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The Impact of Calorie Legislation on Eating Disorders

‘McDonald’s is unhealthy.’

‘Are you sure you want to eat that?’

‘You should try this new diet.’

The constant commentary on what we eat is inescapable, and remarks such as these haunt us perpetually, coming from friends, family, adverts, and the media. Children grow up watching their parents cycle endlessly through diets like fasting, calorie restriction, and juice cleanses, perpetuating the culture of self-hatred which our world seems to foster. Adolescents punish themselves for eating, and many ignore the innate survival instinct of hunger to pursue the ideal ‘thin’ body type. For many people, this obsession rapidly transforms into an eating disorder.

The NHS Health Survey for England in 2019 found that 16% of adults screened positive for an eating disorder, up from 6% in 2007; a statistic that is appalling but not surprising, considering the calorie-centric nature of our health guidelines. The Government recommends 2,000 calories a day for women and 2,500 calories a day for men without regard for size, age, metabolic rate, or exercise levels, taking a reductive stance on health that fails to acknowledge the complexity of weight management. Andrew Radford, Beat’s Chief Executive, suggested that ‘the number of calories consumed is not a reliable indicator of health’ and promoted a move away from ‘obesity-shaming’ - the word shame being particularly indicative of the current guilt-motivated attempts to reduce obesity.

The Government’s calorie legislation introduced on 6 April 2022 is a perfect example of such an approach. These new rules state that all businesses with over 250 employees must display calorie information on non-packaged menu items. This means we are being slapped with judgements from those around us, but we cannot even select a meal without knowing what is precisely in it. Thus, for those with an eating disorder or at risk of developing one, eating out will never be free from a lingering sense of guilt. It will only become harder to silence the voice in their head saying, ‘maybe I don’t need a pizza; perhaps a salad with fewer calories is better.’

In all restaurants, asking for an alternative menu without the calories displayed is an option. This option, however, seems like an escape route for the legislators of such a rule who wish to sidestep any responsibility for worsening weight issues gracefully. When facing scrutiny, a cursory nod towards the token blank menu is all that is required to salvage their caring visage, concerned for mental wellbeing yet valiantly working to solve obesity. Meanwhile, the embarrassment of requesting a different menu and the secretive nature of eating disorders will prevent this strategy from ever having an effect.

For someone with anorexia nervosa, a menu with calorie information rapidly becomes an obsession, a source of intense distress and sometimes a fatal temptation. The tendency is to fixate on the number accompanying each dish instead of on the food itself so that the choice becomes a game of Where’s Wally for the lowest calorie meal instead of a red, stripy hat. Characteristically, like the other people in Where’s Wally drawings who are rendered irrelevant, any consideration of nutrition, recovery or health vanishes the moment calories are introduced into the equation. This is a severe worry because eating out and learning to choose food intuitively, based on hunger and taste, is essential for eating disorder recovery.

So, whilst it is essential to acknowledge that obesity is rising, the number of people suffering from an eating disorder is also increasing. The slight reduction of the former will exacerbate the latter. Some have even suggested that there will not be a positive impact on obesity statistics with which to justify such a change.

A similar strategy was adopted in the US several years before the UK, and studies there demonstrated a slight change initially but no long-lasting effect (Big Hospitality).

We are all familiar with the stereotypical image of an ‘eating disorder’: thin, pale, underweight. However, this is often not the case, and some eating disorders are accompanied by obesity. According to Beat, 30% of those who seek weight management services would qualify for binge eating disorder, indicating that a considerable number of overweight people would not benefit from the new legislation either. Those who binge eat are more likely to select higher-calorie items, contrary to the aim of the laws, which is to ‘make healthier food choices.

The Beat is the UK’s Eating Disorder Charity and naturally has a clear stance on the issue. They have strongly urged governments to relinquish the mandatory calorie labelling and issued three statements:

● The Government should not mandate calorie labelling on menus.

● The Government should take an integrated public health approach to obesity and eating disorders.

● The Government should consult with experts from the field of eating disorders, including people with lived experience, in all campaigns and legislation to address obesity.

The message from Beat is clear - these new rules will invariably damage the mental health of many people, including those with eating disorders, their families, and the NHS workers (who are overrun with those seeking treatment for an eating disorder). Additionally, the many thousands of people at risk of developing an eating disorder, should they be allowed to obsess over calories? They also acknowledge the delicate nature of weight issues and their link to obesity. Neither can be treated as a separate illness but must be dealt with in a mutually beneficial way, hence the ‘integrated public health approach.’

Health is not just a number, and weight is not only a physical attribute but also a mental one. The introduction of calorie labelling must therefore account for the mental impact and the physical one it may have. Even if obesity levels did decrease, we must continue to question whether it is due to healthier, more fulfilling lives or whether it is because of calorie restriction, shame, and starvation. For those with an eating disorder, the quality of life is as low as those with coronary heart disease; this is not a world I want to see actualized.

Undoubtedly, obesity is a huge problem but so are eating disorders, which has led me to this simple conclusion; something must be done, but this is not it.

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Tags: Eating Disorders Health Survey for England


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