the deficit of quality information and support for gluten disorders on the part of the medical community.
(10) Lack of Seriousness / Believability
A lot of people on a gluten-free diet are viewed as demanding or difficult to please, according to a study published in a journal called Appetite. The survey also found that 44 percent of people consider people on a gluten-free diet as “high-maintenance.”
On top of that, the gluten-free diet is often the butt of many jokes despite the fact that it’s the only treatment option for people with celiac disease and non-celiac gluten sensitivity.
Compliance will continue to be challenging until the broader society understands and accepts gluten – and other dietary changes – as the trigger of so many preventable diseases.
Tips for Staying Gluten Free
It’s essential that people with celiac disease and non-celiac gluten sensitivity fully comply with the gluten-free diet, no matter how challenging it may seem.
I first shared these tips about how to stay gluten-free in my article about why you should never cheat on the gluten-free diet, but they’re worth repeating here.
Give Meal Planning a Try. Meal planning can help you stay on track with your gluten-free diet. Be sure to read my 15 Meal Planning Tips for People with Celiac Disease and Gluten Sensitivities, which will help you get started with meal planning.
Stay Home. While I love eating out, I know it’s safer to eat at home. That’s why I eat the vast majority of my meals at home.
Of course, you should never let a gluten-free diet ruin your social life. Find a few trusted restaurants and read my ebook, The Ultimate Guide to Eating Out Gluten Free, to learn how to eat out as safely as possible.
Eat Naturally Gluten Free. It’s essential that you eat as many nutrient-dense, naturally gluten-free foods as possible to not only avoid getting glutened but also to ensure your nutrient tank is always full. Read my list of naturally gluten-free foods and my list of 200+ foods that are gluten-free and safe.
Take Supplements. Taking a few strategic supplements will help you get the missing nutrients you need and fill in any nutrient gaps. I suggest you read my article about supplements for celiac disease and gluten intolerance and the benefits of probiotics for celiac disease to figure out which supplements will help you most.
Always Be Prepared with Snacks. Keep plenty of fresh fruits and healthy gluten-free snacks in your pantry and in pre-portioned bags.
It’s essential that you have gluten-free foods in easy reach for when hunger strikes, after all, you don’t want to be tempted to eat something with gluten in it out of desperation.
Lean on Friends. Surround yourself with people who respect your diet – or even follow a gluten-free diet too. It’s always fun to “break [gluten-free] bread” with others who share in and/or fully support your journey.
Get Help. There are many nutritionists who have studied gluten disorders in earnest. Look for someone who has an integrative, functional, or holistic background like me. I offer 1-to-1 celiac nutrition coaching, and I encourage you to enroll in my SIGNATURE Gluten-Free course if you’re new or semi-new to the gluten-free world.
- Supplements for Celiac Disease and Gluten Intolerance
- Why You Should Never Cheat on the Gluten-Free Diet
- 10 Ways to Eat Gluten Free on a Budget
- 5 Dangers Associated with the Gluten-Free Diet
- 10 Signs and Symptoms of Celiac Disease
- What Happens If You Eat Gluten With Celiac Disease?
- Your Guide to Gluten-Free Flour Mixes and Blends
- 6 Reasons Why Gluten-Free Food is So Expensive