Maintenance Phase - Calorie Menu Labeling

Episode Date: June 7, 2022

This year, the UK implemented a law requiring chain restaurants to list calorie counts on their menus. Where did these policies come from? What impact do they have? And why is a Julia Roberts quote from 1990 the best way to describe them?Support us:Hear bonus episodes on PatreonDonate on PayPalGet Maintenance Phase T-shirts, stickers and moreLinks!Calorie Labelling Regulations - GOV.UKCalorie labelling: implementation guidance - GOV.UKDo Menu Calorie Counts Actually Change How We Eat?Calorie counts on menus: What's the real impact on diners and restaurants?Court Upholds the City's Rule Requiring Some Restaurants to Post Calorie CountsMenu Labeling | Center for Science in the Public InterestMenu Labeling Requirements | FDACalorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York CityThe influence of calorie labeling on food orders and consumption: A review of the literature - PMCChanges in Calorie Content of Menu Items at Large Chain Restaurants After Implementation of Calorie LabelsWhy Listing Calorie Counts on Menus Can Do More Harm Than GoodThanks to Doctor Dreamchip for our lovely theme song!Support the show

Okay, I have one but it's bad and we might get sued. Uh, I'm listening. Welcome to Maintenance Faze, the podcast that's about caloriesa Rees turning Sainson to this week. That has been stuck in my head ever since the last episode. Everything you say that word I think. I have had a similar one which is the more that I have read about this topic, the angrier I have gotten. And at one point, someone drove by our house and was listening to SoFresh and SoClean. Okay. Nobody met as we are just so full of rage. Right?

It works. It works. You definitely want us to get sued. I'm Michael Hobbs. I'm Aubrey Gordon. And if you want to support the show, you can do that on Patreon at patreon.com slash maintenance phase. I haven't done this in a while. We have t-shirts, there's donations, and there's links for you in the description.

And if you don't or can't want to support us, that's also chill. Yeah, hang out, keep listening. And today we're talking about calories again. Calories part two. So many calories. This is the episode that I kept flagging for you, slash threatening to make into a three-parter. And you were like, no!

I remember those negotiations, yes. Yes. So I'm very excited this time around what we are going to talk about is perhaps our most requested topic from UK listeners, which is menu labeling. Yes. And when we talk about menu labeling, we're talking about one really specific thing, which is listing the calories in a dish next to the name of the dish and the price of the dish. So we're not talking about policies that are necessarily like, this has this allergen or like ingredients. Yeah.

It's full on just like, the price is $8.99 and this has 600 calories. And like the calorie count is like almost as big as the price usually or the same size. Yes, and actually that's regulated in these laws and rules. They will set minimum font sizes. If the menu item is in papyrus, the calories have to be in Comic Sans. Yes.

He's just having my mom make the menus. I'm familiar with these. Before we dig in on that, I thought it might be helpful to have a little recap of our last conversation and do a little previously on maintenance face. What do we learn about calories? It's all bullshit. This What do we learn about calories?

It's all bullshit. This is what we learn every episode. It's all bullshit. Cookbooks are fake. And sometimes people aren't from the South. You don't need to listen to our back catalog anymore. So, I mean, we talked about the development of calories as a part of the metric system, this little neutral measurement,

and then how it started to get applied to food. And we talked about calories in, calories out, being much more complicated than that and how all of our clap-backs are perfect and correct. And yeah, just all of this stuff is much more complicated and conditional than a lot of people have been led to believe. I feel like the headline for all of this stuff is, as you noted, isn't, it's all total bullshit,

but it's all 1% of a picture, and that 1% is way more complicated. But it's just the price we pay. But it's good. So I'm going to do it all episode. I apologize. Boy, we're about to get a cease and desist from Brandon Flowers. We can only apologize, and your eyeliner looks great.

We love you, we're sorry. So, like, can we talk about where these policies come from? Yes, I'm excited because the first I ever heard about this was during the passage of Obamacare, where it was like one of those things, they just like threw into Obamacare, and then they passed it and took like 400 years for it to actually happen. And I still, it's still not clear to me like where this is in the United States. I assumed that this would be one of those things

that had been toyed around with for a long time and just caught on recently. It has not. Menu labeling as a policy and as a practice is really, really young. Okay. The first municipal campaign that I found about menu labeling was 14 years ago.

Oh, okay. And since then, menu labeling policies have like completely taken the world by storm. There are many countries that require calorie menu labeling now, but the campaign that sort of started at all was a campaign in New York City in 2008. Oh, right.

This was Bloomberg's whole thing, like Mr. Public Health guys. Absolutely. So, New York was the first major U.S. jurisdiction to mandate calorie labeling on menus. You had to participate if you were a chain that had more than 15 locations nationwide. Okay. So even if you only had one location in New York City, if you had the 15 nationwide, then you still had to label your one in New York City, right?

