Eating disorder study: Calories on menus too 'triggering'

The Scottish Government had proposed making calorie labelling on menus mandatory as part of its obesity strategy, subject to the findings of a PHS investigation.

The plan would also cover vending machines, delis, workplace canteens, online food delivery services, and snack trolleys on trains.

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Regulations introduced in England in April 2022 has already made calorie labelling mandatory across the out-of-home food sector, affecting businesses which employ 250 or more people.

In many cases, this has resulted in customers in Scotland using chain outlets such as Pret a Manger or Dominos pizza - which operate across Britain - being confronted by calorie information on online menus or retail displays.

Eating disorder charity, Beat, said efforts should be made to remove these north of the border following the "compelling" findings of the PHS study.

Tom Quinn, the charity's director of external affairs, said: "We know that some chains that have restaurants in England and Scotland might think it's easier to just have the same menu in both countries, but no - we think this evidence is so clear that we're asking all restaurants that currently have it in place not to include calories on their menus."

The PHS study was based on in-depth interviews with 18 people in recovery from conditions including anorexia, bulimia and binge-eating disorder.

Pubs serving food would be required to include calorie details on their menus (Image: Getty)

The report noted that participants "frequently mentioned that the provision of calorie information, particularly on menus and at the point of service, could be highly triggering".

It added: "For those with a history of eating disorders, seeing calorie information could lead to heightened anxiety, negative body image, and a resurgence of disordered eating behaviours.

"Several participants shared instances where they felt overwhelmed and distressed upon encountering calorie information, leading them to avoid certain foods or even skip meals altogether to avoid the stress it induced".

There was also feedback that displaying calories on menus could "encourage conversations centred around restricting intake" - or "diet-talk" - while eating out with people who were unaware of their history of disordered eating.

The report added: "Participants unanimously agreed that calorie information has a detrimental effect on individuals with a history of eating disorders.

"They emphasised that such information could trigger relapses, heighten anxiety and reinforce disordered eating patterns, making recovery even more challenging."

Patients in recovery said calorie information was something they 'obsessed' about during illness (Image: PA)

It was generally agreed that calorie information "should be available for those who actively seek it, rather than being imposed on individuals who may be harmed by it on standard menus or at the point of service".

Kirsty Pavey, Beat’s National Lead for Scotland said: "It’s never been clearer that adding calories to menus in Scotland would harm people with eating disorders.

"This new research reveals that people would struggle to eat outside of their home and worry they will relapse into eating disorder behaviours if faced with calories on menus.

"We’ve already seen the harm this has caused in England, where cafes, restaurants and takeaways with over 250 employees have been required to display calories on menus since April 2022."

Public health campaigners, including Obesity Action Scotland (OAS), have previously backed mandatory calorie labelling on menus to ensure consumers "can make an informed choice at the point when they are making the decision to purchase".

Responding to a consultation on the proposals in 2022, OAS pointed to evidence that the policy "can result in up to a 115-calorie reduction per meal, with an average of 47 calorie reduction per meal" which "could lead to a significant reduction in calories consumed" when aggregated across the whole population and based on the number of times people eat out of home.

Other research has suggested that an initial 4% drop in average calorie intakes immediately after the policy is implemented subsides one year on.