The dilemma of menu labeling

More than a year ago, when I was still a dietetic intern, learning about HAES for the first time and just thinking about getting back into writing again I pitched an article. It was about the menu labeling law that was about to go into effect nationwide. I was concerned about it. I knew a lot of dietitians and researchers who were excited about its benefits. Many dietitians who work in the weight management field saw it as a positive.

“Hooray, our clients will be able to make more informed decisions!”

I didn’t feel that way though. Going through my high school and college years with an eating disorder and knowing many more both professionally and personally who have suffered from ED, I thought menu labeling was a terrible idea. I can vividly remember standing in a Chipotle and being unable to order because the calories were listed. They all seemed too high and the stress of picking with all that in mind overwhelmed me.

But I wanted to know what others who worked in the ED field thought. I wanted to put the discussion out there – because I felt like NOBODY WAS TALKING ABOUT IT. All the discussion I did see and hear was pro.

So, I pitched the below article and although it was at first accepted, once they saw my angle it was out. Despite three rounds of editing and caving on my part it never got published.

This past week I was searching through some old files and found it. My feelings on this law have not budged after more than a year of working directly with ED clients. I’ve seen dozens of times the negative effects and yet to really see any change in the average American’s eating habits. So I thought, What better time to finally share this?

The obesity epidemic is a phrase we have all become too familiar with over the last few years. As of 2016, over one-third of adult U.S. population is obese, so naturally politicians and health professionals alike have tried to do something about it.

That’s why “menu labeling” – putting the calorie-count of a food item on the menu – began. It started at giant chains like Starbucks and Chipotle, but as of May 7, 2017, the U.S. Food and Drug Administration is requiring all chains with 20 or more locations to include calorie-counts for each regular item listed on their menu. Other nutrition facts – such as total fat and cholesterol – must be available upon request, but are not required to be listed on the menu.

On the surface, this seems like a logical and helpful step in the efforts to prevent an increase in rates of obesity, but most studies have not shown a reduction in the number of calories individuals are consuming. At fast food chains like McDonald’s and Burger King there have been no significant changes in menu choices. In other words, the labeling isn’t doing its job.

But should that be the desired effect?

Kirsten Ackerman MS RD, thinks simply looking for less calories to be consumed is too simple.

“Food is not just fuel, it’s not just calories, it’s so much more than that, and that’s not a bad thing,” Ackerman said. Labeling food with a number “perpetuates this external decision making around food. Instead of someone tuning and listening to how full they are and if they need to eat, they turn to external diet rules for how much they should eat at that time.”

Alison Totta, a dietitian who specializes in eating disorders at Children’s National Medical Center agrees.

My least favorite kind of marketing…no chip should make you feel guilty! Happily eat it or choose not to.

“It’s totally destructive to them (individuals with eating disorders) but not just to them, to our whole society. It’s a totally destructive way to think about food.”

Including a calorie-count beside each food item can turn selecting a lunch or dinner entrée into a math puzzle, promoting the tendencies of Orthorexia and reaffirming the all-too-common assumption that if something has less calories it is automatically healthier.

“Since the information most readily available to consumer is the calorie content of food items, the implication is often that a lower-calorie item is healthier—that’s not always the case,” said Heather Caplan RD, who specializes in disordered eating. “If a consumer is making these decisions on the fly, without the guidance of a registered dietitian, they could be regularly missing out on proper nutrition for their lifestyle.”

And once the math puzzle is begun, it is difficult for many individuals, especially those who have or are struggling with disordered eating, to not take it just one step further.

“To be honest with you the obsession with calories just translates to an obsession with weight and thinness,” Ackerman said.

Unfortunately, for individuals with eating disorders the best advice, according to Ackerman, may be to avoid those establishments all together. Until they are able to ignore the label and choose an item with something other than the calorie-count in mind, smaller chains or stand-alone restaurants might be the best option.

Check out my latest Life With ED podcast this Monday featuring Mariah Staley @rd_plus

“I would suggest they avoid going to their places or have someone they are with read off the menu to them,” Ackerman said.

Although menu labeling may be harmful to many and ineffective for most, it may have its uses when it comes to simple awareness of how many calories are in food and drink items that are not often considered part of a meal – like a coffee or muffin that can contain several hundred to a thousand calories.

However, Ackerman and others still thinks if it is a choice between labels on everything or none at all, none is the better choice.

“I wouldn’t have any other notations on the menu regarding its calorie content or protein or anything,” Ackerman said, “people think too black and white.”

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