There was perhaps unsurprisingly pushback from owners of restaurants and particularly owners of these like larger chain restaurants because it was going to cost the money and they were going to have to do a bunch of stuff that they didn't previously have to do. The opposition on this campaign was the New York Restaurant Association. They filed a lawsuit seeking to stop this local policy from going into effect because they said it was impractical, expensive, and they said it was a constitutional violation. Of course. Would you like to guess what the grounds were? Because I have a free speech right

to not tell people what's in their food. Is that... Yup. It's a violation of free commercial speech. I've such a fetish for bad faith free speech arguments now. This is like 80% of political debate in the United States now. What a time to be alive for you. If you're into this, if this is your thing, so the interesting thing here is that the court

rejected that lawsuit because fucking of course they did. It's not a violation of free speech to say that a corporation has to disclose like what is in the products that it is feeding its consumers. That just doesn't hold water on its face. I don't think this is a good policy, but I definitely don't think it's like a violation of the first amendment calm down. Right. So this policy passes in 2008 by 2009, many, many jurisdictions had followed suit. Oh, interesting. There was a spark and then it just caught on fire and just went everywhere, right?

So I am going to send you a little quote. This is from a book co-authored by Marion Nestle called Why Calories Count. It says, by 2009, California, Oregon, and Maine required calorie labeling, as did a dozen or more counties and cities. At least 30 other jurisdictions were considering similar bills. Confronted with a cacophony of differing laws that would present chains with difficult compliance problems, the restaurant association dropped its opposition. This paved the way for the national legislation that preempted local and state laws. While we waited for the National Law to go into effect, the NYC experienced provided an

opportunity to find out whether menu labels would improve purchases, teach the public about calories, or induce restaurants to reduce the calories in their foods. So basically, it's happening everywhere. Once the restaurants realize that the pendulum has swung against them, they're like, fuck this, we're gonna move our lobbying up to the federal level to make sure that when Congress does a national policy on this, it's gonna be as like watered down as possible.

This is usually how it works. Yeah, pretty much, right? That they were just sort of like writings on the wall. This thing isn't gonna stop. We have to stop fighting each of these individually and instead focus on, we know this is gonna happen federally. So let's make it more amenable to us and to our goals.

Yeah. This comes up quite a bit in these public policy conversations around combating the quote unquote obesity epidemic is that quite often those policies can include a measure of corporate accountability. And it seems like the response from corporations is to go not only do we accept it, we champion it.

We're big fans of this. Right. And we're going to put all our energy into making it happen. And then functionally what they do is soften the policy so much that it stops being like meaningful or useful. Although it's a weird place to be in this particular issue because I agree with the restaurant association on this that like this, this policy is kind of silly and isn't gonna work,

but also just like methodologically, I don't like it when corporations do this. Fucking insane. It's like, I don't really care that they were bad this time. Yeah. I feel weird. I'm sitting here feeling weird. Totally.

I mean, I think the other thing that is sort of slipped into that quote that we just read is while we waited for the national law to go into effect, the New York City experience provided an opportunity to find out whether menu labels would improve purchases, teach the public about calories or induce restaurants to reduce their calories and their foods. There was no research on this at the time. Right. So right after New York, Multnomah County,

which is where Portland is, King County, which is Seattle, the city and county of San Francisco, LA, right, like all of these sort of democratic strongholds on the West Coast just immediately followed suit. Right. And there was not any data illustrating any effects of this because no one had been doing

right. It was just this sounds like a good way to handle this problem. Let's reach for a thing that sounds good to a lot of people and right. Hope it works out. Essentially is the policy model here. And I guess the logic was that a lot of these chains would have to make all these calculations anyway, because they were gonna have to comply with the law in New York.

It's like, well, McDonald's is gonna have to do this anyway. So like, Boise Idaho looks at this, and they're like, well, McDonald's has locations in Boise, Idaho too, so let's make them do it here. Absolutely. I guess it was the logic at the time. I mean, I will say there are times when you do have to move policy

in the absence of research, right? Like I think COVID is a great example, right? This was not one of those times. Nothing was on fire. There were no immediate consequences of people not knowing the number of calories in like a griddle. It was much more of a sort of like,

this is a decades-long trend and now is the point at which we have decided to freak out about it. I mean, it's also worth noting, these policies are passing at the time that the biggest loser is at the height of its popularity. Right. And Michelle Obama is running, let's move,

and we are talking about the childhood obesity epidemic. This is absolutely the height of anti-fat panic in the US. This is also peak Brian Wonsink times, too. Oh my God, the number of Brian Wonsink citations in these fucking policy white papers, Michael. Did you know smaller plates? And a bunch of the policy white papers and a bunch of the popular media reporting on this

were all like, you know, it takes 3,500 calories cut from your diet to lose a pound of fat. Oh yeah, of course. All of the research that I read in preparation for this episode, all of the analysis, all of the everything would just go from fat people are a huge problem. We have too many of them. They cost too much. People are going to die because they're so fat.

