Since April 2022, large cafes, restaurants and takeaways across England have been legally required to display calorie information on their menus. The policy was designed to support the government’s wider aim of tackling obesity and encouraging healthier food choices, and for many people, this information passes without a second thought. For someone living with an eating disorder, calories on a menu can turn a simple meal out into a source of real anxiety.
At ABBI Clinic, we believe it’s important to look at both sides of this debate: the public health reasoning behind calorie labelling and the impact it can have on people already struggling with their relationship with food.
The public health challenge: calorie labels and eating disorders
The intention behind mandatory calorie labelling is straightforward. By giving people access to the same nutritional information in restaurants that they would see on packaged food in a supermarket, the government hoped to make it easier for the public to make informed, healthier choices and help address rising obesity levels nationally.
However, this well-intentioned policy has faced consistent criticism from eating disorder charities and clinicians since it came into force. Beat, the UK’s eating disorder charity, has repeatedly raised concerns that displaying calories in restaurant menus can cause distress for people with an eating disorder, rather than supporting healthier decision-making. A commentary published in the BMJ in 2022 similarly described calorie labelling as a reductionist strategy with the potential to cause collateral damage for people with eating disorders.
How calorie information triggers disordered eating behaviours
For someone without a difficult relationship with food, a calorie count on a menu is easy to ignore. For someone living with an eating disorder, that same number can dominate the entire experience of eating out.
Increased anxiety and food fixation
Calorie labels can quickly become the main focus of a meal, rather than one small detail. This can lead to heightened anxiety before, during, and after eating, along with an intense fixation on numbers rather than on the meal itself, the company at the table, or the occasion being celebrated.
Reinforcing restrictive and compensatory behaviours
Seeing calorie counts can also reinforce unhelpful patterns that are already part of someone’s eating disorder. This might involve leaning towards the lowest-calorie option regardless of appetite or nutritional need, feeling compelled to adjust eating later in the day to “make up” for a meal, or avoiding eating out altogether to sidestep the discomfort of seeing the numbers at all.
Not a monolith: different impacts on different eating disorders
One of the most important points often missed in this debate is that calorie labelling doesn’t affect everyone with an eating disorder in the same way. The impact can vary significantly depending on the specific condition someone is living with.
Anorexia nervosa and bulimia nervosa: fuelling restriction
Research, including one study from PubMed Central, suggests that people with anorexia nervosa or bulimia nervosa typically select meals with significantly fewer calories when calorie labels are present, compared with menus that have no labelling at all. For these individuals, calorie labelling can reinforce the restrictive thinking that already underpins their eating disorder.
Binge eating disorder: a counterintuitive effect
Interestingly, another PubMed study also found the opposite pattern for people with binge eating disorder, who selected meals with significantly more calories when labels were visible. This highlights that a one-size-fits-all approach to calorie labelling policy may not account for the different ways eating disorders present.
What the research says: key findings on menu labelling
The evidence base in this area is still developing, but the findings so far are worth paying attention to. A recent BMJ Public Health review of calorie inclusion research found that just over half of people with a diagnosed eating disorder who took part in one study felt that calorie labelling made their symptoms worse, and the majority reported that calorie information on menus had caused them difficulty in some way.
A widely cited British Medical Journal-featured study of American restaurant chains also found that calorie labelling led to a small reduction in the average calories consumed, an effect that had disappeared entirely within a year.
Navigating a labelled world: coping strategies for individuals
If calorie information on menus is something you find difficult, there are practical steps that may help:
- Decide before you look at the menu: Where possible, choose your meal based on what you feel like eating before opening the menu, so the calorie count doesn’t influence your decision.
- Ask about calorie-free menus: Some restaurants and food outlets will provide a version of the menu without calorie information on request.
- Cover or avoid the numbers: If you’re using a printed or digital menu, it can help to fold or scroll past the calorie column so it isn’t the first thing you see.
- Bring support with you: Eating out with someone who understands your experience can make the whole process feel less overwhelming.
If you find that calorie labelling, or eating in general, is affecting your day-to-day life, this may be a sign that it’s worth speaking to a specialist eating disorder service.
The path forward: re-evaluating policy and public health messaging
The debate around calorie labelling isn’t a simple case of right or wrong. The policy stems from a genuine public health need, but the evidence increasingly suggests that its impact on eating disorders needs far more consideration in how it is designed and delivered.
Offering calorie-free menu options alongside labelled versions, involving eating disorder specialists in future policy reviews, and ensuring public health messaging doesn’t equate lower calories with better health are all steps that could help reduce harm without abandoning the policy’s original aims.
Access eating disorder support at ABBI Clinic
If you suspect that you or a loved one might be demonstrating the behaviours and signs of an eating disorder, we are here to help you seek the support you need. At ABBI Clinic, we have the expertise and compassion to help you heal at every stage of the journey, whatever that looks like for you.
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