From the proliferation of gluten-free items on grocery store shelves, to the emergence of gluten-free items at restaurants and bakeries, it's clear that the decision to forgo wheat, rye and barley products has become a lifestyle choice.
For those with celiac disease or a separate issue known as gluten sensitivity, it's medically necessary to avoid products containing gluten. But as the Daily Beast reported earlier this week, some doctors have noticed that more people are taking up gluten-free diets to lose weight or mask extreme dieting and eating disorders.
Evelyn Attia, director of the Columbia & Weill Cornell Center for Eating Disorders told The Huffington Post that throughout the last few years, gluten has increasingly been cited as a dietary restriction by people who are being treated for anorexia and bulimia.
"There's no question that more and more individuals are coming in claiming a sensitivity to gluten, asking to have only gluten-free items or a completely gluten-free diet. But that only tells us that in this day and age, that’s the diet du jour," Attia said.
Several years ago, Attia said, there was a similar trend with patients who were adamant about being vegetarian or vegan.
Gluten-free diets (for non-medical reasons) aren't unlike other diets that have gained notoriety through pop culture and the press. In fact, some celebrities who don't have celiac disease or gluten insensitivity still extoll the virtues of a gluten-free lifestyle. For example, Lady Gaga went gluten-free last summer to lose weight, and Gwenyth Paltrow has taken up the diet to lose holiday weight.
Still, Attia explained, there is also a vulnerable population for whom a gluten-free diet can be problematic.
"For some individuals, they will cling onto ways of eating," Attia said. "Those diets will interface very dangerously with their vulnerability to develop an eating disorder. And that really may mask the initial phase or even may get in the way of the ability to engage in a treatment."
As Forbes previously reported, a high school cheerleading coach from Arizona noticed that at least three girls on her squad were lethargic and losing weight rapidly. When confronted, each girl claimed to have been diagnosed with a gluten allergy. Though the girls' parents confirmed their allergies, two of the students were later treated for eating disorders, and the third was eventually taken out of school.
At the same time, gluten-free diets are on the rise for a legitimate reason: Many more people have an intolerance for gluten than did so in years past.
As CBS notes, celiac disease is four times more common that it was 50 years ago. And it's estimated that as much as 6 percent of the U.S. adult population might have a gluten sensitivity (though that figure was based on patients at a celiac research center).
While celiac disease -- an autoimmune disorder that can cause intestinal damage -- can be diagnosed through blood tests, a person with a gluten sensitivity may test negative for celiac but still exhibit some of its symptoms, such as bloating, fatigue and stomach problems.
For some who do have celiac or an intolerance to gluten, having their medically necessary restrictions dubbed a fad diet, or a risk to those vulnerable to eating disorders, is proving frustrating.
"Just because select people have chosen to use Celiac Disease or gluten sensitivity to mask their eating disorder does not lessen the fact that there are millions of Americans who must follow this diet for legitimate health reasons," wrote blogger Kim Bouldin following the Forbes article. "One actually has nothing to do with the other."
Still, there's no doubt that the number of people suffering from gluten intolerance can't account for the explosion of the gluten-free market in recent years; it's grown by 28 percent annually since 2008 and now sits at $4.2 billion, according to the Los Angeles Times.
"The vast majority of people that are fueling this industry right now are people that embrace the diet for non-medical necessity," Dr. Alessio Fasano with the Center for Celiac Research at MassGeneral Hospital for Children told HuffPost. "These are the people who may have a misconception about what the gluten free diet is all about."
Fasano explained that if a person adopts a diet that relies largely on the gluten-free products available at grocery stores, he or she most likely wouldn't lose much weight. A gluten-free cookie or a piece of bread will be higher in calories than a regular one, he said.
Still, Fasano argued that there's nothing wrong with giving up gluten for non-medical reasons.
"Nutritionally speaking, gluten is totally useless," Fasano said. "We evolved without gluten, and it's not a useful protein for us."
Fasano added that going without gluten shouldn't be confused with an extreme diet.
"You can eat everything you want but three grains," Fasano said. "The caveat and the challenge is that these three grains are everywhere."