Dr. Pinhas: Calorie Legislation Will Do More Harm Than Good

I do not think that I can stand to witness the unnecessary ruination of more young lives. 

Through this blog I implore Ontario’s decision-makers to reconsider the new legislation that comes into effect in 2017 that compels restaurant chains to prominently display the calorie count of food item on their menu, on their price boards.  It is a well-intentioned intervention that will certainly do more harm than good.  I also suspect that this new legislation contravenes the Ontarians with Disability Act. 

If your intended audience is the restaurant industry, it is true that insisting corporations post nutritional information does encourage the reformulation of food products.  However, it is also true that the resulting changes may actually reduce the nutritional quality of the food.  If the intended audience is the consumer, the effect of this legislation is once again disappointing.  The results of studies examining these types of interventions are quite mixed.  Posting calorie content does not predictably improve customer decision-making when it comes time to order.  That any good might come of this legislation is unlikely enough that it cannot make up for the harm that will come from this legislation. 

The greatest risk of harm will be to our vulnerable young people.  Ontarians struggling with eating disorders (about one out of every six adolescent girls) will be negatively impacted. Knowing caloric content a food item is often a significant barrier to being able to eat that food item.  Some patients struggling to recover will now be forced to avoid coffee shops and restaurants they once felt comfortable patronizing.  We have legislated their exclusion from various social settings.  No longer will it be safe and fun to join their friends at the local coffee shop. For patients with eating disorders, it’s the equivalent of removing a wheelchair ramp and replacing it with stairs.

A second group of Ontarians at risk of harm from this legislation are children who are committed to being the best students.  We all know a child who is working hard to anxiously ensure they have straight A’s.  What we are creating for these children is a recipe for disaster.  Over the last few years school have been busy teaching these kids all about calories in a very didactic way, often leaving kids with a sense that calorie dense foods are “bad” and should be avoided.  They are being taught how many calories a day they should eat as if nutrition is a “one size fits all concept”.  The problem with this is that for some kids, the ones who want to excel at everything, the ones who want to be “perfect”, these numbers can get overwhelming.  It can lead to restriction and the rejection of many foods in order to fit into an arbitrary limit in number of calories.  With this legislation, we will be encouraging normal healthy eaters to ignore their hunger and satiety cues and to eat by numbers.  We make it much easier for them to inadvertently develop an eating disorder.  This will be a disaster for every family who has a child affected in this manner.  We do not have any specialized treatment programs for children with eating disorders in this country and these kids are often treated alongside adolescents, who they kids tend to emulate.  It’s not surprising that kids with eating disorders have a worse prognosis than adolescents, as they are exposed to developmentally inappropriate treatment. 

The health care system is already overwhelmed by the treatment needs of a relatively common mental health disorder that we keep insisting is rare.  Treatment programs are few.  There is no room in the system for an increase need for treatment.  Many of us are overwhelmed by the sheer suffering of these kids and their families, and how commonly they are made sicker, at the hand of health care providers who have biased and stigmatizing beliefs about people with eating disorders.  We cannot let the few experts who work in the field burn out.  They are few and we do not train replacements for them.  If they go, there will be nobody to fill their shoes.  Please, let us not create more suffering by placing more children at risk of developing and eating disorder.  Please let us avoid exposing these lovely, hard-working children to cruelty that they could avoid.  Let’s add burden to a treatment network that is barely sustainable. It’s not too late.

There is a solution to this problem.  We can meet the needs of the Ontarians who might really want to know how many calories are in the foods they are buying and still protect our young.  Go ahead and post the calorie content of foods served in the restaurant, but in a different location (a billboard on a side wall, on half the menus, etc.) away from where prices are not listed. That way folks who just want to pay without being attacked by the calorie count can do so, and those who really need to know how many calories are in their latte can know.  We could have our cake and eat it.  It would be a Wynne-win.