And then the next paragraph is just like, we have to label calories on menus. And I'm like, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, whoa, right. You haven't established that people actually don't have enough information. Right. You haven't established that people avail themselves of that information and then make different decisions, right? Like, it yada yada's the entire link between the policy and the problem that it says it's

solving. See, I'm torn because on one hand, I'm actually in favor of cities doing ambitious policy. You can't really have data on something that you're the first city to try. This is how we got smoking bans, right? It's like, let's try this wacky thing and then it turns out that it works and every city does it. But then on the other hand,

this is built around weight loss, which I don't think cities should be doing as a matter of public policy at all. And if you're going to do these ambitious public policy experiments, you need to have a really clear idea of what indicators you will be looking at to say after a couple of years,

this is working or this is not working. Yeah, I mean, I feel like that kind of stuff, that kind of policy experimentation, I'm with you, that stuff feels really exciting and interesting to me. That stuff functioning is contingent on a few different things. One, you have to have really clear and robust program evaluation measures of like,

we need to see this kind of change in this kind of time frame. And if we don't, then it didn't work, right? It also has to include a really clear sense of who your stakeholders are. And none of these had any of that. There was no sunset timeline. There was no evaluation set of metrics. We'll talk about some of the evaluation of some of these.

It is some of the worst evaluation that I have ever seen. Yeah. Like, one of them actually just tell you about one of them right now. It's wild. In New York, there was a point at which a number of municipalities had calorie labeling and a number did not. So they essentially did a comparing contrast. They put up billboards in communities that had calorie labeling.

And the billboards were for a campaign called I Choose 600 and it was about teaching people to choose, like use calorie menu labeling to choose meals that were under 600 calories per meal. The way that they evaluated that program, they called people who were in their sort of desired target audience for calorie menu labeling, and they asked them if they remembered

the billboards that they saw. Okay. And more people in their target audience were like, yeah, I remember those billboards, and they were like, cool, cool, did you use them ever? And the people were like, yeah, I totally used them. Oh.

You remembered seeing a billboard is not the same thing as creating a measurable difference in public health outcomes. I'm getting such a stress nostalgia response, thinking of the development projects I worked on, where it was like the funder wanted some like really dumb indicators and you're like, okay, we want to do a survey, but like we kind of know this project is dumb because they're like not giving us enough money to do it effectively or whatever. So I remember having literal meetings of like,

okay, how can we make this project look like it was successful, even though it was a total joke. Totally. And a great way to do that is to use indicators that refer to outputs rather than effects. You say like, how many billboards did we put up? And then you're like, we're successful because we put up six billboards,

but like that's not what you're trying to do. You're not trying to make people see billboards did we put up? And then you're like, we're successful because we put up six billboards, but like that's not what you're trying to do. You're not trying to make people see billboards. Totally. That's not actually a measure of public policy or of like health outcomes changing. That's a measure of, you asked people if they saw a specific billboard and either they do remember that specific billboard

or they thought saying yes would get you off the phone. If somebody called me up and was like, have you seen the billboards advertising yak meat in your neighborhood? I'd be like sure, whatever. Do you intend on eating yak meat? I'd be like, yeah, why not? Oh, sure. I think people just answer yes to stuff,

especially if it's like someone is telling you to do something because it's healthy. You're like, yeah, yeah, I'll do that totally. Sure, sure, sure, sure, close enough. Yeah. So in 2008, New York passes its first municipal ordinance in the US. And again, this is the earliest one

that I could find anywhere. And by 2010, we had a federal law requiring calorie counts be published nationwide. Oh, wow. I didn't know it was that fast. So within two years, it was written into the ACA, the Affordable Care Act, also known as Obamacare. OK.

As you noted, it took a long time for rules to actually go into effect around this. The rules for that law didn't go into effect until 2018. So eight years after the passage of the law, and the specific reason that was given was to give restaurants and grocery stores more time to comply. So this is the result of that, like the restaurant association organizes and goes, all right, we're just going to put all our focus into the federal one and part of putting all their focus into it is make sure it doesn't

go into effect for eight years, right? That's a pretty big win for them. Right. Basically, the press around this sort of change in the ACA is generally like really glowing. Those sort of press responses to this and characterizations of it are like, we're doing the right thing. Finally, someone's doing something about this quote unquote obesity epidemic. Yeah. But then when you get into the article, as is the case in so many of the studies that you and I read, so many of the analyses that we read,

like the actual numbers are wilds and very different than the narrative that is being presented around those numbers. So I am gonna send you a quote from a news media piece at the time about this change in the ACA. It says, the menu labeling rules will improve public health. The Food and Drug Administration Commissioner Scott Gottlieb said last week in an interview. He pointed to studies showing that enlightened customers order on average up to 50 fewer

calories a day. While that equates to the calories in a small cookie, Gottlieb says, the impact compounded over weeks and months can deliver a large benefit. This is a meaningful incremental step in addressing the country's obesity epidemic, he says. This whole policy is built on the idea of calories and calories out, which as we discussed last time, is way the fuck more complicated

than anybody wants to think that it is, right? The idea is if you cut 3,500 calories from your diet, you will lose one pound. That's not true. But if you apply that totally outmoded and debunked rule that a lot of people believe, if you're cutting 50 fewer calories each day, you're eating 50 fewer calories each day,

you would lose one pound in two and a half months. Every 70 days. And what we know is that your metabolism downshifts over time and burns fewer and fewer calories, so one pound in two and a half months is the most weight someone would lose. Right. And it would decrease significantly over time. Right.

