New research suggests calorie labelling could be dangerous for the mental health of people with eating disorders.
Research published by the British Medical Journal in January found that there is “cause for concern” regarding the negative impacts of calorie labelling on menus, particularly for people with eating disorders.
The government made it a legal requirement for large businesses to display calorie information on their menus in April 2022. The policy was introduced to help combat obesity, but Beat, the UK’s leading eating disorder charity, has raised concerns about its potential negative effects. Chief Executive Andrew Radford said in a press release that the legislation is “causing great distress for people suffering from or vulnerable to eating disorders”.
“From what we know so far in our review, most of the impacts [on people with eating disorders] are negative,” says Tom Jewell, a researcher working on the study. “People are saying that when they go to a restaurant or a café, their eyes are drawn to this information.”
Many people reported frustration with the government for encouraging a problematic approach to eating. Participants felt that the legislation implies low-calorie foods and calorie counting are the only ways to remain healthy, supporting disordered thinking.
Treatment for eating disorders often discourages calorie counting, so adding calories to menus can seem counterproductive to this advice. “Seeing the [calorie] info often triggers days-long spirals,” said one person featured in the study.
However, there is a lack of overall research, Jewell is quick to highlight. “One thing that surprised us was that the samples were not very diverse,” he says. “The people we’ve heard from in research tended to be white women with restrictive eating disorders like anorexia nervosa.”
Jewell suggests that when considering obesity policies, conversations should include eating disorder sufferers, as well as people working in public health and the food businesses themselves. “Having all these different voices together would make it easier to come up with solutions,” he says.
The legislation was introduced as “part of the government’s ongoing commitment to level up the nation’s health”, but just how well has it done this?
A recent Cochrane Report found that calorie labelling leads to adults selecting foods with 1.8% less calories on average (equivalent to 11 calories in a 600-calorie meal). Although this is a small number, the effects could be significant. Dr Gareth Hollands, who worked on the study, says that “you don’t actually need to see drastic cuts in calorie consumption to have an effect on population health.”
Government research estimates that 90% of adults aged 20-40 will gain 9kg over 20 years. “Reducing the amount of energy they consume per day by only about 1% would prevent that increase in weight,” says Hollands. The policy also encourages businesses to make healthier substitutions in their foods.
However, the legislation only covers businesses with over 250 employees, meaning only 18% of UK food outlets are obliged to comply. A 2023 study published in the British Medical Journal found that when it is required, the legislation is poorly implemented, with calorie labelling “perceived by enforcers as low priority” compared to other acute food threats such as allergens.
Businesses should also provide menus without calorie information when requested; however, many restaurants don’t provide this. ‘‘They could do a lot more to make it mandated that there has to be options available without that information,” says Hollands.
Hollands believes that whilst his review supports the government’s continuation of the policy, “they do need to think about ways of making it less triggering or upsetting for people with disordered eating.”
“It also placed a lot of onus on individual people, whereas we know that the food environment and much wider systemic factors are very important,” says Hollands, “it really should be implemented alongside a package of other interventions.” Government research published in 2023 found that amongst children, those who are deprived are more likely to be considered obese.
Further research has been commissioned by the government to assess the policy and is currently underway. “What we’re trying to do with our research is find out how people have been impacted, including people with different kinds of eating disorder symptoms, but also people of different ages and people at different stages of recovery,” says Jewell.
But with at least 1.25 million people in the UK living with an eating disorder, should the risks of the policy have been better considered before its implementation?
If you or someone you know is struggling with an eating disorder, you can contact Beat’s eating disorder helpline on 0808 801 0677.
Beat also offers advice for how to approach eating out with calorie labelling.