Victoria Richards was ready to spend Sunday -- date day -- with her boyfriend. He was nice, funny and he had the bluest blue eyes. That afternoon, as they sat together on her porch, he leaned in for a kiss, and Richards leaned back.
"What have you eaten today?" she asked him.
Inquiring about a date's food intake could kill the romantic mood, but the question is a familiar one to people who have severe allergies. A kiss can be deadly if your loved one has eaten a food to which you are allergic. And for teenagers in particular, an allergy can add yet another degree of difficulty in the dating arena.
"He got kind of freaked out," said Richards, 16, who has a fatal nut allergy. "I was definitely looking out for myself on that one because I did like him a lot."
Having a severe food allergy can be like dealing with the possibility of a terrorist attack, according to Lisa Provost, a licensed mental health counselor at Integrity, Psychological Counseling in Indiana.
"In unexpected places, things can pop up," Provost said. "The challenge is, they need to be vigilant."
But being vigilant about a food allergy can be frustrating when it prevents someone from enjoying things most people take for granted. For Ross Peterson, 15, listing his allergies, which include milk, peanuts and tree nuts, can seem like dating caveats.
"That's the hardest part," Peterson said. "I feel obligated to tell [girls] before I ask them out."
The problem is compounded because an allergic person needs a strong sense of confidence and the ability to assert his or her needs in order to stay safe in any environment, skills that teenagers are still developing.
"It's a difficult icebreaker to say, Please don't eat peanuts or, I can't kiss you if you have that milkshake," said Dr. Robert Wood, director of Pediatric Allergy and Immunology at the Johns Hopkins Children's Center. "Once couples become couples, everything gets much easier. … The more comfortable they get with someone they're friends with or dating, the easier it is."
According to Wood, allergic reactions from kissing or other social contact may be one of the most underreported types of reactions, especially if the reactions are mild, involving some itching, swelling or redness. No one wants to go home and tell their parents that they had a reaction because of something they were doing with a boyfriend or girlfriend, Woods said.
Flirting With Disaster
Although it would be impossible to quantify the number of teenagers who risk a reaction because they are in a social or romantic situation and don't want to draw attention to their allergy, Wood said he believes nearly all teens have taken such a risk more than once.
"The proportion who act the same way in social situations as they do with parents is the minority," Wood said. "A lot of them do bend the rules."
For example, when eating in a new restaurant with a group of friends, someone might forgo speaking to the manager or chef about the ingredients in a dish for fear of seeming picky or annoying. A teenager might endure the discomfort of a mild reaction because they do not want to reach for their antihistamine medication or an EpiPen for a self-administered shot of adrenaline in front of their friends.
One 2006 study published in the Journal of Allergy and Clinical Immunology found that about 60 percent of teenagers with severe allergies, such as one to peanuts, reported "always" carrying lifesaving devices such as EpiPens. But "always"' varied depending on where these teens were going and what they were doing. For example, while 94 percent said they carried EpiPens while traveling, only 61 percent took them to school dances. Fifty-four percent of the study participants chose not to carry EpiPens while wearing tight clothing.
But this is a dangerous way to approach having an allergy, said Woods. Even if a reaction seems mild at the start, it can become more severe 20 to 30 minutes later.
And teenagers in high school are most likely to take those risks.
"It's the age when most people do the greatest number of stupid things," Wood said.
And for the 12 million Americans who have allergies, about 3 million of whom are children, taking an unnecessary risk, even if it's around friends or a crush, may not be worth it.
"If you're close enough to somebody … you're close enough to talk about the need to be careful and say, 'I'm worried about what could happen to me if you've been eating peanuts,'" Provost said.
Kiss and Tell
But having food allergies might make it easier to pan for gold in a murky dating pool.
"It makes it easier to know when a boy is really into you," said Danielle Roberge, 19, who is allergic to milk products. "I've had a guy ask me before if he could get my food allergy as an STD." The two did not date.
On the other hand, Roberge described a moment when she and a boy were kissing and she began to get a bit red in the face because her lips were chapped.
"He made me go wash my face and brush my teeth," Roberge said. "I asked him, 'Did you brush your teeth?' and he said, 'Yes, of course.'"
Unfortunately, Richards never got to kiss the boy that Sunday on her porch because he had eaten a Twix candy bar, an "automatic no-no," she said, because the candy bar contains nuts. But eventually, Richards said her boyfriend became so conscientious that he would proudly volunteer that he hadn't eaten nuts that day so could give her a kiss.
"I'd say, 'Good job!'" Richards said. "It became like a reward."