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Why listing calories on menus can be harmful

England recently passed a policy requiring all restaurants, cafes, and takeaways with more than 250 employees to display the caloric information for all food and drinks on their menus, delivery platforms, and websites. In the United States, a similar policy was passed in 2018 requiring menu calorie counts for restaurants that are part of a chain of twenty or more locations. (1) But this can be harmful for several reasons.

This policy is a result of the government’s focus on reducing “obesity” rates throughout the country. The thinking is that if people are more aware of the calories they’re consuming, then they may make healthier meal choices. 

However, research indicates that menu labeling has little to no effect on weight loss and health-related outcomes. (2) And even if it were effective, the policy is still fatphobic and harmful to those in eating disorder recovery or people who are vulnerable to developing eating disorders.

7
 minute read
Last updated on 
March 15, 2023
Why listing calories on menus can be harmful
In this article

The policy is fatphobic

Fatphobia is defined as a fear and hatred of fat people, which leads to weight stigma, discrimination, and negative stereotypes related to people living in larger bodies.

Anti-obesity campaigns, such as calorie counting menus, may  seem to be well-intentioned on the surface. But they are actually misguided and misinformed, promoting fear-mongering over education and inclusion. And while the government and public alike may consider “obesity” to be an epidemic, the true epidemic is fatphobia.

In fact, some of the health risks associated with “obesity” could actually be caused by fatphobia and weight stigma, not by a person’s weight. One study found that weight bias and discrimination can increase a person’s risk of: (3)

  • Heart disease
  • High cholesterol
  • Stomach ulcers
  • Diabetes

The reality is, adding caloric information to restaurant menus sends the message that fat people—a term many people living in larger bodies have reclaimed as a neutral descriptor, like tall or short, without a negative, stigmatizing connotation—ought to be choosing low-calorie meals when they go out to eat, a message that can harm a person’s mental and emotional well-being, as well as lead to profound shame.

People are healthy at diverse weights and sizes

Anti-obesity campaigns like the menu labeling requirement claim they intend to improve people’s health, but weight is not an indicator of a person’s health status. Something as complex and as multifaceted as health cannot be reduced to a simple measurement of weight or size. And despite what the anti-obesity campaigns may want you to think, people of all weights, shapes, and sizes can be physically and mentally healthy. 

Countless studies back this up. Here’s what the research says: (4,5,6,7,8)

  • Being “overweight” is often associated with a reduced mortality rate
  • Nearly half of all U.S. adults who are overweight are healthy (as indicated by cholesterol, triglyceride, blood pressure, and glucose levels–which are actual indicators of metabolic health)
  • 20 million U.S. adults who are considered “obese” are healthy
  • Black women tend to be healthier at higher weights and larger waist circumferences than white women
  • Older African-American men and women have lower amounts of fat around their organs (a risk factor for many health conditions) than their Hispanic and white peers

Additionally, the location of fat is a more accurate indicator of health than the amount of fat a person has—fat in the mid-section is a risk factor for heart disease, even among people of average weight. (9)

Calories are not an indicator of nutrition

Putting calories on restaurant menus equates health with caloric consumption. This is a dangerous practice, as many people already falsely conflate thinness with health. Consuming a high number of calories doesn’t make a person unhealthy. And restricting calories certainly isn’t a healthy choice, contrary to what many messages our culture and even healthcare providers are communicating to us. 

There are plenty of calorie-dense foods that provide you with much-needed nutrients and vitamins, without which your body does not function optimally and could result in harmful physical and mental health complications. They include:

  • Red meat
  • Pork
  • Chicken with the skin
  • Salmon and other oily fish
  • Cheese
  • Eggs
  • Full-fat yogurt
  • Beans
  • Potatoes
  • Brown rice
  • Whole grain bread and pasta
  • Nuts and nut butters
  • Avocado

Food is meant to be enjoyed

Eating food is meant to be a pleasurable experience, not only because we find the food delicious, but also because mealtimes are an opportunity for friends and family to come together and socialize and bond. And this is never more true than going to restaurants and cafes, which provide a desirable atmosphere for celebrations, date nights, family gatherings, and friend get-togethers.

Adding calorie information to menus takes the focus away from the joy and pleasure of food and prioritizes the number of calories patrons are consuming. People may stray away from ordering food based on flavor, curiosity, ingredients, nutrition, or cooking craft.

Calorie counting menus trigger those in eating disorder recovery

Calorie counting is commonly found in people with eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder, and orthorexia nervosa. People struggling with eating disorders have fraught relationships with food and movement, struggling with an intense preoccupation with weight, appearance, food, and behaviors related to consumption. 

During eating disorder treatment, people who struggle with calorie counting and caloric restriction must unlearn these maladaptive behaviors to heal their relationship with food and learn how to eat intuitively. With help from their treatment team, they put in the necessary work to move away from calorie counting and label checking. 

