Thought leadership

Calories on menus won’t tackle the obesity crisis, community engagement will

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community engagement to tackle obesity crisis

On 6 of April, the UK government introduced new calorie labelling rules in an effort to tackle obesity and “improve the nation’s health”. While these measures are intended to reduce the prevalence of obesity and conditions associated with high body fat percentages, it is unlikely that they will have the desired effect.

It is now a legal requirement for cafes, restaurants and takeaways with more than 250 employees to display calorie information on all non-pre-packaged food and drink items. The calorie content of items must also be displayed on physical and online menus, third party apps, food delivery platforms and food labels. Additionally, menus are now required to include information on daily recommended calorie intakes.

The new measures have prompted much public scrutiny. Many believe that labelling all food items with their calorie contents could be triggering for those living with eating disorders. Some have even suggested these labels may encourage restrictive eating for those previously unaffected.

This is a worrying possibility given that anorexia nervosa (a common calorie restrictive eating disorder) has the highest death rate of any psychiatric illness, and a death rate 12 times higher than all other causes for females between 15 to 24 years old. Economically, it is also concerning; a report by the Hearts Minds and Genes Coalition estimated that the yearly cost of eating disorders (including anorexia nervosa, bulimia nervosa and binge eating disorder) to the UK is £9.4 billion.

“Patients should be treated on an individual basis and the unique circumstances which have led to their obesity should be appropriately considered and addressed.”

More harm than good

It is unlikely that the new labelling regulations will have a significant impact on obesity levels. The FDA introduced similar measures in the US in May 2018, and since then calories have been listed on the menus of restaurants and all food establishments with 20 or more locations. However, according to a report by the Centers for Disease Control and Prevention (CDC), the number of states with high obesity rates has doubled since the measures were put in place.

While the measures may be helpful for some individuals looking to manage their weight, trends in the US suggest that labelling is generally ineffective. When considered in conjunction with the potential risks these labels pose for people with eating disorders, the new policy may be doing more harm than good.

Treating the individual

Fears of obesity have grown since the start of the Covid-19 pandemic, as there has been a steady rise in the number of people in the ‘overweight’ or ‘obese’ categories. However, given that most restaurants, cafes and takeaways were closed for large portions of the pandemic, it is unlikely that this rise is linked to a lack of awareness of calorie contents when eating out. Instead, the rise is more likely to have been precipitated by lower levels of physical activity and higher levels of stress exacerbated by health fears, grief, and loss of social connections.

Obesity is a complex health issue; excess body fat is linked to poverty, certain physical and mental health disorders, and a range of other social and cultural factors. Measures to reduce obesity and improve overall health should move away from the one-dimensional ‘eat-less and move-more’ approach and should instead also account for the wider determinants of a person’s weight.

When seeking support, patients should be treated on an individual basis and the unique circumstances which have led to their obesity should be appropriately considered and addressed. Engaging with individuals in their community is likely to be the key to supporting health and weight management goals. Obesity tends to be the result of a combination of social and medical factors, and therefore obesity and its health impacts must be treated or managed within its social context.

Re-investing in community

On 11 of April, the government announced its decision to pull the plug on a £100 million grant for community-based weight management services . Last year, this grant was shared between the NHS and local authorities for services including weight management groups, coaches, and specialist support. The funding also supported a free NHS weight loss app. The loss of this grant means that many of these services will close, and community-based support for weight loss will no longer be provided to many in need.

If the government is serious about improving the health of the nation, it should scrap the potentially harmful practice of labelling calorie contents on food items, which is likely to induce, or worsen, life threatening eating disorders. Instead, it should re-invest in community based strategies for weight management, and services which work with individuals to understand and treat the complex factors leading to obesity.