Something I feel myself gradually changing my mind on is the ubiquitous labelling of how many calories each food contains on restaurant menus.

The basic idea there is that if consumers see that some restaurant food choices options have a very large amount of calories in them then they might be less likely to pick them and, as such, consume fewer calories. This would add up so in the long term they’d be less likely put on excess weight with all the concomitant difficulties and associated conditions which that can entail for some.

There might also be some side-effect benefits too, such as restaurants or food producers providing less calorific meals because they don’t want to have a menu full of dishes that exceed the average person’s recommended calorie intake in one ago.

I never felt there was much likelihood that the labelling initiative would actually have a big effect on behaviour, let alone health. It always seemed a bit “this seems like common sense so let’s assume it works” rather than “we have evidence it works so let’s do it”. Intuition over evidence; something that unfortunately rife and occasionally dangerous in the world of weight loss amongst others.

Another potential defect came from its seeming centring of the issue of overweight and obesity on the incorrect, stigmatising and counterproductive idea that the large increase in the proportion of people living at higher weights reveals something about the people concerned being ignorant or making “bad” choices; as though in recent years some evil wizard cast a magical spell over us all that made most of us into foolish greedy gluttons.

This way of thinking is harmful nonsense. It also puts all the “blame”, for want of a better word, on us as individuals and lets us ignore the structural factors - the things that are harder to think about, more complicated to act on and often less favourable to the profits of associated businesses - that are so clearly at play.

Since then most of the research I’ve seen about the various labelling initiatives seems to have confirmed that indeed we’re not going to reduce the rate of obesity meaningfully by making it clear how many calories a Big Mac has at the point of sale. It may even be a entirely ineffectual intervention in terms of clinical significance in the long term.

But, my scepticism on its likely efficacy aside, I saw no significant harm in trying it out as a policy - plus have a personal bias towards always wanting more information, more data, to be made available. It felt like it may even have shifted my own eating behaviour a tiny amount.

But I’m privileged enough that I’m not someone the policy was ever likely to harm. However, critically, those people may well exist. And if so, well, calorie labelling is now mandatory in the UK, a policy that most of the population seems to have been in favour of, so it’s a potential concern we should look to mitigate.

The evidence on the harms side is scant so far to be fair, so caveat emptor, but there are hints of adverse effects showing up in some recent research.

A recent paper by Brealey et al reviewed some of the literature on the impact of food labelling on people that have eating disorders (ED).

They found four studies - listed and summarised as part of this table - that use qualitative methods to end up suggesting some potential for harm.

The researchers summarise the results as:

Recurrent themes describe how calories on menus: can lead to a hyper-fixation on calories, restrict food freedom (meals are chosen for their calorific value rather than what was actually wanted or appropriate for hunger levels), reduce eating out opportunities, increase feelings of anxiety, guilt and shame around food choices, and inhibit ED recovery.

Some participants in these studies expressed anger over the messaging from ‘trusted’ public health authorities on the normalisation of calorie counting, because calorie counting had played a pivotal role in the development of their ED

To be clear, the feelings on labelling weren’t all negative for the participants concerned. Some saw benefits. Many of them also felt that calorie labelling may overall be a net good thing even if it might put them themselves at risk.

The researchers found only a single study that looked at more objective changes to the symptoms of eating disorders themselves, carried out in a university café. That work found no significant effects of labelling on some symptoms associated with eating disorder, but also came with a large number of limitations - not least that the participants hadn’t been formally diagnosed as having a ED.

So honestly the evidence base for harms also seems pretty weak at present. There’s simply not enough research out there to form much of a strong conclusion. And almost none that looks at objective rather than subjective harm in terms of ED symptoms - not to suggest that any types of harm should be disregarded.

But on the other hand, given the dearth of evidence that labelling actually leads to much of a relevant change in peoples' behaviour, let alone any positive change in their health, the risk equation shifts someway in the anti-labelling direction when any evidence, even if it’s weak, for the potential for harm comes to light.

Without wanting to be a cliché, this is one are where “more research is needed”.