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Does calorie labelling even work?

This year in April the UK mandated that restaurants with over 250 employees put calorie counts on menus. There’s been pushback from Beat UK, a charity helping those with eating disorders and disordered eating, requesting the UK government drop its plan. Their argument is backed by their research which found that calorie labelling puts people with eating disorders in states of distress and Beat frequently cites a 2018 research paper which found calorie labelling ineffective.


My goal this week is to explore the pros and cons of calorie labelling on menus. I'll walk through research behind calorie labelling, explain the behavioural design perspective of calorie labelling, and will finish off with the potential big pro I found out about the impact calorie labelling has.



What do I think? (i.e. what are my biases going into this)


At first, I was on board with Beat, but as I thought about my own experience with disordered eating and conversations with multiple friends, I began to question the research. I just came back from an all-inclusive beach holiday in Mexico, I didn’t worry about a calorie the entire week, but in my day-to-day life, I like to make informed decisions about what I eat and I like calorie labelling because it encouraged me to eat out more. This has made me more social which according to the New York Times is crucial to mental health.


Calories on menus have given me freedom, additionally, I believe obesity is an epidemic. The population of the UK sits around 68 million. There is an estimated 68% of the UK Male population and 60% of the UK female population whom are considered obese compared to at most 4.9% of those with eating disorders.


I do think eating disorders are an issue, but because of the volume of the issue I believe the need to solve the obesity epidemic is greater at this point in time. I’m telling you this because although I’m aiming to be neutral, I want you to know in advance I have a bias to prove why calorie labelling is good. So take everything below with a grain of salt, and make sure you look into the studies yourself.


BEAT's research




When I looked at the 2018 study cited, the study showed over half of the participants didn’t even notice the calorie information. Those who did were most frequently used to avoid high-calorie-menu items or have smaller portions. The study stated that using the labels was related to binge eating and weight-related concerns in men and women and suggested that nutrition professionals proceed with caution when it comes to calorie labelling.


BEAT also conducted a survey where experiences contrasted my own. Those surveyed said:


“Counting calories has been almost deadly for me and ruined my life.”


“The thought of seeing the calories on menus makes me feel so sick and sends me straight back into the depths of my eating disorder.”


“To watch someone you love dearly be further deprived of enjoying a meal, which they have bravely chosen, due to calories is heart-breaking.”


Additionally, the UK Government announced their plans to develop and test a “Mental Health Impact Assessment” for all new policies to work with stakeholders “to explore the development of a policy tool which allows policymakers to examine the impact of their proposals on mental health.” No such assessment for this proposed legislation, although this is likely because the tool hasn’t been developed yet.


Lastly, a Cochrane review found that there is only a small body of low-quality evidence supporting the idea that calorie counts on menus lead to a reduction in calories purchased with at least two studies showing the positive effects of calorie labelling at risk for high levels of bias.


Applying behavioural design - what are the concerns with calorie labelling


The main concerns I have with calorie labelling from a behavioural design perspective are compensatory behaviours and over-simplification.




Addressing my concerns about negative behaviours, first I looked into compensatory behaviours. What came to mind when I was talking about this was the study where people who chose diet drinks tended to compensate by choosing higher-calorie foods. However, a 2019 article from The Washington Post shows there isn’t compelling evidence against diet beverages. So I dug further and I found studies on compensatory behaviour found the compensatory consumer behavior model, which shows consumers buy products that express who they want to be, and that purchases aligning with their goals make them less likely to compensate. More research needs to be done on compensatory behaviours and calorie labelling, however applying the model to calorie labelling leads me to believe that people making choices in line with what they want might mitigate unwanted behaviour post meal, not make it worse - unless the identity that someone is striving for is someone who doesn’t care about calories.


Next on the list is over-simplification. Calories are notoriously difficult to measure, and don’t tell the whole story about the nutritional quality of a meal. For those with pre-exisiting nutrition knowledge, calorie labelling can help form a better choice, however there is work to be done for those who don’t know enough about food. I once read a quote that said something along the lines of “If you think calories don’t matter, you don’t know much about nutrition, but if you think calories are the only thing that matter, you know nothing.” The calorie labelling information on menus in the UK is part of a wider plan to encourage people to choose more vegetable dense dishes, but people concerned with calories can get it wrong if they don’t know enough about how to stay full. For example, looking at the Nandos UK menu, a Rainbow Bowl salad has 521 calories per serving, while Bottomless Frozen Yogurt has 134 calories per serving. It’s easy to picture how a hungry and tired dieter would choose the easy to eat option with less calories but a short-term sugar high and easily surpass the calorie count of the salad only to be hungry again an hour later.

Impact - The potential big pro of calorie labelling


In my research, what surprised me at first was calorie labelling from the consumer side seems to lead to a low 4% decrease in calories per meal, and although we discussed a calorie isn’t a calorie, and the nutritional quality of the meals weren’t measured, it almost immediately made me think - that’s almost nothing, what’s the point? The point is, although it may not be changing consumer behaviour, there is evidence to suggest it might be changing corporate output.


Research from 2018 suggests menu items at chain restaurants added after 2018 contain 25% fewer calories than items on menus before calorie labeling rules in the USA. It’s not clear whether this is because of the government rules, changing consumer preferences in food type or preferences for companies with strong corporate social responsibility. More research needs to be done on this, but if UK menus post calorie labelling cause companies to offer more appealing dishes with more vegetables, it could change the way people eat out.





Conclusion


I said at the beginning of this blog post that I personally like calorie labelling even though I’ve struggled with disordered eating. What I’ve found is, most consumers won’t even notice calorie labels are there unless they’re looking. Whether calorie labelling is overall good or bad is a matter of opinion right now. We don’t know the true long-term effects of a behaviour change programme like this. I understand the government’s urgency to do something because the rising rates of obesity in the UK are concerning, but so is the clear severe impact on the mental health of those recovering or struggling with eating disorders/ disordered eating.


The idea that calorie labelling could change what consumers are offered is exciting, but it’s clear from my research there isn’t enough research on the effectiveness of calorie labelling, especially for consumers who aren’t nutritionally literate. It’s concerning that the government would impose a nationwide programme that isn’t backed by sufficient evidence, and I hope research is being done to assess the success or failure of this mandate and action is taken accordingly.


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