Accounting for the Harm of Menu Labeling with Minimal Benefits

What’s the harm? For many “interventions” to reduce obesity prevalence, this rationale seems to be good enough to spur implementation. Menu labeling is a good example. Restaurants in the U.S. and in numerous other places must publish the number of calories in food portions they sell. This went into effect based upon suppositions. Policy makers presumed harm of menu labeling would be negligible and it would nudge at least some consumers toward healthier choices.

Evidence for both of these suppostions was also negligible.

Real Potential for Harm

Now, in the International Journal of Obesity, a new article tells us the potential for harm with menu labeling is real. Jane Brealey and colleagues write about the lived experiences of people with eating disorders (EDs) and their interaction with menu labeling:

“Four studies have examined the opinions and experiences of people with EDs using qualitative methods. Recurrent themes describe how calories on menus: can lead to a hyper-fixation on calories, restrict food freedom (meals are chosen for their calorific value rather than what was actually wanted or appropriate for hunger levels), reduce eating out opportunities, increase feelings of anxiety, guilt and shame around food choices, and inhibit ED recovery. Some participants in these studies expressed anger over the messaging from ‘trusted’ public health authorities on the normalisation of calorie counting, because calorie counting had played a pivotal role in the development of their ED.

“EDs are complex mental health conditions. Many people with EDs also have obesity, and having obesity is also a risk factor for developing an ED. thus large numbers of people that are the ‘target’ of calorie labelling are at risk of harm.”

Negligible Benefit

In the risk/benefit assessment for menu labeling, the risk to persons with eating disorders might be justifiable if the benefit to the whole population were great. But this is not so.

At best, menu labeling mandates might prompt small, short-term changes in food purchases. There is no evidence for an effect on obesity prevalence – or even a sustained effect on purchasing behavior.

The only reason people believe that it “ought to help” is the prevalent bias that obesity is merely a problem of people making bad choices. Bad behavior. Nudge them to shape up and the problem will fade.

This presumption has proven false more times, in more ways, than we can count. It’s time to reconsider policies based on flawed thinking.

Click here for the new article in IJO, here for further perspective.

Wall tiles of the Escola de Ciência (Science School), Vitória, Espírito Santo, Brazil. Photograph by Paul R. Burley, licensed under CC BY-SA 4.0.

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September 8, 2024