Food calorie labels on menus in cafes and restaurants can be helpful for people with binge eating disorders, even aiding their recovery, finds new research from King's College London and UCL.
Food calorie labels on menus in cafes and restaurants can be helpful for people with binge eating disorders, even aiding their recovery, finds new research from King's College London and UCL.
The study, published in BMJ Public Health, is broadly consistent with previous research showing a primarily negative impact, finding that about half of the participants said calorie labels made their eating disorder symptoms worse.
But the study - the first of its kind to see if certain people with eating disorders find these labels more difficult or more helpful - also found that a quarter had a neutral attitude towards food labels and the remaining quarter viewed them positively.
Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, are one of the deadliest forms of mental illness and relapses are common, but some of the study's participants said they felt reassured by seeing calorie labels on restaurant menus because it gave them a sense of control about what they were eating.
However, the authors found a divide in their findings between people with different types of eating disorders symptoms.
The researchers found that participants who binge ate regularly were more likely to have positive views, as were older people, men and people with a higher body mass index. By contrast, people with restrictive eating disorders, such as anorexia nervosa, were more likely to have negative views.
Our findings provide important insights for both evaluating the effectiveness and implementation of the policy in England, given the unintended negative consequences experienced by a vulnerable group in the population.
Dr Tom Jewell, Senior Lecturer in Child and Adolescent Mental Health at King's College London
The study, which was funded by the National Institute for Health and Care Research, also looked at alternatives to calorie labels - when ranking different nutritional label policies, optional calorie labels were the most popular policy, with 63.6% ranking the policy in their top three options.
In England, all restaurants, take-aways and cafes with 250 employees or more have had to display the calories of the food and drink they sell on menus, online menus and take-away platforms since 2022. The measure was introduced to try to curb rising obesity levels as one in a series of initiatives to support consumers to make healthier choices.
The Government is due to publish a review of the effectiveness of that policy by April 2027 and the researchers say optional calorie labels displayed, for example, via Quick Response (QR) codes would be more acceptable to people with eating disorders and could minimise negative impacts while retaining information for people who find calorie labels helpful. Approaches that emphasised broader nutritional benefits of menu items also received support.
Dr Nora Trompeter (UCL Great Ormond Street Institute of Child Health) said: "The bottom line is that people with eating disorders have a variety of views about calorie labels, but people with binge eating are more likely to find them helpful."
"People with binge eating are under-represented in most research, but more than half our sample reported regular binge eating.
"We hope our findings can inform the Government's policy going forwards."
Dr Tom Jewell added: "Eating disorders are highly recurrent in nature with approximately 30% to 40% of patients relapsing within 10 years of successful treatment."
"Public health policies need to consider not only the needs of people with current eating disorders, but also those with past histories, to reduce risk of relapse and aid recovery."
For the first time since developing my eating disorder, I am able to go out and eat at restaurants without fear and anxiety.
Study participant
Another paticipant responded: "For me, calories on menus enable me to eat at restaurants with friends, family and colleagues with minimal anxiety."
The study, based on a survey of 1,001 people, was open to people aged 16 or over who lived in England and had experienced disordered eating. Most had received an eating disorder diagnosis from a health professional. The study is the first of its kind to include children (up to 16 years old).
The study found that 50% reported a negative attitude to calorie labels on restaurant menus; 24% were neutral and 26% positive.
Those most likely to report negative impacts were people who had treatment for an eating disorder, the highest level of clinical impairment and were more likely to have restrictive eating disorders.
In terms of those who found them unhelpful, that category split into three groups: a moderately negative group; those who were highly negative and avoided venues with calorie labels; and those who were highly negative but did not avoid venues with calories labels.
Overall, there was a broad desire for policies that provide personal choice over whether nutritional information is presented, allowing greater agency while reducing distress.
Last year the same researchers published another study in BMJ Public Health, a review of the existing evidence on this topic, which confirmed that having calorie labels on restaurant menus was negatively impacting people with eating disorders.
