The gold standard for measuring food allergy treatment success may be creating more problems than it solves in modern drug development. While oral food challenges have served as the definitive test for food allergies for decades, their expanded use as primary endpoints in clinical trials is generating significant concern among leading allergists. The oral food challenge requires participants to consume increasing amounts of their trigger food under medical supervision until they react—a process that can exclude large numbers of potential study participants and create substantial barriers to developing new treatments. Expert allergists convened by clinical research organization Parexel identified multiple critical limitations when these challenges become the sole measure of drug efficacy. The approach can systematically exclude representative patient populations through arbitrary reaction criteria, dramatically increase costs and logistical burdens for all stakeholders, and most concerning, expose study participants to unnecessary risks and distressing experiences that may not reflect real-world treatment benefits. This represents a fundamental tension in food allergy research: the most rigorous scientific measure may paradoxically be hindering scientific progress. The panel's discussion signals growing momentum toward incorporating immunologic biomarkers and alternative endpoints that could capture treatment efficacy without requiring patients to deliberately trigger allergic reactions. This shift could accelerate development of desperately needed therapies for the estimated 32 million Americans living with food allergies, while reducing the physical and psychological burden on trial participants who currently must endure repeated exposures to foods that could trigger severe reactions.