Calorie labels on menus could be making eating disorders worse, according to new research.
The review, published in the British Medical Journal Public Health, examined 16 existing studies from the UK, US, Canada and Saudi Arabia which included 8,074 participants, with a focus on how nutritional labels on menus impacted people with a lived experience of eating disorders.
The researchers found evidence suggesting there is a “cause for concern regarding negative impacts, particularly for those with restrictive eating disorders” and called for further research.
They said such impacts included avoiding restaurants based on the menus, triggering eating disorder thoughts and paying more attention to calorie labels, as identified by eye-tracking research.
The review highlighted one American study which showed people with anorexia or bulimia selected food with an average of 550 calories when they were given calorie labels, compared to 1,615 calories when they didn’t have calorie labels.
In another study in England, researchers found 55% of participants with an eating disorder reported that calorie labelling may worsen their eating disorder symptoms.
The academics involved in the review said more research was needed to better understand the impact calorie labelling was having on people with eating disorders, rather than the focus being predominantly on tackling obesity.
A law introducing calories to menus in restaurants, takeaways and cafes with more than 250 staff came into force in England in 2022 in a bid to help reduce obesity levels.
But recent studies have raised doubts over its effectiveness, with a Cochrane review published earlier this month suggesting calorie labels on menus and food packaging lead to people eating one less crisp than usual – though experts said that was a “small but potentially meaningful effect on people’s food choices”.
The new review’s co-author, Dr Nora Trompeter, said: “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.
“Our review also shows that more research is needed to fully understand the impact of calorie labels on individuals with eating disorders. For example, none of the studies included young people.”
Fellow co-author Dr Tom Jewell added: “Our study highlights that people with lived experience of eating disorders are frustrated at being left out of the conversation around calorie labels.
“Striking a balance between the positive and harmful impacts of calorie labels on menus is vital in any public health policies.
“Policymakers should consider the impact on both obesity and eating disorders when making decisions about nutrition labelling.
“A recent review found that calorie labelling has a modest effect on people’s behaviour but this needs to be counterbalanced with the potential harm it does for people with eating disorders.”
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Reacting to the study, Tom Quinn, director of external affairs at eating disorder charity Beat, said: “This vital research adds to a growing bank of evidence: calorie labelling on menus doesn’t help anyone.
“People with eating disorders are harmed, and the general population see such a negligible benefit that it can’t be justified as an effective health policy.
“For those with eating disorders, calorie labelling can worsen feelings of anxiety and stress and lead to harmful behaviours such as binge eating, exercising excessively or restricting food.
“Going out for meals is also an integral part of eating disorder recovery and having calories on display can make this much more challenging and keep people unwell for longer.
“We hope that the government now takes this into account and chooses to prioritise the 1.25 million people affected by these serious mental illnesses, rather than continuing with a so-called health measure that simply doesn’t work.”
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A Department of Health and Social Care spokesperson told Sky News: “This government is committed to tackling the obesity crisis head on, shifting our focus from treatment to prevention as part of our 10 Year Health Plan.
“We will continue to evaluate the impact of out of home calorie labelling on people with eating disorders and overhaul the NHS to ensure those living with eating disorders are given the support they need.
“This includes delivering talking therapies to an extra 380,000 patients, recruiting an extra 8,500 adult and child mental health staff and providing access to mental health support in every school.”
