Acceptability and perceived harm of calorie labelling and other obesity policies: a cross-sectional survey study of UK adults with eating disorders and other mental health conditions

Abstract

Objective: We assessed perceptions of recently proposed UK obesity-related public health policies (mandatory calorie labelling, banning of advertisements of unhealthy food and drinks online and before 9 pm on TV, and banning “buy one get one free” deals for unhealthy food and drinks) in people with an eating disorder (ED) and other mental health conditions. Method: 1,273 participants with a self-reported mental health condition (N=583 with an ED) completed an online survey in September – November 2022. Multinomial logistic regression was used to examine support for and potential adverse effects of policies in participants with and without an ED. Qualitative analysis of potential effects of the policy on current ED symptoms was also conducted to better understand how and why policies may be damaging or beneficial.Results: Participants with an ED tended to support all obesity policies, but were less likely to support the implementation of the calorie labelling policy (43% of ED participants supported vs. 58% of non-ED participants). Half of the participants with an ED (55%) reported that labelling may worsen their ED symptoms. Qualitative data indicated perceived potential harm (e.g., a gateway to relapse, negative effects on mood) and perceived benefits (e.g., feeling informed and reassured) of calorie labelling in participants with an ED. No differences in support or perceived harms of the other two policies were observed between participants with vs. without an ED.Discussion: Future studies are warranted to understand how to mitigate the potential harmful effects of calorie labelling in people with an ED.

Point-of-choice kilocalorie labelling practices in large, out-of-home food businesses: a preobservational versus post observational study of labelling practices following implementation of The Calorie Labelling (Out of Home Sector) (England) Regulations 2021

“…There has been some public concern about the implementation of mandatory kcal labelling in England, 39 specifically about the potential negative impacts on people with eating disorders. 42 In an attempt to mitigate potential negative impacts, as part of government guidance for kcal labelling, it was recommended that kcal-free menus be available in outlets on request. Our results found that only 12% of outlets implementing kcal labelling were able to provide researchers with a kcal-free menu when requested in-store.…”