My Lords, it is a pleasure to follow the noble Lord, Lord Brooke of Alverthorpe, who has done so much in his own way to bring together those of us who speak with the eating disorder community and those who represent those with obesity. I wish the Government would take on his approach of encouraging yet more joint dialogue.
I support the Government’s ambition to make the nation healthier, but these regulations are to be regretted and I therefore wholeheartedly support the amendment in the name of the noble Baroness, Lady Bull. At best, there is weak evidence for their efficacy and there is insufficient attention paid to the impacts on extremely vulnerable people, and the growing number of people suffering from eating disorders.
First, the weak evidence. The Explanatory Memorandum makes it clear that the approach is based on the 2018 Cochrane review, which concluded:
“Findings from a small body of low-quality evidence suggest that … energy information on menus may reduce energy purchased in restaurants.”
It went on to recommend the need for:
“Additional high-quality research in real-world settings”.
So I ask the Minister: did the Government consider trialling this approach first?
Secondly, these regulations will create another place of fear for a vulnerable community of eating disorder sufferers, having the potential to impact on their often-fragile recoveries and shattering the chance of moments of connection with families and friends.
I want to explain what I mean by a “place of fear”. When our daughter, Rose, was in the depths of her eating disorder and was hospitalised, part of her specialist treatment over many months involved taking the eating-disorder patients into cafés and other eating venues to learn how to manage these frightening situations. For those suffering from an eating disorder, the stress of a restaurant is huge: fear of other people watching you eat, fear of people eating less than you and fear of not having safe foods on the menu. It means obsessing about it the day before and restricting food intake beforehand. Going is a known risk, but one that is taken to try to have a moment of joy and celebration, given that food is a way to strengthen all those positive social bonds of connection with family and friends.
Those in recovery—and to be clear, recovery is not a linear process for sufferers; many get dragged back down time and again—will be at greater risk once this measure is introduced. Seeing calories on a menu will be one more way, once they are seated at the table, of stacking the cards against them as they battle the demons in their head telling them exactly what they are allowed to eat. In short, it turns what might have been a manageable situation—a moment of all too brief happiness for a family eating out—into one that descends into a paralysing stand-off.
There is no logic in eating disorders, only triggers to letting the illness claim control of your loved one. Victoria, another eating disorder sufferer, described it to me like this:
“During my recovery, I found calorie labelling highly triggering as it held me back from rebuilding my relationship with food and my understanding of how to feed myself in a healthy way without being controlled by numbers ... Eating disorder recovery is very fragile and I am daunted by the prospect that calorie counts will be harder now to avoid”.
This is the reality of these regulations for eating disorder sufferers.
The Explanatory Memorandum refers to the concession that menus without calories will be permitted—but, when I asked about the guidance that businesses were being offered, the department confirmed that there will be no obligation to produce such menus. So there is no guarantee of one being available and no sanction if the restaurant just turns around and says no. Why does the guidance for businesses not at least strongly recommend that such menus are available on request?
So the noble Baroness, Lady Bull, is right. We must review the impacts of this legislation within 12 months of its introduction, including assessing fully the impacts on eating disorder sufferers. We all want to encourage more healthy eating, but interventions should be evidenced-based and consider the implications for other vulnerable communities.
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