Gluten Free for Life: Celiac Disease, Medical Recognition, and the Food Industry. By E. K.Abel, New York: NYU Press, 2025. 232pp $30 (paperback) $89 (hardcover) $30 (ebook) ISBN 9781479834938

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In Gluten Free for Life, Emily Abel explores social, political and historical tensions related to celiac disease in the United States. An autoimmune disorder with no cure, the only treatment for the disease is the lifelong strict adherence to a gluten-free diet. Abel comes to the topic with a personal connection through family history. This intimate familiarity serves as a strength: the lived experience at navigating the gluten-free diet within the American context on behalf of loved ones adds a further layer of nuance to an already intriguing analysis. As a reviewer, I come to the book as a sociologist diagnosed with celiac disease over 20 years ago within the Canadian medical system. Drawing on public data sourced from online community discussion forums, and other secondary sources, the text begins by overviewing a brief history of medical (mis)conceptions. Each subsequent chapter then moves to explore various ongoing challenges related to this sometimes contested illness. Chapters 2 and 3 examine how the use of hyperbolic language in diet endorsements from so-called wellness influencers and celebrities has trivialised the gluten-free diet as a lifestyle choice, and how failures of transparency and consistency in front-of-packaging labelling (FOPL) regulations on food products sold within the United States have produced a culture of distrust amongst patients and consumers. From there, chapters 4 and 5 reveal how the work of health-advocacy organizations (HAOs) is at risk of compromise through conflict of interests when partnered with food industry and pharmaceutical companies, and how structural inequalities related to social class and ethnicity directly impact access to safe, affordable and accessible medical supports, while also compromising food security. In chapters 6 and 7, the author tracks how those same structural barriers play out through practices and policies in place at various institutions, whether public or private, such as workplaces, schools, hospitals and prisons, and how narratives presented by social media content creators and public academics endorsing positive psychology tell a particularly optimistic celiac story, one that may not be reflected within the celiac community. The final substantive chapter considers how people with celiac disease are constantly navigating how best to perform in various social settings, whether at workplace lunches, first dates or family gatherings, for example, so as to accommodate the perceived expectations and judgements of others. Throughout the text, the author successfully shows how various social actors come to impact the celiac experience. Because celiac disease is managed without much interference or guidance from medical professionals, commercial actors from within the food sector play a determining role in how people carry the illness in everyday life. Amidst gaps in knowledge within the medical community, failures in government policy and seemingly growing distrust in food companies, Abel reveals how online community forums have emerged as a potentially contentious space, offering resources and support while also platforming (mis)information. It will be interesting to see what role generative AI will ultimately play at further helping or hindering the celiac experience for those seeking guidance in online spaces. The text draws attention to how certain social determinants of health, such as one's social class, alongside their position within the labour market and their geographic location, will ultimately impact their capacity to navigate the gluten-free diet. Although it does offer examples to show how structural inequalities impact medical care as well as access to safe and affordable foods, it could go further to show the particular ways in which class, gender, ethnicity, and age, for example, collide and intersect with regard to the celiac experience. For example, it does not address tensions related to disordered eating, or the role gender performance may play in how individuals navigate social pressures and expectations. Moreover, the book does not provide many specific examples related to cultural differences within the United States. However, by framing the analysis within the broader American context, Abel highlights the role politics plays in shaping how dominant culture comes to understand health and wellbeing. As a result, it offers a case for comparative analysis with other jurisdictions. As more social research is needed to further understand these issues, this text lays a strong foundation. This book will be of particular interest to anyone looking to understand the history of celiac disease in America, the economic incentives driving commercial interest in the gluten-free community, ongoing challenges related to celiac diagnosis, and the socio-economic barriers restricting adherence to the gluten-free diet. Importantly, it will also be of interest to people living with celiac disease: they may find their own experiences reflected in its pages, and may also recognise the names of organizations, companies and influencers featured throughout. As America continues to grapple with changes in dietary guidelines, policy interventions on labelling, and access to safe and affordable food and medical supports, it is clear the celiac experience will remain in flux. Mary Hanlon: writing – original draft, writing review and editing. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.