So what we're talking about here functionally is like two to five pounds in a year. Also, one of the things that always bugs me about these little nudge things is that you could easily argue that the thing that's affecting people's behavior is the novelty of the things that always bugs me about these little nudge things is that you could easily argue that the thing that's affecting people's behavior is the novelty of the calorie labels, right? That the first time you notice it, you're like, oh, a big bag is 580 calories. I'm not going to get that today or whatever. And then you change. But then once they've been on the menu for a while, it's part of the background.

It's just another thing that you ignore. Like I think of, remember when Twitter added that thing that's like, do you want to read the article before you retweet the title? And at first, you're like, oh, maybe I think of, remember when Twitter added that thing that's like, do you wanna read the article before you retweet the... You had to, and at first, you're like, oh, maybe I should read the article, but then I was thinking about now, I don't even like notice that little bar anymore. This was on my list in my notes.

For this episode was I was like, no one has actually tested in political world, you would call it the durability of the message. No one's tested the longevity of the message. Like the first time you see it, it probably makes a big impact. Right. Six months from then, what's the impact it creates? Five years from then, what's the impact that it creates?

Right. So this guy, Scott Gottlieb, the FDA commissioner, in this same news media piece, he says, well, you know, I really like to go to McDonald's every once in a while. And I've actually switched from an Egg McMuffin because of this calorie labeling. I've switched from an Egg McMuffin to an egg white delight. Okay, Scott.

The article to its credit immediately goes, that's a 20 calorie difference. Yeah, yeah. Yeah. The difference is, is there a yolk in the egg or is there not a yoke in the egg? If you made that change every single day, it would take him almost six months to lose one pound. Right.

But still, the message of so many of the media pieces at the time are like, this is one of the greatest tools public health has. Right. So I think it's worth noting that the primary supporter of this sort of federal policy was the Center for Science in the Public Interest, which we have talked about before on the show.

Complicated feelings. Complicated feelings, real bummer in this particular case. I went to their resource page and read all of the resources that I could find. They included like polling data on the popularity of calorie counts. I will say that part was really fascinating. Quite a bit of the media was like, these are very popular and consumers are clamoring for more calorie counts on menus.

Most of the popularity rates were in the 30s and 40s. Yeah, that's not like a resounding endorsement. It sounds like a resounding mess. Yeah. You do it a resounding man. Yeah. You do it one. The other thing that I will say is the cross tabs on it are totally fascinating and that the support is highest amongst highest income households.

Ah, see, yeah, that's interesting. Functionally, as this stuff plays out, you're like, man, the people who are most invested in it are people who make like more than 100 grand a year. I mean, no offense that's got guttly, but if you're running the FDA, you're probably like an educated guy, you're probably a wealthy guy. Yes, your statistical life expectancy if your Scott Gottlieb is probably like 84. Those really aren't the people who like we need to really worry

about their mortality rates. Ditto for federal policymakers working on the hill. Right. I mean, I think the other thing that I wanted to talk about here, which I find really fascinating is the lead sponsors of the menu labeling stuff are overwhelmingly Democrats. So it's interesting that this is also sort of like a policy that's being pursued without any real science behind it at the same time that Democrats are developing this identity around like where the party of science.

There's something very unscientific about acting as if providing people information will change their behavior in any meaningful way. It is also like deeply condescending. I think, I don't think people mean it to be, but the idea is like, oh hey, you just don't know enough. Right. It's not that you're making choices for yourself. It's not that you know where to get information. Right. It's a very enlightenment era kind of approach. And again, what we know from political research is that those kinds of facts and figures

don't actually change people's behaviors. It's also interesting that anti-fatness really does span the ideological spectrum. Yeah. And yet, Republicans have no interest to actually do anything about it. Which is interesting. Yes, totally. Like, they want to be able to make fun of fat people, but they don't actually want to do anything to solve the quote unquote obesity epidemic.

But then, it seems like the Democrats also sort of subtly make the same point in that they want these like technological fixes. It's like, I want something easy. I want something where nobody has to make any sacrifices and nobody has to ask poor people what they need. Nobody has to increase welfare. It's like, we're gonna do this one weird trick and then everybody's gonna lose weight.

I think on this issue honestly, and I feel like I will be struck down for saying this, I would prefer doing nothing. I agree, and I'm doing the opposite of striking you down. I'm bawling you up. So I looked at a handful of meta-analyses on this topic that one of them, so we'll talk about a 2014 literature review that looked at 39 studies on this that happened between 2008 and 2013. And then we'll talk about one from 2021 that looked at a cohort study of 59 restaurant chains, right? Here is a quote from the findings

of that 2014 literature review. It says, we find that while there are some positive results reported from studies examining the effects of calorie labeling, overall, the best designed studies show that calorie labels do not have the desired effect in reducing total calories ordered at the population level. Moving forward, researchers should consider novel, more effective ways of presenting nutrition information while keeping a focus on particular subgroups that may be differently impacted by nutritional policies. So basically they don't work and in the future try to think of what you actually want to achieve with the policy and for whom and like do that instead before you pass a bunch of policies.

