FDA Rule Has Side Effects

 A new rule from the Food and Drug Administration (FDA) may have some unanticipated negative side effects for people with eating disorders. The new rule, which requires restaurant chains and food vendors to clearly display the number of calories in their regular menu items, has been welcomed by many healthy eating advocates. Eating disorder specialists are, however, concerned about the impact of the new rules on those who have a genetic predisposition toward eating disorders.

The idea, when framed as an anti-obesity initiative, is appealing because it gives consumers an increased awareness  of the number of calories they are consuming when eating out. In a 2012 survey, the vast majority of students responded that they would be in favor of calorie labeling on foods. For people suffering from eating disorders, however, this calorie-focused labeling can provoke obsessive calorie counting. People who are  in recovery  from  eating disorders sufferers may, however, be put into an increased risk for a relapse when forced to be more aware of the calorie count for their next fast-food meal.

For the majority of the population, calorie labeling on restaurant menus probably won’t have much effect, although it may lessen their enjoyment of the overall dining experience. Some individuals, including those who suffer from orthorexia, an eating disorder in which only very healthy foods are eaten, could be more seriously affected. Some psychologists have noted that, even with people who have never suffered from a clinical eating disorder, an excessive concentration on the nutritional content of food could push some consumers into an unhealthy obsession about their food choices.

Rob Rosado, from the Food Marketing Institute, believes making restaurants label the calories content of their meals will result in the replacement of  “better for you ” fresh food with processed, packaged food with lower calorie contents. With restaurant managers now having to calculate every calorie in every meal that they offer, there is the concern that the experience of dining out will be adversely affected and reduced to a focus on numbers rather than taste and enjoyment. Eating disorder advocacy groups are worried that people with a genetic predisposition to disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder and other such illnesses will suffer some unanticipated collateral damage as a result of seeing the caloric content of their restaurant meals.

Anorexia nervosa for example, is a very complicated, and very deadly illness. It has the highest rate of mortality of any psychiatric disorder, and can have dire consequences for sufferers if left untreated. Anorexia nervosa, like bulimia nervosa and other expressions of eating disorders, has a biological basis. In most cases, it is a complicated interaction between genetic influence and environmental factors which lead to the expression of an eating disorder. This means that some people have a genetic predisposition for an eating disorder but, for many of those people, the condition remains dormant because they have not been exposed to the environmental factors that trigger the development of actual symptoms.  Many eating disorder specialists are concerned that the new  calorie  labeling requirements may create an environment that could trigger eating disorders among consumers who are not even aware that they have a genetic predisposition that puts them at risk for an eating disorder.

This has led to speculations that, as society becomes more weight and body focused, the prevalence of eating disorders will increase, a concern borne out by several anecdotal studies. New York based psychotherapist Diane Barth reports that several of her eating disorder clients  have admitted that seeing the number of calories on a menu does not change their food choices but does inspire greater feelings of self-loathing and guilt. Barth also notes that, for people suffering from clinical eating disorders, menu fortified with calorie counts appear to invoke feelings of shame, thus  reinforcing their belief that eating is shameful, and that they have to restrict their food consumption to regain self-respect and obtain approval from others.

One of the greatest threats accompanying an eating disorder is the compulsion that the sufferer has to protect themselves from discovery  by hiding their disorder. When treated, eating disorders can be overcome, but many sufferers evade treatment due to the mental impact that the illness has on them. Resistance to treatment is a common and difficult problem faced by sufferers. When dieting behavior is turned into a social norm, it becomes easier for sufferers to dismiss their behavior as “healthy eating.” Turning calorie counting into a normal, everyday activity is an example of a social norm that enables eating disorder behavior and makes it much easier for sufferers to hide their problem.

While mandatory calorie content labeling may have the desirable effect of increased calorie content awareness for overweight consumers, it might not be a good idea for people with other kinds of eating disorders. With the new rules already in effect, at a cost of many millions of dollar to calculate the calorie contents of menu items and revise the menus accordingly,  the FDA has embarked on a large scale social experiment that may have serious, unanticipated consequences for a significant percentage of the eating public who suffer from eating disorders.  To date, however, there is no published research on the effect that food labeling has on people who suffer from eating disorders, nor do there appear to be any plans to implement studies to determine the social impact of the new legislation.

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