Has calorie labelling on menus done more harm than good?

Going out for a meal has always been pretty simple. You leave the pans, the peeling and the washing up, and head out somewhere to eat, opening up a menu of delicious, hassle-free options. At least until recently, when a controversial measure brought in by the government in April mandated that every restaurant, cafe and takeaway with upwards of 250 employees must now add calorie labels to their menus. Some welcomed the change while others have vehemently opposed it. Boris Johnson claimed the measure would “tackle obesity levels” and “level up the nation’s health”, but less than six months on, and with Liz Truss now in government, the policy may already be under threat. One report suggests Truss may move to reduce the number of businesses which are forced to comply with the reform; another says she may do away with the policy altogether.

One of the biggest objections to the law is that calorie counting is a blunt instrument when it comes to a good diet. This is because it doesn’t take into account the various nutrients that actually make up our food – such as proteins, fats, carbohydrates and sugars. The British Obesity Society, a charity working to improve the lives of overweight people across the UK, says that while “all transparency is good transparency”, the policy does not go far enough to educate people about nutrition. For example, it’s led to some people abandoning perceived healthy options (such as salads) in favour of typically “unhealthy” options (like a burger) because the former has more calories. “In some instances, it’s actually influencing food choice negatively, because it’s obviously not all about the calories. People have a right to know how many calories are in their food, but the amount of saturated fat and sugar should also be known,” says Louise Payne, a nutritionist and co-chairperson of the organisation.

There are those, though, that have found it helpful: for some overweight people, menu labelling has served its purpose as a deterrent from high-calorie foods when eating out. “In the past, it’s been really hard to work out what’s good for you,” Elaine Blacks, 47, says. She recently went to a cafe where the only things on offer were flapjacks, muffins and other sweet treats. “I was in two minds about buying something and faced by a wall of sugar. The calorie labels made it much simpler to decide that actually, it wasn’t worth it, and I didn’t buy anything”. For others, like Tracey Siflet Carey, it has been an “eye-opener” as to just how calorie dense some everyday dishes in restaurants may be and encouraged more conversations around food. “I think it has got people thinking more carefully about what they eat,” Carey says. “It’s really common for people to put their blind trust in a restaurant to serve them healthy food. But now we’re asking where those calories are coming from.”

And yet calorie labelling can have a potentially destructive impact. One of the most significant issues raised by experts is that it could fuel disordered eating habits. In April, a YouGov survey found that half of young women aged between 18 and 29 do not support the inclusion of calories on menus, for this reason. With diet culture invariably affecting women more than men, women are being more influenced by the additional information than men, according to the British Obesity Society. Blacks says her husband pays significantly less attention to the labels than she does, while Carey is “always” aware of calorie counts when looking at a new menu. Stephen Barber, 58, says he “never” thinks about the calories in his food, and the change on menus has made no impact on his dining choices. “I look for something healthy sometimes, such as a leaner cut of meat, but it doesn’t matter how many calories are in it,” Barber adds.

Some of the staunchest criticism of calorie labelling at the time of its inception came from eating disorder charities. Eating disorders impact 1.25 million people across the UK, according to Beat. “More generally, the people we support often talk about the negative impact that calorie counting has had during their eating disorder, and we know that counting calories can keep people unwell for longer,” says Tom Quinn, the charity’s director of external affairs. Cara Lisette, who is currently in recovery from anorexia, says the labels contradict some of the healthy behaviours she has adopted to improve her relationship with food. “A big part of treatment is learning to be less calorie focused and allowing yourself to eat what you want, when you want. This feels almost impossible when faced with calories in a cafe or restaurant,” she explains, adding that it has led to her actively avoiding eating out.

Under the policy, those struggling with an eating disorder can request a calorie-free menu, but this provision is both little-known and can feel like an additional stressor. Danika Cavill, who previously suffered from an eating disorder, says going out to eat is a “huge step” for those unwell. “[The labels] can trigger negative thoughts, as people may look at the number of calories and think negatively about how eating that meal could cause an impact on their weight and body image,” White adds. Beat has urged the government to avoid any legislation which may harm its users. “It’s essential that health policies protect those with eating disorders and that they are founded on quality evidence,” Quinn adds.   

Research surrounding the impact of calorie labelling on menus has delivered mixed results. Most of the evidence comes from US-based studies, where calorie labelling for all restaurant chains with 20 or more outlets has been mandatory since 2008. One study from the University of Minnesota found no significant difference in calorie consumption (an average of 15 calories) between people who ordered from a labelled menu and those who did not. A 2019 study of more than 5,500 adults, children and parents found that calorie labelling at McDonald’s stores in the US resulted in more people noticing calories on the menu but had no effect on the number of calories they purchased. Where studies did find a difference, it was small. A New York-based study which surveyed more than 15,000 adults found that on average, customers who viewed a calorie-labelled menu consumed 100 less calories than those who didn’t. Researchers said that after adjusting for demographic and other factors, the average calorie reduction was 78 calories.

Even those in support of the policy have warned that calorie labelling alone cannot solve a mounting public health issue. The government estimates that 63 per cent of UK adults are overweight – an increase of more than 10 per cent (52.9 per cent) since 1993. Additionally, obesity-related conditions account for £6.1bn of NHS spending annually. In January 2021, research by the University of Cambridge concluded that obesity policies in England across the last three decades had been inadequate. Experts said measures had “largely failed” because of problems with how they were implemented, and a reliance on trying to persuade people to change their behaviours rather than tackling the issues driving obesity. Tam Fry, chair of the National Obesity Forum, insists that while calories on menus are important information, the move is “a very simple, political gain” if the government does not take more radical steps.

One potentially transformative step could be for the government to expand the soft drinks industry levy – a tax on manufacturers of soft drinks containing more than 5g of sugar per every 100ml – to salt and sugar in processed foods. Fry says the success of the existing levy shows this would incentivise companies to help improve people’s health. It was a call made by co-founder of fast-food chain Leon, Henry Dimbleby, in his two-part National Food Strategy, a government-commissioned independent review of the food system. But the proposal was ignored by former prime minister Boris Johnson, who said he didn’t want to “start whacking new taxes on” and that people should “eat less”.  “Any government that does not take the scale of the [obesity] problem seriously is woeful, and that is exactly what has happened,” Fry says. “The government has introduced the calorie scheme so easily because it hasn’t cost them anything, and it is regarded as a win-win situation that shows we are moving in the right direction.”

Six months on from the introduction of calorie labels, feedback from experts, members of the public and those vulnerable to eating disorders suggests the move is having limited impact on those it targets, and drastically affecting the experience of dining out for those vulnerable to eating disorders. While it remains unclear when, or if, Truss will move to amend the policy, it’s evident that calorie labelling alone is unlikely to solve one of the UK’s most pressing public health concerns.