Calorie Labelling (Out of Home Sector) (England) Regulations 2021

Lord Brougham and Vaux Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Bull (CB)]

My Lords, I share government’s commitment to addressing obesity. My concern with these regulations is not their underlying intent; it is that they will have limited impact on reducing obesity while causing real harm to people with eating disorders.

If body weight was entirely under volitional control, this measure might be the answer to the obesity challenge, but obesity is more complex than that. Metabolism, poverty, environment and psychology all play a part, while hundreds of different genes influence our propensity to gain weight. The assumption that voluntarily eating less and/or exercising more can entirely prevent or reverse obesity is at odds with a definitive body of evidence developed over decades. They are not my words, but those of 100 obesity experts in a statement co-ordinated by the World Obesity Federation. Yet government’s obesity strategy turns a blind eye to this evidence and to the complex interface between obesity and mental health. I am astonished that the Minister did not mention this.

Eating disorders affect 1.25 million UK citizens and have the highest mortality rate of all mental illnesses. While some manifest in low body weight, others, such as binge-eating, lead to obesity. Obesity is not a mental illness, but the two often co-exist, with 30% of the extremely obese having a diagnosable eating disorder. Obesity measures will work only if they take these interactions into account. These regulations do not. While the impact assessment admits the poor quality of the studies supporting calorie labelling, the evidence for harm is strong. It drives people with anorexia or bulimia to eat less and those with binge-eating disorders to eat more. It leads to unhealthy weight control behaviours such as laxative use or vomiting, and it increases disorders in the wider population.

Calorie counting is an all-consuming obsession and a common trait in eating disorders. One person described her disorder as thriving off counting calories, while another said it ruined their life. Recovery is possible but fragile, with learning to eat in public a key part of the pathway. The affordable chains that these regulations affect are exactly the places where this happens. One sufferer described overcoming a terror of restaurants but said, “With calorie counts on the menu, I don’t think I’d have coped”. Given the complex and secretive nature of eating disorders, it is unduly cruel to insist that restaurants provide label-free menus only on request. Will the Government reconsider this, and can the Minister confirm that daily calorie requirements in the guidance now match what the NHS recommends?

Public health always involves trade-offs, with small harms to a few the price of gains for the many. The risk of my mammogram is worth it because I am screened for a disease to which I am vulnerable, but can it be justified for a public health measure to hurt people with no risk of the disease? If labelling was really going significantly to impact obesity, this prioritisation of physical over mental health might be justified, but evidence suggests it will not. We need instead an integrated approach to weight-related issues across the spectrum, recognising the co-occurrence and shared risk factors for obesity and eating disorders, and involving both fields from the outset. These regulations are not that. Given the high levels of concern, I ask government to commit to reviewing their impact not just on obesity but on any rise in the rate of eating disorders.

My regret today is genuine. I regret the limited effect that the regulations will have on obesity and the distress they will cause to those with eating disorders, and I deeply regret that we have failed in our efforts to protect them. I regret that, despite so many people bravely speaking out and despite the efforts of charities and clinicians, it has not been possible to work together on a public health approach to obesity, an approach that would more effectively support one part of the community without causing lasting collateral damage to another.

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

I remind noble Lords that the time limit for speeches is four minutes. I call the noble Lord, Lord Brooke of Alverthorpe.

--- Later in debate ---

[Baroness Wheatcroft (CB)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Bennett of Manor Castle, and her sensible comments on nutrition.

I support the amendment tabled by my noble friend Lady Bull. She is absolutely right: these regulations are misguided and will be counterproductive. If calorie labelling were an effective way of curbing obesity, sales of crisps would not have grown by 4.6% in volume last year. Neither would biscuit manufacturers have been able to enjoy a bumper year, with sales up 7.2% to almost £3 billion. Among the top 10 biscuit brands, only two failed to register growth—they were the ones in the healthier category. The best seller, McVitie’s chocolate digestive, has 86 calories. That may not sound a lot, but those prone to obesity find it hard to stop at a single biscuit.

These regulations are intended to hit in particular those who frequent fast-food outlets, but no one in Britain can be unaware that a Big Mac and fries will not win favour at Weight Watchers. In fact, together they add up to 845 calories. Throw in a caramelised frappe and you have 1,164 calories. Spelling it out on the menu will not reshape the eating habits of those intent on a quick and relatively cheap hunger fix, and it is the cheapness that is important. Obesity is strongly linked to poverty. A study of children in 2018-19 found that the incidence of childhood obesity was more than twice as high in the most deprived areas of the country as in the least.

Insisting that calorie numbers are on the menu will not deal with the obesity problem, but it will feed the problems of those suffering from eating disorders, the numbers of which are rapidly increasing. Only today it has been reported that hospitalisations of young people with eating disorders rose by 50% last year, and many more are queueing up to try to access treatment. Someone with anorexia nervosa will be as fixated on these calorie lists as a heroin addict on getting the next fix.

The regulations will make the struggle of trying to persuade an anorexic to eat something—anything—even harder than it is now. I know this because I spent many hours trying to persuade my desperately sick daughter to eat. It was sometimes easier to try to do this in a restaurant rather than at home, where she could take flight to her bedroom. As the noble Baroness, Lady Parminter, said, these trips were often very stressful for the anorexic and for all concerned.

My daughter nearly died. Had it not been for the brilliant Professor Janet Treasure and a year in hospital, she almost certainly would have done. Instead, she is a happy mother who has just produced her second child. Before making this speech, I asked if she would mind me talking about her, and she was keen that I should, because she wants to add her voice to those who counsel against insisting on this calorie labelling measure. She agrees that it would have added to the agonies of those sessions when she tried to find the least worst, in her demented view, item on the menu. Anorexics see calories as the enemy. I have been so fortunate that my daughter managed to overcome this pernicious illness, but these regulations will make it harder for others to do so while achieving very little positive.

While I realise that the Minister will not be swayed from his decision to go ahead with these regulations, may I add Lucy’s plea to that of my noble friend Lady Bull that he agrees to a timely review of their effects on everybody?

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

I now call the noble Baroness, Lady Fall. This debate is running out of time—four minutes, please.