From fast food to a la carte – Scottish Government plans to label menus with calories should be scrapped.
That’s certainly the viewpoint from leading psychiatrists like myself who treat patients with eating disorders every day.
The original idea of calories on menus was to help reduce obesity which continues to be one of Scotland’s leading public health challenges.
But we know there is no good evidence that this tactic is effective in reducing obesity.
Eating disorders are characterised by extreme fear of weight gain driving sufferers to sacrifice other values to focus on weight loss or overactivity.
Research by the Royal College of Psychiatrists in Scotland reveals anorexia nervosa is prevalent among 1% of women and 0.5% of men. It has the highest mortality rate for any type of severe mental illness. Half of these deaths are by suicide.
Other marginalised communities may not seek help - so these statistics are only the tip of the iceberg.
People in the obese weight range can also suffer from eating disorders and are not helped by calorie counting.
The College believes along with our partners BEAT, that plans put forward will have a huge impact on those with disordered eating habits.
There are many things wrong with the proposals. There is a lack of evidence for starters.
While we recognise that we need to improve the health and wellbeing of Scots – a study in 2018 by the Cochrane Review found existing evidence of calorie labelling to be weak.
Our patients tell us that they already find calorie labels and nutritional information a trigger for them.
Most are obsessed with calories and the act of putting calories on menus would have a very negative effect on these patients.
And it’s not just labels. We’re seeing an increase in the use of calorie counting apps. Again – they act as a harmful trigger.
We work to support people who are often very ill and try and get them off these apps. They’re harmful and we feel the same about calories being put on menus.
Calories are one of a range of measures used in assessing someone’s diet but they’re unhelpful in isolation. They give no information about nutritional quality or about individual needs that help us judge whether we’re eating a balanced diet.
Counting calories is an unhelpful distraction for those who already have eating disorders and dangerous for those who might be on the brink of succumbing to one.
We would recommend the Scottish Government to make greater efforts to address obesity through looking at health inequalities within society.
There also needs to be improved public health measures – perhaps behavioural change campaigns and management of food outlets to provide a healthier nutritional environment.
If the Scottish Government does introduce calories on menus, we would suggest that there needs to be a ‘sunset clause’ – a review process by which these proposals could be evaluated and discarded if found to be harmful or ineffective.
Eating disorders are deadly. It’s important that we get this right.
Dr Philip Crockett is the chair of the Eating Disorders Faculty, RCPsych in Scotland
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