As such, it’s easy to see how triggering menu labeling can be for those in eating disorder recovery. They’ve worked so hard to shift the focus from numbers to nutrition and pleasure, only to have the numbers forced upon them. It may be difficult for those in recovery to fight the urge to return to calorie counting, as well as other monitoring behaviors. Listing the caloric information for food and drinks also emphasizes calories over vital nutritional information people need to make truly informed decisions about their food—thus triggering a person in recovery to focus on calories consumed as opposed to mindful, intuitive eating.

Counting calories can lead to disordered eating in vulnerable individuals

Aside from triggering people in recovery, listing calories on menus can also trigger disordered eating behaviors, such as compulsive calorie counting, label checking, skipping meals, and restricting calories and food groups, as well as full-blown eating disorders in vulnerable individuals. Research indicates that about 35% of people who diet—which often involves counting or tracking calories—develop disordered eating behaviors and attitudes, while 15% progress to an eating disorder. (10)

People who may be at an increased risk of eating disorders include those who:

  • Have a family history of eating disorders or mental health conditions
  • Have a history of dieting
  • Have body image dissatisfaction
  • Have perfectionism
  • Have an anxiety disorder
  • Have a history of trauma

Since menus with calorie information encourage people to choose their food based on calories, this harmful policy could potentially cause countless people to have unhealthy relationships with their bodies and food.

Tips for eating at restaurants that use calorie labeling

If you are in eating disorder recovery, the notion of going out to eat and being subjected to calorie counts can be intimidating and even frightening. But there are some things you can do to still enjoy your time out with loved ones. One of the best ways to prevent anxiety is to prepare and plan for the upcoming event. Everyone’s preparation may look different, but examples of things you can do to plan include knowing:

  • Where the restaurant is and how you’ll get there
  • Who you will be going out to eat with
  • What food will be offered

If you are in eating disorder recovery and have a solid support system, you can reach out to someone you trust to process your anxieties with. This could be a friend, someone you met in a support group, or your therapist.

You can also look at the menu ahead of time online and write down a few options of meals you’d like to order, regardless of calories. Choose your food based on what you find enjoyable—nothing else. Selecting your meal ahead of time can alleviate anxiety when it’s time to order at the restaurant. If the menu isn’t available online, plan generally, such as wanting to enjoy a seafood pasta dish if it’s an Italian restaurant. 

It’s also important to set a time limit for how long you are allowed to view the menu. This can help prevent you from obsessing over all of the different options and calories associated with them.

Another helpful tip may involve ordering the same thing as a loved one who will be at the restaurant with you. You can plan this ahead of time with them while explaining to them your thought process behind it. Communicating your fears and anxieties to those you’ll be eating with can also help prepare you for the meal, especially if they are people close to you whom you trust. And if you’ll be going to eat with people you aren’t as close with, such as work colleagues, you may still want to talk about your feelings with a friend or family member beforehand. 

Remember, if you begin to feel stressed or upset at the restaurant, don’t blame yourself for your feelings. Your feelings are valid, and you aren’t the only person experiencing them. Try to use your coping skills, such as deep breathing, and even discuss your feelings as they arise. Noting them without judgment can help you to manage them without shaming yourself.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Food and Drug Administration. (2022). Calories on the Menu. https://www.fda.gov/food/nutrition-education-resources-materials/calories-menu 
  2. Yelowitz, A. (2016). Menu Mandates and Obesity: A Futile Effort. Cato Institute. https://www.cato.org/policy-analysis/menu-mandates-obesity-futile-effort 
  3. Udo, T., Purcell, K., & Grilo, C. M. (2016). Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity. International Journal of Clinical Practice, 70(12), 1003–1011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215793/ 
  4. Flegal KM, Kit BK, Orpana H, Graubard BI. (2013). Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis. JAMA, 309(1):71–82. https://jamanetwork.com/journals/jama/fullarticle/1555137 
  5. UCLA Health. (2016). BMI a Poor Measure of Health. https://www.uclahealth.org/u-magazine/bmi-a-poor-measure-of-health 
  6. National Public Radio. (2020). Fat Phobia and Its Racist Past and Present. https://www.npr.org/transcripts/893006538 
  7. Katzmarzyk, P. T., Bray, G. A., Greenway, F. L., Johnson, W. D., Newton, R. L., Jr, Ravussin, E., Ryan, D. H., & Bouchard, C. (2011). Ethnic-specific BMI and waist circumference thresholds. Obesity , 19(6), 1272–1278. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933952/ 
  8. Carroll, J.F., Chiapa, A.L., Rodriquez, M., Phelps, D.R., Cardarelli, K.M., et. al. (2012). Visceral Fat, Waist Circumference, and BMI: Impact of Race/ethnicity. Obesity, 16(3): 600-607. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933952/ 
  9. Powell-Wiley, T.M., Poirier, P., Burke, L.E., Despres, J., Gordon-Larsen, P., Lavie, C.J., et. al. (2021). Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation, 143: 984-1010. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000973
  10. Whiteside, A. (2022). Collateral damage in a reductionist strategy: the effect of calorie labeling on those with eating disorders. BMJ, 377.  https://doi.org/10.1136/bmj.o1402

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