Well, not only that, they're saying this policy of providing more information doesn't work. So in the future you should find more exciting ways to present more information. Oh God, okay. So very clearly, we looked at 39 studies. This doesn't have an effect. The result here is not, we should probably give up on these policies. The result here is, make it more fun when you present the calendar. Yeah, that's right, dark.

It's dark, dude. That's like the president's physical fitness research where it's like this hasn't worked forever, but it might. Totally, totally. It's dark, right? And on top of all of this, like what we talked about last time is there is a dramatic difference between the number of calories in a food and the number of calories that your body can put to use.

So also all of these calorie labels are deeply misleading, right? And unless you're getting the exact same size of scoop of chicken at one Chipotle as another, you're not necessarily actually getting actionable information about the number of calories. Well, this is my thing is that restaurant portions differ fairly significantly. I mean, maybe if you're eating it somewhere

that's like super duper regimented and everything's in like a fucking little sous vide pouch or something, then it would be standardized. But oftentimes if we're talking about like, I don't know, fettuccine Alfredo or something, they're just like grabbing a thing of fettuccine in like a of Alfredo, you know, might say like 800 calories on the thing, but it might be like 900 or it might be 700.

If what we're talking about is like people choosing 50 calories less a day, the margins are so small here and the differences are so big. Like I think people are deeply in denial about the fact that you just don't know how many calories people are eating. Right. And like the difference in calories of like this idea of cutting 20 or 50 calories, like 20 or 50 calories is like a tablespoon or two of sour cream at Chipotle. Right. You know what I mean? Right. It takes so little to correct for even the big claims of quote unquote success that are coming with calorie menu labeling. So over time, the sort of arguments around menu labeling started to shift in subtle ways

that I think most people didn't track particularly closely. Initially, it was sort of like, we'll provide more information, consumers will make more and different and better decisions and by better in this case, we mean less caloric. And over time, that shifted to actually this is going to provide pressure from consumers onto businesses, and then the businesses will have to offer less caloric things. Right. I remember at the time a lot of talk of when Starbucks had to start menu labeling in New York City,

they switched their lattes or something from whole milk to 2% milk. Yeah. That was like the little parables that went around that it's like, ah, once you force them to disclose how many calories they'll change. How many calories are in it? Right. It sort of transformed after its passage into like corporate responsibility. And you're like, well, that's not what it was before.

Okay. So that idea was explored in a 2021 cohort study that came out of Harvard's School of Public Health, another frequent flyer on maintenance days. Friend of the pod. They did this large cohort study looking at 59 restaurant chains. So this is a quote from the findings of that cohort study looking at 59 restaurant chains. So, those are quote from the findings of that cohort study out of Harvard. It says, this cohort study comprising 59 large restaurant chains followed up from 2012 to 2019 found that restaurants did not change the calorie content of continuously offered

items. However, new items introduced after calorie labeling had a mean of 113 fewer calories, approximately 25%, compared with new items introduced before labeling a statistically significant reduction. So it didn't affect anything on the foods that have been on the menu, but when they introduced new stuff, they have 25% fewer calories. If you believe that people need to cut calories, this sounds pretty good, right? It sounds like this is sort of like doing what it's designed to do.

25% reduction in calories, sounds pretty good. We're on our way, team. Yeah. No, Michael, we're not on our way. So this is one of the first large scale studies that has looked in a real way at like, how does this actually impact folks calories consumed? Because that's what it was ostensibly aimed at.

And what it found is on an individual level it doesn't change people's behavior. And on a corporate level, when you drill down into their actual findings section, they did find that there was a decrease in calories, this 25% decrease in calories, so 113 fewer calories per new menu item. So anything that was introduced that was new, that was only true at fast food chains. Okay. In sit-down chains, so like Applebee's Olive Garden,

whatever, and coffee places, like Starbucks, those places had pretty statistically insignificant decreases in calories per menu item. It went down like 15 calories to 17 calories is the range that they offer. So like you have a whole meal at Applebee's. Black Angus, think about how big that meal would be, think about how color it would be. Now imagine that it has 16 fewer calories, right? Now I wanna bake your potato. And in fast casual chains, places like Chipotle or Panera or Cudoba, the calories actually went up on new menu items. Oh.

So they're saying, oh, we put this policy into place and now when they add new menu items, they have fewer calories. That's only true of fast food places. Every other kind of establishment that is governed by this policy either had their calories stay the same or go up. But also to know what to make of this, you would have to know how much of their sales are made up of new items.

Yeah, absolutely. I have no idea, but I feel like most people that go to McDonald's probably get like a quarter pounder or Big Mac or something fries, milkshake, something like fairly standard. It's actually a pretty big deal that like it doesn't, it doesn't affect their continuously offered items. Totally. Also, I mean, 2012 to 2019 has also appeared where there's just a lot of like wellness, diet, stuff happening.

