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

Debate between Lord Brougham and Vaux and Baroness Bull

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.