Not too many years ago, Massachusetts and at least one other state mandated some education for restaurants and a note on menus saying if you have an allergy, make sure you say something. I'm not sure whether that was a cause, or just another effect of a larger trend, but I can definitely say that the last few years of dining out has been really different than my early life was.
As a baby, I was diagnosed with a cow's milk allergy, and given soy formula, rather than cow's milk formula. I was apparently taken into the pediatrician's office or possibly even the hospital on more than one occasion as a baby for a shot that I was told as a young adult was "adrenaline", but was probably actually epinephrine. I took a lot of allergy medication as I was growing up, and I had limits on how much milk I could have. I had a spreader in my mouth that helped with the chronic nasal congestion/PND, but things didn't really get _good_ until I hit a second crisis in my teens. Unfortunately, on a visit to my eldest sister in Boston (Cambridge, technically), I discovered Steve's Ice Cream (it was the '80s, and still amazing). I also had fudge for the first time. I got incredibly sick and I _stayed_ incredibly sick. I was thin anyway (5'7" and weighed between 105 and 110), and it was not looking good for me. I wound up cutting out every milk product I could find and started reading labels religiously. The change was unbelievable. Within a very short period of time (a few weeks), I felt better than I had in my entire life, and I quit having stomach cramps after lunch that would cause me to double up in pain. I'll spare you some of the other symptoms, but I was even able to cut back substantially on the allergy medication.
At some point before that crisis, I had had shrimp in salad a couple times, and wound up vomiting it all up. I assumed at first I got bad shrimp, but after the second time, I was like, you know, no one else is getting sick off this. I'll just skip it. Fast forward a few years, and I had crab cakes. They were amazeballs. I threw up, but I thought it was something else. I learned how to make crab cakes. They were amaze balls. And I started having debilitating migraines, instead of a couple times a month, I was missing half a week. You would think, by this point, I would have figured it out, but I wound up food journaling to track it down, because it took hours for the effect to happen, and I often would have had at least one other meal in between. So: no more crab. While I was at it, I got religion on shrimp, and started asking questions when I had pad thai and I ultimately gave up on miso soup entirely. No more migraines. Like, not even the ones I had assumed were random. Incredible.
No doctor was ever involved in any of this debugging, and I eventually got the background post nasal drip down to a point where I could notice that I was getting congested from eating milk products, the wrong kind of shellfish (lobster, it turned out, was also not my friend, altho mussels, clams, and oysters all seem okay), and possibly lemongrass. I've become a little suspicious of mango, altho I rarely put a lot of effort into avoiding it because it just isn't that common in the first place. When medical histories ask about food allergies, I list milk and shellfish, and it's been weird how careful hospitals are about the shellfish thing. I tell them I've never been diagnosed by a doctor, and just tell them how I figured it out and they all just believe me.
When I read an article like this one, it makes me scratch my head:http://www.bostonglobe.com/magazine/2015/10/14/why-food-allergy-fakers-need-stop/PB6uN8NF3eLWFjXnKF5A9K/story.html
"That helps explain why so many Americans believe they have a food allergy and act on it without ever going to the doctor to confirm the hunch."
"Fasano is troubled that so many people are diagnosing themselves with gluten intolerance, changing their diet without ever going to the doctor. “You don’t say, ‘I’m drinking a lot and peeing a lot, so I must have diabetes,’ and then start injecting yourself with insulin.” "
I don't think you have to go see a doctor to figure out that you have an allergy. A friend of mine wound up in the ER recently, TWICE, with severe allergic reactions that the doctors there weren't able to immediately figure out. For a variety of reasons, my friend had trouble accessing specialists who might have been able to help. Initially, the thinking was that the correct specialist would be a dermatologist (it was a skin reaction, not a respiratory reaction), but after the second ER trip, it was pretty clear it had to be allergic, and by that point, my friend had already eliminated all the obvious topical triggers (stabilized everything she was putting on her skin, and carefully gone through all the clothes detergents and so forth). We discussed it several times, and she concluded it was probably either pork or avocado, after reviewing the most severe days and what she had eaten in the 24 hours prior. It ultimately turned out to be pork. The hope was that it was just the nitrates/nitrites (bacon), but alas, no, it really was pork. Which means she can still have turkey bacon. The net result -- without doctors providing meaningful input -- has been that there are no further ER visits needed for a skin condition that was seemingly randomly getting really, really bad and then abating slightly (I mean, we're talking significant fluid retention and getting so thin and fragile that scratching made her bleed.).
You can have a pretty awful food allergy or intolerance, and epi-pens have nothing to do with it. My husband, for example, has been forced to really cut back on the entire onion family (and boy, he's neither the first or the worst person I know with this problem) because the acid reflux caused by these foods is severe and long-lasting, and while you can do a little with medication, those medicines have some pretty negative side effects, especially used over time -- not to mention the impact on his sleep.
I don't mind paying extra to get something that won't kill me. I don't mind having to pick something else on the menu to get something that won't kill me. I rarely get to order dessert, because I don't want to eat something that will kill me. And by "kill", I mean make me incredibly miserable for something like a few hours or a few days, perhaps a stuffed head, maybe some diarrhea or vomiting, maybe a monster migraine, maybe just making it that much more likely that I'll come down with the next cold and have it for so long it turns into something worse and I need abx. The dairy side isn't a cross-contamination problem -- it's straight up dose response. The shellfish side isn't a severe cross-contamination problem. I've never needed an epipen. (<-- I'm leaving some scary detail out here.)
If there really are people out there who don't like the taste of something and are claiming it's an allergy and it isn't, and they will have the thing they claim is an allergy if the payoff is good enough (like saying no dairy, but eating ice cream, in the article, or no gluten but having a beer) -- well, that's bad. I hope those people stop. But if people like my husband are saying they really can't be eating garlic and onions are perceived by others as being "fakers", well, anyone who sees it that way probably shouldn't be in the "hospitality" industry. Cause that's some pretty fake "hospitality" right there.