There's been a trend, especially among fast food corporations, to have more healthy menu items. So to say that this is all due to menu labeling also seems a little bit superficial. Oh, Michael! Oh, did I predict it? Michael! Did I spoil it?

I love it when you cue up a quote! So this is like a slightly longer quote. This is from Eater, the website Eater, did a roundup on like, here is sort of the impact of these policies. And here is there, they did a great little summary. So here's Michael, here's what we know. It says, it's true. The average American's calorie consumption

has overall gone down since 2003, though there's no clear evidence that shift has been directly linked to calorie counts on menus. In 2015, researchers at NYU reported that while diners changed their ordering patterns in the short term, over the years, the percentage of respondents noticing and using the information declined, and that overall, there were no statistically significant changes over time in levels of calories or other nutrients purchased or in the frequency of visits to fast food restaurants. Also, even if calorie consumption has fallen nearly 15 years after the implementation of the first laws, obesity rates around the country have continued to increase.

So, people paid attention for a little while, it didn't change their behavior, and no one is less fat. So in other words, we did it. Nailed it. Nailed it. And there's another quote also from that Harvard study where they say, quote, analyses revealed a long-term decrease about 17 calories per year in the calorie content of items removed for restaurant menus that began before labeling implementation. Labeling was not associated with additional changes independent of this secular trend.

So well before menu labeling, there was already a slight decrease happening in terms of calories offered on fast food and fast casual menus. And these policies don't appear to have affected that trend one way or the other. It seems to continue in this like very shallow downward slope in calories. So basically, this was already happening and then we made a bunch of policies and the policies don't appear to have had an effect.

I do think that it's telling that I don't know if there's menus labeling in America. I think I just either we have it and I've completely tuned it out or we don't have it. We have it and you have completely tuned it out by it. Would last on one to Panera were there were there numbers on the menu? I mean, I guess there were and I just completely edited them out. Yeah. So despite all of this evidence, in 2021, the UK introduces and proposes a policy to mandate calorie labeling on menus in restaurants

and takeout places and coffee shops and all of that sort of stuff, right? Yes, and 400 people emailed us and we're like, you should do an episode on it. So many people emailed us and we're like, you should do an episode on it. So many people emailed us. Do you have a sense of like, why the UK did this? Because there's this whole trend of like evidence-based policy making and data-driven, mm-mm-mm.

Did they say like, this is why we're doing this? The interesting thing about this policy in the UK is that it's being presented into separate frames. One is combating the obesity epidemic, right? And the other interestingly is as a COVID strategy. Oh, oh fuck off. Oh fuck off.

It is rich for the UK to be doing this. Oh, the reason why our COVID deaths were so high is fucking fat people. Yes. Mr. like having a party during lockdown, fuck off. So the 2014 study is out, the 2021 study is out. They are resoundingly like this doesn't do anything, but that 2021 study got trumpeted

from the fucking rooftops in the UK being like, what a great policy we're about to enact. Really? This was their basis. When this study came out because the regulations had already been passed, this study became heavily covered in the UK because I suspect many journalists just read the executive summary and didn't read the actual findings.

And saw, oh, there's a 25% decrease in the calories on new men. Oh my God. That's pretty promising. And never looked at that. That only applies to a very small number of the establishments that we're talking about. And it doesn't change people's individual behaviors. And it's like, it's like 95% bad news. Like this policy doesn't work.

And then 5% is like, ooh, but just in fast food restaurants, just on new menu items that are not seasonal, but our new permanent menu items and their first subject to this law, some of those are 100 calories less than they used to be. So we're really doing it, team. Like, no. Right. And this wasn't the original justification for the law, and there's no indication that this law meets its original goal, which is reducing obesity, which is not something that the government should be engaged in anyway. But it's like the indicator was never will, will, will new menu items be restaurants? No one said that in 2008 when they were passing this stuff. No jurisdiction has reduced its rates of fatness or fat people at a population level. It's not happening.

It's honestly incredible to me that anyone would look at literally anything that America is doing at this point and be like, let's have that. Let's make our country closer to that thing. So I was like, you know, I love to find a fun tidbit in the research that doesn't really have any bearing on what we talk about. I love about the tidbits. There's a little paragraph in an article from the independent in the UK about measures

that restaurants have taken to reduce the calorie counts of their foods. And this one is very fun. I just said you a quote. Okay. Zoom. And this one is very fun. I just say you quote. Okay, zoom. It says, the concept of offering diners a less calorific meal is not a new one. A decade ago, pizza expressed, launched its Le Jera pizza. You remember the one.

It literally cut a hole in the middle of the pizza and replaced it with rocket leaves. And then claimed it had reduced the calories by a third. It made a fucking pile of arugula and put a pizza halo on it. rocket leaves and then claimed it had reduced the calories by a third. Made a fucking pile of arugula and put a pizza halo on it and called it like a less calorie pizza. They cut a hole in the middle of a pizza and then filled the hole with arugula and we're like, like, it's like the last calories. And I just, I love it in part because the image that it is is like in like a wily coyote, cartoon, a wily coyote,

might dig a big deep hole and then cover it up with leaves and wait for the road runner to like fall through the hole. Like it feels like this is the pizza equivalent of that. But the policy passed, right? So the policy is now in place. It is in effect. I can get my little rocket hat, my little bitter disc, I can get my bitter disc.

