April 11, 2022 - 11:41am

The first part of a key government drive to tackle obesity came into force last week. From now on, diners will be greeted with calories on menus when visiting restaurants, cafes and takeaways with more than 250 employees.

Many people will be supportive of such a policy — after all, rates of obesity have ballooned during the pandemic, particularly among children, and some intervention is urgently needed. However, the benefit of including calorie counts on menus remains to be seen. Research from America — where the practice of putting calories on menus is widespread — has shown mixed results, with many studies showing no overall impact on calories consumed.

Alongside these significant questions over the benefits of the policy there are other concerns. When the plan was first announced, eating disorder charity BEAT condemned the changes, stating:

“Requiring calorie counts on menus risks causing great distress for people suffering from or vulnerable to eating disorders, since evidence shows that calorie labelling exacerbates eating disorders of all kinds.”

In fact, a BEAT survey of individuals with experience of eating disorders found that 93% thought that calorie labelling on menus would have a ‘negative’ or ‘very negative’ effect, with some respondents arguing that, even for those without diagnosed disorders, such labelling risked encouraging obsession over calories and anxiety around eating.

This belief is borne out by the data. A recent study found that 1 in 10 dieters who calorie counted became bulimic, with participants admitting to behaviours such as skipping eating for days after a ‘binge’, eating ice and misusing laxatives. Such negative effects aren’t just limited to anorexia and bulimia — for those with binge eating disorder, the inclusion of calorie counts on menus has actually been found to increase calories consumed.

To make matters worse, this change also comes on the background of already soaring rates of eating disorders. Doctors have described a ‘tsunami’ of illness, especially in the young, with experts suggesting that isolation during lockdown, combined with a lack of control and freedom triggered eating disorders.  As restrictions became more stringent, controlling food became a way for many to deal with the loss of control felt in nearly every other aspect of their lives.

This crisis hasn’t just been limited to new diagnoses; for many with pre-existing eating disorders lockdown had a devastating effect. Recently, a Channel 4 documentary chronicled the heart-breaking experiences of former Big Brother contestant Nikki Graham, who died of complications associated with anorexia in April 2021. Her mother has been candid about the effect that restrictions had on her worsening illness, as Nikki struggled with social isolation, and the closure of gyms during what she calls a “hellish” lockdown.

As a result of the rise in cases, and worsening of pre-existing illness, waiting lists for treatment of eating disorders have quadrupled, with many mental health services being overwhelmed by demand. These grim statistics are likely to represent only the tip of the iceberg. Even before Covid, some studies suggested that between 80-90% of those who exhibit the symptoms of an eating disorder do not seek diagnosis or treatment.

Much like lockdowns themselves, the policy of including calories on menus has the capacity to cause significant harm and increase rates of disordered eating. Rather than risk worsening an already dire situation for questionable benefit, the government would do better to educate about healthy eating, ensure that healthy food is cheaper, and make access to gyms more affordable.

Amy Jones is an anonymous doctor who has a background in Philosophy & Bioethics.