Calorie labels on menus may benefit people with binge eating disorders

Food calorie labels on menus in cafes and restaurants can be helpful for people with binge eating disorders, even aiding their recovery, finds new research from UCL and King's College London.

For the study, published in BMJ Public Health, the researchers surveyed 1,001 people aged 16 or over who lived in England and had experienced disordered eating. Since 2022, all restaurants, take-aways and cafes in England with 250 employees or more have had to display the calories of the food and drink they sell on menus, online menus and take-away platforms as part of measures to curb obesity and encourage health eating.

Of those surveyed, half said calorie labels made their eating disorder symptoms worse, a quarter (24 per cent) had a neutral attitude towards them and the remaining quarter (26 per cent) viewed them positively.

Those more likely to have positive views were participants who binge ate regularly, were older, male and had a higher body mass index. They said they felt reassured by seeing calorie labels on restaurant menus because it gave them a sense of control about what they were eating.

By contrast, people with restrictive eating disorders, such as anorexia nervosa, were more likely to have negative views.

Eating disorders, which as well as binge eating disorder and anorexia nervosa include bulimia nervosa, are one of the deadliest forms of mental illness and relapses are common.

The study, which was funded by the National Institute for Health and Care Research, also looked at alternatives to calorie labels – when ranking different nutritional label policies, optional calorie labels were the most popular policy with participants, with 63.6% ranking the policy in their top three options.

The Government is due to publish a review of the effectiveness of the policy in England by April 2027 and the researchers say optional calorie labels displayed, for example, via Quick Response (QR) codes would be more acceptable to people with eating disorders and could minimise negative impacts while retaining information for people who find calorie labels helpful. Approaches that emphasised broader nutritional benefits of menu items also received support.

The bottom line is that people with eating disorders have a variety of views about calorie labels, but people with binge eating are more likely to find them helpful.

People with binge eating are under-represented in most research, but more than half our sample reported regular binge eating.

We hope our findings can inform the Government's policy going forwards."

Dr. Nora Trompeter, First Author, UCL Great Ormond Street Institute of Child Health

Corresponding author Dr Tom Jewell, Senior Lecturer in Child and Adolescent Mental Health at King's College London, said: "Our findings provide important insights for evaluating both the effectiveness and implementation of the policy in England, given the unintended negative consequences experienced by a vulnerable group in the population.

"Eating disorders are highly recurrent in nature with approximately 30% to 40% of patients relapsing within 10 years of successful treatment.

"Public health policies need to consider not only the needs of people with current eating disorders, but also those with past histories, to reduce risk of relapse and aid recovery."

Most of the people who took part in the study had received an eating disorder diagnosis from a health professional. The study is the first of its kind to include children (≥16 years).

Out of all the participants, those most likely to report negative impacts were people with restrictive eating disorders, those who had received treatment for an eating disorder, and those reporting higher levels of clinical impairment.

In terms of those who found them unhelpful, that category split into three groups: a moderately negative group; those who were highly negative and avoided venues with calorie labels; and those who were highly negative but did not avoid venues with calories labels.

Positive comments from participants included: "For the first time since developing my eating disorder, I am able to go out and eat at restaurants without fear and anxiety."

Another participant said: "For me, calories on menus enable me to eat at restaurants with friends, family and colleagues with minimal anxiety."

Overall, there was a broad desire for policies that provide personal choice over whether nutritional information is presented, allowing greater agency while reducing distress.

Last year the same researchers published a review of the existing evidence on this topic, also in BMJ Public Health, which confirmed that having calorie labels on restaurant menus could make eating disorders worse.