It sounds like we don't have any good evidence that these policies, quote, unquote, work. But is there any evidence of like the harms that they're causing? In terms of academic research, I would say no. In terms of outcry from experts and survivors of eating disorders and fat people, very clearly yes, right? For people with restrictive eating disorders like anorexia or bulimia, if they are in recovery or not, if they're actively in their eating disorder, seeing these kinds of calorie counts can actually trigger a relapse of their eating disorder or trigger a worsening of their eating

disorder. So, someone can go into a restaurant, see calorie counts on a menu that they weren't expecting to see and they might be early in Treatment for their eating disorder and feeling like good about themselves and then go in and see those calorie counts and just spiral, right? The other thing that it's not really asking is what are the social impacts of a policy like this, right? Since this went into effect in Portland, there are absolutely places that I am not going with certain people in my life, because calories are listed on the menu, and I absolutely don't need to hear that from that person,

right? I know that what will happen is I will go in, I will order whatever I'm going to order, and the person I am with will have things to say about the calorie count of the thing that I ordered, no matter what it is. So people have actually mentioned the fucking number to you? Yes, absolutely.

Oh, fuck off. When you erase any kind of social context around this stuff, you're erasing arguably one of its biggest impacts, right? Yeah, I wonder if it gives people ammunition to be like, oh, that fat lady just ordered a salad, but she doesn't know that the salad has like 800 calories or something, or like, you can look at all the items

on a menu and be like, oh, this guy just ordered the one with the most calories. Yeah, I was 100% in line at a fast casual place. It was in fact a Chipotle. And the person behind me in line leaned over and was like, you know, there's actually a lower calorie option. I had gotten the like salad bowl thing. And I think they thought I was getting the salad bowl thing

because I didn't want to get fat or something. Oh, my fucking God. It really does invite these fucking gremlins to tell you unbidden what they think about what you're doing. Do you remember what you said in that moment? What I said to them was, I picked what I wanted to order. Okay. To me internally, it felt like my response was extremely aggressive.

Like, I feel like I had a lot of energy behind that response. I don't know if it came off that way. But I definitely like had a very strong response as both a fat person and a person who's had needing this order. Like, there are a few things that elicit a stronger response from me than people offering unsolicited comments on what I eat and how I move and what I wear and all that kind of

stuff, because it's both massively fucking insulting. Oh, it's so patronizing. So patronizing. So dickish, just so utterly dickish, that's not just a person being a jerk, right? That's a person being a jerk in a way that if I don't handle it pretty quickly for myself and have some good support around and all that sort of stuff,

can genuinely mess with my physical and mental health? Yeah, it's awful. Yeah. In ways that that person is not tracking and does not give two shits about. I expect that from assholes in line at Chipotle. I would like to be able to expect better of like law makers and public health policy people, right?

Right. The Harvard School of Public Health, right, gets held to a higher standard, agreed. Right, yeah. But as it stands, it doesn't. And honestly, even the research here doesn't get held to a higher standard of like, hey, wait a minute, it seems like somebody's having a hard time with this one. Let's check in with that very significantly

large group of people. I would also love it if random bystanders like bystood into situations like that. Fucking, like, hey, can you fuck off and leave this lady alone, please? Yeah. Like, I would love to see that happen. Somebody stand up for Fuckin' is like, hey, can you fuck off and leave this lady alone, please? Yeah. I would love to see that happen. Somebody stand up for somebody and just be like, choke on it, order your fucking sour cream and move on. You don't need to comment on other people's bullshit right now.

I would love it and also I would love it honestly, even just if someone would check in with a fat person after that stuff happens, which also doesn't happen. Everyone just falls silent and pretends like nothing happened, which is, I can't express a more isolating experience than being like publicly shamed or humiliated and having nobody say or do anything or even acknowledge that it happened.

That happened to me at one point when I was receded on a plane, like absolutely no one said or did anything. So that's, yeah, that's so good. And it is the quickest way to feel like fully worthless as a person. The baller move in that situation is to like wait five minutes and then walk up to you and be like, excuse me, miss, I just keyed that guy's car. I just really want to know.

I'm just gonna come back in with a giant like five very fancy shopping bags in each hand and what have one of them be a hat box that just be like big mistake. That's what you reached for the Julia Roberts. Just the full Julia Roberts. Pretty loving. I don't know why it would matter to the dude at Chipotle that I went shopping. that I went shopping. Just like the lady I shopping by is now, but whatever. I feel owned for some reason, it's not good in the world. Yeah, I don't know why, but listen, I handled it.

