The law of unintended consequences strikes again. Since the 1990s, when the United Kingdom and the United States rolled out nutrition labels, countries around the world started following suit as regulators fought to rein in rising obesity rates. But now, new research raises questions about what these well-meaning policies have done to those with eating disorders or disordered eating habits.
A group of UK researchers launched an exhaustive review of more than a dozen studies (covering more than 8,000 participants) to find out how these evolving requirements have influenced this vulnerable group.
What they found suggests that while nutrition labels might encourage healthier choices for most people, they can confuse and trouble those with eating disorders by exacerbating calorie preoccupation while reinforcing restrictive eating behaviors.
“Our study highlights that people with lived experience of eating disorders are frustrated at being left out of the conversation around calorie labels,” senior author and King’s College lecturer Tom Jewell, MD, said.
A Threat to Those with Eating Disorders?
The investigation – the first to curate existing evidence on the issue – provides fresh insight for public and mental health policymakers.
The research team included experimental, cross-sectional, and qualitative studies in their examination. One common thread? Individuals with eating disorders are more likely to notice and respond to calorie labels than the average consumer. That response usually took the form
of changes in eating behaviors, such as avoiding restaurants with prominent calorie displays or enduring heightened anxiety during social meals.
Qualitative research highlighted five recurring themes:
- Preoccupation with calorie counts.
- Reinforcement of disordered eating patterns.
- Temporary reassurance from calorie awareness.
- Challenges in social eating situations.
- And frustration over feeling ignored in public health discussions.
That being said, some participants reported positive feedback, such as feeling reassured by labels. Even so, the researchers uncovered a link between those benefits to restrictive eating behaviors that come with long-term consequences.
It’s worth noting that the research also exposed variations in how different eating disorder subtypes – such as binge eating disorder and anorexia nervosa – responded to calorie labeling. Restrictive eaters appeared to be more sensitive to calorie information, while binge eaters showed more nuanced reactions.
Public Policy Implications
The review illustrates just how challenging it can be to draft public health policies that tackle obesity without posing a threat to those with eating disorders. While calorie labeling might encourage healthier choices for some, the authors insist that policymakers should consider alternative approaches, such as making calorie information available upon request, through QR codes, or online instead of mandatory in-menu displays.
“Our study provides an important addition to the evidence base around calorie labels,” UCL Research Fellow and co-author, Nora Trompeter, MD, said. “Our review also shows that more research is needed to fully understand the impact of calorie labels on individuals with eating disorders. For example, none of the studies included young people.”
The paper’s authors stressed the need for more research to explore how nutrition labels influence other underrepresented groups, such as adolescents and children. They also called for a deeper dive into whether tweaking the label designs might help.
Finally, the researchers encouraged policymakers to work with individuals with lived experiences of both obesity and eating disorders to come up with more balanced policies that promote physical and mental health. Understanding the nuanced impacts of nutrition labeling might help ensure that public health efforts are inclusive, effective, and mindful of all segments of the population.
Further Reading
Eating Disorders and Alcohol Misuse
Psilocybin Shows Promise for Treating Anorexia
Eating Disorders May Be More Prevalent, Harder To Diagnose In Athletes
