Mandatory Calorie Labelling - Viewpoint & Survey
Following the announcement of Government plans to introduce mandatory calorie labelling on food outlet menus and signage in restaurants, pub chains, fast food outlets etc., we are very concerned about the impact this legislation could have on those living with any form of disordered eating and associated issues such as body image concerns, compulsive excessive exercising, bingeing and purging behaviours.
Whilst it is vital to acknowledge the importance of reducing obesity levels for the general health of the population, this can not be at the expense of those that need support and help for an eating disorder. On this point, the Department of Health & Social Care (DHSS) states;
“Although the Department acknowledges this concern, with more than a third of children leaving primary school overweight or obese and nearly two-thirds of adults, it is important to equip people with the information to make decisions about their food intake. Information on the energy content of food and drink is already widely available in supermarkets through mandatory nutrition labelling requirements on pre-packaged foods and some restaurants. We are committed to striking a careful balance between informing and educating people to make healthier choices whilst not negatively impacting people with eating disorders or those in recovery from eating disorders.”
There are two key points here. The first is that we believe the introduction of calorie labelling and information will be detrimental to those affected by eating disorders. The second being if we were to accept that some kind of legislation could be implemented to strike the balance between reducing obesity but without negatively impacting those with eating disorders, then that legislation should provide some proactive means of ensuring those with eating disorders are positively supported too.
In their public consultation report, DHSS cites several research studies, (see links below), in response to comments and concerns about the impact on those with eating disorders. The first, by Lillico et al, is described in the DHSS report as finding no discernible impact;
“Research by Lillico et al. considered the effect of menu labelling on those at high risk for eating pathologies and found no significant change in calorie consumption in response to posting calorie labels.”
And the second, by Christophe et al., indicates only some impact;
“…although research by Christoph et al., found that label use on packaged foods was related to engagement in some unhealthy weight behaviours, there was a larger likelihood of participants engaging with healthy weight control behaviours."
We have looked at these studies, and others, in more detail. Our concern with the reliance on the Lillico research to illustrate ‘no discernible impact’, is that it was conducted amongst female undergraduates in a university cafeteria setting. Whilst the group was considered an ‘at risk’ demographic, it does not clarify whether any of those in the research group were currently living with an eating disorder and therefore the researchers did not appear to study the impact from that critical perspective. In fact, the researchers themselves concluded that additional research was needed amongst those with an ED diagnosis:
“Overall, no adverse outcomes were found for this at-risk population. Calorie labels did not differentially affect those with higher levels of eating disturbance. Future research should focus on examining the impact of calorie labels among those with clinical eating disorders.”
Whilst DHSS highlights that the likely impact on mental health and those with eating disorders is ‘somewhat mixed’, their report does not highlight some of the most critical aspects of the research studies it relies upon. For example, when we looked closer at the findings of the Christophe et al., study, there was evidence of greater detail of the likely impact on those with specific disorders:
“In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating.
Backing this up, another research study by Haynos et al., concludes:
“However, when examined by eating disorder diagnosis, participants with AN or BN ordered significantly fewer (p < .001) and participants with BED ordered significantly more (p = .001) calories in the menu label versus no label condition. Menu labeling may decrease the calories ordered among individuals with AN or BN and increase calories ordered among individuals with BED."
These research studies are referenced as sources within the DHSS report and our view is that consideration of the true impact of mandatory calorie labelling on those with eating disorders has not been sufficiently considered or evaluated.
Furthermore, and perhaps most importantly, where existing research is showing a 17% increase in the risk of bingeing, a decrease in calories ordered by those with Anorexia or Bulimia, and a general increase in calories by those living with Binge Eating Disorder, in all consciousness it cannot be claimed the much-quoted ‘balance’ to have been sensitively and successfully struck.
In summary, we understand the need to reduce obesity, the prevalence of Type II Diabetes, heart disease and associated conditions amongst the general population, and acknowledge these are some of the most critical health issues of our time. However, we are deeply concerned that the Government’s conclusion that the impact of this legislation on those with eating disorders is, in overall terms, ‘neutral’, is flawed.
We want to see far more consultation with eating disorder and mental health communities taking place prior to the progression of this legislation and certainly, before the process of practical implementation begins. The needs of those with eating disorders are not incidental to those with obesity, and the Government must find further ways of supporting people with these devastating illnesses if they are to proceed.
Your views - survey
If you would like to share your thoughts on this issue and to let us know how you think mandatory calorie labelling might affect you, fill in our short survey. Your responses will be submitted anonymously but will help us gather crucial first-hand insight and testimonies to continue the debate.
Research Study Links:
"The effects of calorie labels on those at high risk of eating pathologies: a pre-post intervention study in a University cafeteria"
Lillico et al., 2015
"Nutrition Facts use in relation to eating behaviors and healthy and unhealthy weight control behaviors"
Christophe et al., 2018
"The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating"
Haynos et al., 2017