Mandatory calorie labeling on food and beverage menus has sparked a heated debate: do they do more harm than good? As more countries adopt such measures to combat obesity, growing evidence highlights unintended consequences, particularly for individuals with eating disorders. The question remains whether the benefits of these policies outweigh their drawbacks—or if a more nuanced approach is required.
Calorie labeling policies: a global trend
In England, calorie labeling became mandatory in April 2022 for food businesses with 250 or more employees. Restaurants, cafés, and take-out establishments must display calorie counts on in-store menus, delivery platforms, and online ordering systems. The move aimed to curb obesity by encouraging consumers to make healthier choices. Similar regulations are in place in the US and Canada, reflecting a global effort to address rising obesity rates.
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These measures target a significant challenge: obesity is linked to numerous health conditions, including cardiovascular disease and type 2 diabetes. Recent research published in The Lancet Public Health journal modeled the potential impact of menu calorie labeling on obesity prevalence and cardiovascular mortality in England. The study projected that current calorie-labeling policies could lower obesity prevalence by 0.27 percentage points over the next two decades, preventing or postponing 730 cardiovascular disease deaths by 2041.
Furthermore, a full implementation scenario—expanding the policy to all out-of-home food businesses—could reduce obesity prevalence by 2.65 percentage points and prevent 9,200 cardiovascular disease deaths within the same timeframe. Researchers noted that the policy neither widened nor reduced health inequalities, as its effects were consistent across socioeconomic groups. However, critics argue that the broader implications of such policies, particularly their psychological toll, must be carefully examined.
A harsh reality for individuals with eating disorders
For individuals with eating disorders, though, calorie labels on menus can reinforce harmful behaviors and perpetuate disordered thinking. A recent study published in BMJ Public Health reviewed 16 studies from the UK, US, Canada, and Saudi Arabia, encompassing 8,074 participants. It revealed that calorie labeling had adverse effects on people with eating disorders, such as avoiding restaurants, paying excessive attention to calorie counts, and experiencing heightened eating disorder thoughts.
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Tom Jewell, PhD, Senior Lecturer in Mental Health Nursing at King’s College London, emphasized the frustration of individuals with eating disorders being excluded from discussions on calorie-labeling policies. “Our study highlights that people with lived experience of eating disorders are frustrated at being left out of the conversation around calorie labels,” Jewell said. He stressed the importance of balancing the positive and harmful impacts of calorie labels in public health policies, urging policymakers to consider both obesity and eating disorders in their decision-making processes.
Nora Trompeter, PhD, Research Fellow at University College London and co-author of the study, echoed this sentiment. “Our study provides an important addition to the evidence base around calorie labels. Typically, there is a lot of focus on whether policies are effective in reducing obesity, but it is also critical to investigate whether these policies inadvertently harm people with eating disorders,” she said. Trompeter noted that further research is essential, particularly studies focusing on young people who are often underrepresented in such analyses.
The bigger picture: balancing benefits and risks
While calorie labeling may empower some consumers to make informed choices, it has limitations as a public health tool. Critics argue that calorie counts reduce health to a single metric, failing to consider the complexities of nutrition and individual well-being. For instance, a calorie-dense meal might provide essential nutrients, while a low-calorie option could lack nutritional value. This oversimplification risks perpetuating misconceptions about food and health.
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Moreover, the rise of calorie labeling reflects a broader societal trend of prioritizing obesity prevention, often at the expense of addressing eating disorders. In the UK alone, eating disorder charity Beat estimates that 1.25 million people are living with an eating disorder. Hospital admissions for such conditions have risen by approximately seven percent annually since 2005 to 2006. These figures underscore the need for public health policies that do not exacerbate existing health challenges.
Reformulation and behavioral changes
The Lancet Public Health study highlighted the potential of calorie labeling to influence food industry practices. Researchers assumed that retailers might reduce the caloric content of menu items by an average of 15 calories per meal, contributing to lower obesity rates. However, they also acknowledged the limitations of relying on consumer behavior alone. Many consumers compensate for reduced calorie intake during meals by consuming more food later, a phenomenon known as energy compensation.
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The study modeled an average decrease of 47 calories per meal due to labeling, with consumers compensating for 26.5 percent of the reduction. While modest, these changes could cumulatively impact public health over time, particularly when combined with broader efforts like food reformulation and nutrition education.
Navigating the path forward
The implementation of calorie labeling policies has undeniably sparked important conversations about food, health, and societal values. While the potential benefits for obesity prevention are evident, the risks for vulnerable populations, particularly those with eating disorders, cannot be ignored. Policymakers face the challenge of developing inclusive strategies that address diverse health needs without creating unintended harm. Striking this balance will require ongoing research, collaboration, and a commitment to nuanced, evidence-based approaches.
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