So like, it just feels like there is a categorical disinterest in what if this isn't good? Much less, what if there are people for whom this is like harmful to them? You know, in the UK, they made some sort of placating But much less, what if there are people for whom this is harmful to them? In the UK, they made some sort of placating kind of response in the policy where you can under the UK policy, you can go into a restaurant that has calories labeled on the menu, and you can ask for a paper copy of a menu that doesn't have calorie labels on it.

Oh, in much smaller font, and you have to go out of your way to get it, basically. You have to go ask somebody. So again, if you think about going into like a Chipotle or whatever where the menu is hanging on the wall, you then go up to the counter, you ask someone for a copy of the menu that doesn't have calories on it. That doesn't change the social context around you. And it doesn't mean that that person with an eating disorder doesn't still see all of those calorie counts and still have a really hard time with it, depending on the nature of their eating disorder, depending on a lot of different things, right?

So it just seems extremely wild to me that we're talking about eating disorders, which depending on who you ask and the source of the numbers is up to one in five people, we'll have an active eating disorder in their lifetime, that is not an insignificant number of people. Right. There is this sort of categorical disinterest in anything

that seems to indicate that maybe this policy wouldn't be universally helpful and good. There's also something... This is why it's so good you host a show with a thin person, Aubrey, this is the insights that I bring to the show. Because to me, those calorie counts are invisible. Because I'm not counting calories, I'm not dieting, and I'm not a fat person who gets scrutinized on the basis of those numbers. But then if you're somebody who had an eating disorder or has an eating disorder or a fat

person who's afraid of getting comments from somebody else, those numbers are probably the most hyper visible part of the menu for you. And I think most of the people making these policies, I'm assuming, are approaching it like me, and are like, oh, it's invisible, and nobody even notices. But to some people, those numbers are not invisible. Well, and it's just more information. What could that hurt? Yeah.

There was a piece in Bloomberg writing up the UK change that said, quote, survey suggests people underestimate how much they eat by up to 50% and also tend to underestimate how many calories certain foods contain. So information and transparency can hardly be a bad thing. The main argument here seems to be like, couldn't hurt. And then a bunch of people go,

oh, it does hurt though, for me it hurts. Is there another way we could do it? And they're like, nope, couldn't hurt. In order to get to that point, you already have to be kind of irrationally invested in a policy that had no data behind it and now has bad data behind it. If you're like, we can make it work for everyone.

I'm like, but even when a quote unquote works, it doesn't fucking work. Right, it's like, look, I know you hate this, but on the other hand, it's not achieving any of its goals. Have you considered it's not working for anyone else? It makes people feel nothing or terrible. Well, great. I think one of the central dilemmas here too is that the quote unquote benefits of this

policy, this weak shit about 113 fewer calories or whatever of new menu items, that's quantitative. That's a number, right? And policy makers love numbers. They love pretending to be all data driven. Like, I have no ideology. I'm just following the data. But then when you talk about something like this contributes to weight stigma, which I think it absolutely does, I see no scenario in which it makes weight stigma better.

Yeah, no. That's diffutural, right? I can't imagine a scenario in which it doesn't add to weight stigma, but that's really hard to quantify. Oh, yeah. The harms of it either haven't been studied or they're so hard to quantify that you can't really put them in like a pros and cons column against like a hundred and thirteen fewer calories versus Contributes to this in co-ate thing called weight stigma that like kind of nobody really cares about anyway Yeah, yeah, we don't create the research around it

We don't fund the research around it and then we go, oh, you don't have any numbers too bad pack it in right? Like that we just refuse to pay attention because it's not quantified and conveniently ignore the fact that collectively we refuse to quantify it, right? Right. You know, if you wanted to do food labeling stuff, there is a ton of stuff that we could do that would materially improve health outcomes for lots of people, for people who are hypertensive or dealing with heart disease, sometimes the recommendation that will come along with that is reducing salt intake.

You could have a check mark that's like, this is low sodium and approved for low sodium consumption, or you could for diabetic people who need different levels of carbohydrates in different scenarios with different levels of fiber, you could decide to come up with a labeling scheme that is designed to help people with diabetes, the most common chronic illness in the US,

navigate their foods and improve their health outcomes, which would also drive down health care costs and all of the things that we say matter to us about reducing fatness, right? I think a great example is like, for people who have celiac, the only way that we really got reliable gluten labeling was when people thought gluten made you fat

and a bunch of people stopped eating gluten as a functionally a diet. Right, I guess it reveals the extent to which these labels are designed as weight loss tools when it comes to actual health stuff. It seems like that's kind of functionally taking a back seat. It's totally about weight loss. And I don't feel like at all opposed to people having access

to more food information and for a lot of people particularly disabled and chronically ill people, that's like really important information to have. That's not what these policies are doing. These are ways that we call ourselves down, right? That like a bunch of our public conversation around fatness and weight loss and health is all about spinning us up and getting people way the fuck anxious about their own mortality and about policing other people's food choices and all of that sort of stuff and policies like this which are not rooted in science which don't create the effects that they say they do are more about calming people down

right I think I would feel differently about it if we talked about other things with the level of excitement and interest and energy that we put into calorie labeling. We just need to empower consumers to open up my e-girl. No, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no Thank you.