Needs vs. Wants in Diets and Disability
A useful distinction, but a dangerous dichotomy
It’s often useful to distinguish needs from wants, because the alternative can be sacrificing what one person needs in favour of what other people want. You’ll sometimes get people denied acccommodations for their disabilities, for example, because ‘if Jonny gets that, everyone will want it!’ Everyone doesn’t need it, though; the rest of the class will be fine without it, but Jonny won’t be able to learn. Accessibility needs are very often confused with preferences.
It is essential to recognise that wants and needs are not equivalent. This is one of the key learning outcomes of LEANS (Learning About Neurodiversity at School), and I stand by that, but it’s also not that simple. It’s vital to undersand why needs can sometimes look like wants and vice versa, and that there is actually a huge grey area in the middle. I’ll start with disability here, because so many disabled people will recognise the damage done by false-binary thinking, but this post was prompted by an experience relating to food, and I’ll be arguing that the two have more in common than many seem to think.
Capabilities and Costs
People with no experience or understanding of disability often imagine that it means you simply cannot do certain things. If you use a wheelchair or walk with a stick, it must be because you cannot walk otherwise; so people getting up from their wheelchair to reach for a piece of shopping can be subject to harassment from people who think they’ve caught a fraud. This starts to get at the trouble with the assumption that needs are absolute: for many with limited mobility, some walking is possible, but it costs far more than it does abled people. Too much walking dramatically limits their ability to do other things.
Similar calculations apply across many (but not all) disabilities. I have an energy-limiting condition, which means that too much exertion or standing up can cost me immense discomfort and days of being unable to do other things. I’m Autistic, and sensory stress can have similar effects. Do I need to wear sunglasses to the supermarket? Surely not. I could just be in pain the whole time and exhausted afterwards, like I used to be before I realised there was a choice! Understanding the experience of neurodivergent people at school, in the workplace or elsewhere means seeing how their day might be full of these costs, constantly building up if the environment is not as accessible as possible.
What does ‘need’ actually mean? I think it’s necessary to think in terms of costs, rather than absolutes. I need to shield my eyes to avoid the cost. Too many unmet needs might add up to meltdowns, burnout or days in bed, but for any single thing I might say that I need as a result of my disabilities, there is often, technically, a choice. I won’t die in an inaccessible environment, but the cost may be very high.
Hospital Food
I recently contracted a serious infection, requiring surgery and a hospital stay. I was extremely limited in what I could get into my mouth, and how much chewing I could do. Also, I am a vegan, which seemed to throw the staff. Apparently 3% of the UK population is vegan now, but maybe not in Livingston?
In any case, in the evening after my surgery they brought me a menu for the next day on which vegan options were supposed to be marked ‘Ve’, but not a single dish was. Nobody could tell me for sure what vegan food was available, and their alternative menu made things even worse. It turned out to be an ‘allergen-safe’ menu, with many meat options for every meal (the nurses guessed wrongly that it was vegetarian fake-meat). The ‘easy-chew’ option was completely absent, and there was still nothing marked as vegan.
The upshot was that this was my lunch, the day after my mouth surgery:
…and this was my supper the evening after my surgery:
I don’t blame any of the extremely busy staff on the ward, and to be fair my giant potatoes were accompanied by small bowls of thin soup, but these were just not healthy meals for someone recovering from mouth surgery (I had to send the second one back untouched, after exhausting myself attempting the first one). If a hospital is incapable of catering adequately for vegan patients, in the UK, in 2026, I think something is going badly wrong. I was relieved that the response to my complaint, and NHS Scotland guidance, seem to agree.
So when a friend who works in this field sent the following later in my stay, it was unwelcome, but it did get me thinking about why this kind of thing still goes wrong:
Choices like vegan food come behind immediate needs (nursing) and hard requirements (allergens / soft food)
So… is vegetarian or vegan food a choice? Is it just a preference, or is it something that people need?
Dietary Choices
When I became a vegetarian, as a child in the 1980s, I faced a lot of puzzling hostility, and many weird questions. One that came up a lot was:
What if you were on a desert island, and you had to eat meat or starve to death?
I was never sure what motivated this. Maybe some people relish scenarios where people whose ethical choices they don’t understand are tortured for it? Or maybe they didn’t get that it would be torture to force someone to choose between starving or directly violating their moral code?
I can’t rule out the second possibility, which is basically why I’m writing this. I have the sense that people who have never become a vegetarian or joined a religion genuinely may not understand what it means to do so.
When someone decides to become a strict vegetarian, that is a choice: they are committing to not eating flesh. They are becoming someone who does not eat flesh. From that point forward, until they reverse that decision, meat and fish are things they simply do not eat. Similarly, when someone becomes a strict adherent of a religion that prohibits certain foods, those foods become things they do not eat.
This means that when a menu includes vegetarian and meat options, vegetarians are not choosing not to order meat; they already made that choice, potentially years ago — or maybe they were born vegetarian, and have never made the choice not to be. Meat is effectively not on the menu for them. It might as well not be a food at all, because the type of person they are is someone who does not eat it.
I should say here that of course not every self-identifying vegetarian sees things in these terms (and nor does every Muslim, Hindu or vegan). For some, the desert-island scenario above might be trivial; obviously they would eat whatever they need to survive. Similarly, many people with medical reasons to avoid certain foods are actually quite flexible about it! I’ve met a surprising number of lactose-intolerant people who feel that the digestive price they pay for consuming dairy is worth paying.
For many, though, the cost is far too high, whether medically or psychically. In a physical sense, sure, they could eat a certain dish, but it would cause substantial suffering, and might make them ill. Perhaps if you’re a meat-eater yourself, you could imagine how it might feel to be offered a friend’s pet as a meal. A vegetarian might feel sick, violated and wrong if they somehow end up eating meat. They are likely to vomit, and a feeling of wrongness could stick with them for a long time afterwards. They might well choose starvation over eating flesh. Whether or not you can personally understand this sort of commitment, it is a grave error to think of compatible food as a mere preference or want. People need to eat, and many people do not eat certain foods.
We might ask whether anyone is obliged to cater for all dietary needs. In many cases, the answer is surely no: if one establishment doesn’t cater for my needs, I can hopefully find another that does. If someone invites me for a meal, I would want to know they are actually going to feed me, but that’s a matter for conversation; I can always turn down an invitation.
In a mass catering situation, I would say that organisations really ought to accommodate common dietary needs by default. If a minority of attendees at a conference are very poorly fed, that seems like a lousy result, and perhaps discriminatory. In something like a hospital, I would argue that there is a need to cater for everyone they possibly can, because patients have no option to go elsewhere, and can’t rely on visitors bringing food from outside (which is often discouraged) — and besides, being decently fed is essential to recovery. That doesn’t mean they need to provide anything fancy! It might mean going simpler; many staples can easily be made without flesh, eggs or dairy. It definitely means kitchens clearly communicating what options are available.
Catering in general needs to recognise dietary needs for what they are. If someone can’t eat something because they have made an ethical or religious decision to rule out eating it, then treating their dietary requirements as optional risks starving them. Whether someone’s needs are down to ethics, disability or something else entirely, we should not need to understand them in order to respect them.
With thanks to for some helpful suggestions.
