This story mentions calorie counts, weight, and weight loss.
The panic started at Margaritaville. I was there reporting for another story, and ready to order the coconut shrimp I’d been dreaming about since I got the assignment. But next to the price was another number — 1370, the amount of calories in the entree. I felt a guilty flutter in my stomach, one I have done my best to kindly ignore since I was a preteen, but which is there no matter what I do. That was nearly a day’s “worth” of calories, and I’d already had breakfast and a margarita. I thought maybe I could order something else, but every entree seemed within the same range, whether it was a sandwich or a salad or a teriyaki chicken bowl. Short of ordering a plate of plain fries (590 calories) there was no way I could eat anything and stay within a “healthy” range of calorie consumption.
I ended up ordering the coconut shrimp, which was delicious. But just because the decision was made doesn’t mean I felt settled. For the rest of the day, there was a voice in my head doing the math, telling me I should “make up” for the transgression of ordering, telling me I was bad for eating something I wanted.
Adding calorie counts to menus began as a way to encourage (and shame) people into making “healthier” choices while eating out. Given that Americans eat one in five of our calories at restaurants, the logic was that maybe you’d choose a smaller soda, or a side salad instead of fries, if you were faced with raw numbers. Experts believed this would trickle down to fewer cases of type 2 diabetes, heart disease, and other diet-related illnesses. But as is often the case, people gather these illnesses under the umbrella of “the obesity epidemic,” conflating size with health and providing dangerous fodder for the diet-obsessed. Which is why it’s time for calorie counts to go.
In the U.S., the push to include calorie counts on menus started a little over a decade ago. In 2008, New York City became the first locality to require chain restaurants to include calorie information on their menus, defined as any restaurant with 15 or more locations. A similar law went into effect in California in 2009. In 2010, the Affordable Care Act ruled that chains with more than 20 locations must post calorie counts, though the FDA delayed implementation until 2018.
Legislators and scientists theorized that informed consumers would amend their orders to have fewer calories. “The big picture is that New Yorkers don’t have access to calorie information,” said Dr. Thomas R. Frieden, then the city’s health commissioner, in 2007. “They overwhelmingly want it. Not everyone will use it, but many people will, and when they use it, it changes what they order, and that should reduce obesity and, with it, diabetes.”
Frieden’s “should,” however, did some heavy work. 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 New York University 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 across the country (the term which the CDC still uses to lump together diet-related illnesses) have continued to increase.
There are two issues at play when it comes to the effectiveness, or lack thereof, of posting menu calorie counts. One is the calorie itself and its use as a metric for nutrition, along with the public’s understanding of what calories even are. A calorie is a unit of energy defined as the amount of energy needed to raise the temperature of water by one degree. Once we figured out humans derive energy from food, the calorie became a unit of nutrition. In 1990, the FDA mandated nutrition labels on packaged foods, and set the 2,000-calorie diet as the baseline for meeting one’s daily caloric needs.
However, according to Dr. Fatima Cody Stanford, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School, the FDA “anticipated that Americans would adjust as necessary based on their age, sex, stage of life, activity level, etc.” That’s because a calorie is not one-size-fits-all, and caloric restriction isn’t the ultimate path to health or weight loss. “Caloric restriction works on the basis of simple mathematics which does not correspond with how the body actually works,” says Stanford. “For example, one of the most common calorie deficit models tells one to reduce their calorie count by 500 calories a day if they want to lose one pound a week.” But even if your body does respond to this method and you start to lose weight, “you can’t lose 1-2 pounds a week forever. It is impossible to get to zero pounds and still be a living being. So, the body will halt you at some point.”
Stanford also points out that there’s a ton of brain chemistry and genetics that influence weight, and that regardless of how many calories a particular meal has, what tends to be more important is the quality of that meal. Even if two meals have the same number of calories, your body is going to react differently depending on what you’re eating. “Our bodies process less-processed food better than processed food,” she says, and if you’re already in a chain restaurant, anything you choose will likely be on the more processed side. All this means that seeing one burger is 500 calories and a fried chicken salad is 700 calories does not actually allow one to actually make an informed decision about one’s health and hunger needs. But it does lead to potential stress and triggers, especially for people with a history of disordered eating.
Like many girls raised in the ’90s (when the aesthetic ideal was regularly termed “heroin chic”) and early 2000s (when women’s fashion was based entirely around bare midriffs), having an at-best complicated and at-worst disordered relationship with eating was practically predetermined. For decades, the U.S. was flooded with low-calorie soft serve, “diet” cookies, and the general message that no matter what I ate, it would be better for everyone if I ate less of it. But over the past few years I’ve done my best to develop what might broadly be considered “intuitive eating” skills. I try to ask myself questions. What would you like to taste right now? How hungry do you feel? And sure, Is something that cheese-heavy the best idea if you’re going to a place with no bathrooms after this?
But when presented with calorie counts, all that thoughtful consideration of needs and desires flies out the window in favor of a singular motive: Eat the least amount of calories possible and get thinner. It doesn’t matter if the food with the lowest calories is unappetizing, or if it contains ingredients that actively cause me GI distress. Everything gets rewired.
“Unfortunately, for most, the word ‘calorie’ has taken on a negative connotation due to the pervasive message that eating ‘too many calories’ results in poor health and weight gain,” says Amanda Villescas, a registered dietitian nutritionist and certified intuitive eating counselor with the Radical Well-Being Center. For those with a history of disordered eating, that means calorie counts on menus can be triggering, and lead to people making decisions that are actually worse for their overall health.
But even if you don’t have a history of disordered eating, listed calorie counts can cause issues. “I think many people feel pressured to choose a lower-calorie menu option because we’ve been taught that less calories equals more healthy,” says Villescas. And in our culture, health is virtuous. “The moralization of food choices can invoke subtle or strong feelings of guilt ... alternatively, a ‘good’ choice may not satisfy or meet your energy needs on a given day.” This isn’t just an issue of nutrition, but of overall wellbeing and enjoyment. Villescas says, “It’s kind of sad, too, to think of the nourishment, connection, and/or joy might be lost from a person’s dining-out experience as a result of seeing what measured energy data happens to be associated with an appealing or favorite restaurant dish.”
One thing that those advocating for calorie counts on menus have missed is why people eat out, and more specifically why they frequently eat fast food. Yes, people eat it because they find it delicious, and because a life of perfectly nutritionally balanced meals would be boring as hell. But a 2017 study suggested that the more time-crunched you are, the more likely you are to eat fast food. It is less a matter of choice than one of convenience, especially if your options are eating an “unhealthy” burger, or not having lunch at all. Another issue is that most restaurants have not been motivated by calorie counts to diversify their offerings with “healthier” options. Salads at Wendy’s often have similar amounts of calories as burgers, and at McDonald’s the lowest-calorie combo meal (the Filet-O-Fish combo) is still 900 calories. Once you’re in a fast-food restaurant, there’s only so much choice available.
It would be one thing if diet-related illnesses were entirely caused by individual choices. But as more and more people are learning, diet-related illness isn’t about willpower; it’s a problem of the American food supply chain. In his seminal article “Everything You Know About Obesity Is Wrong,” Michael Hobbes points out “all of our biological systems for regulating energy, hunger and satiety get thrown off by eating foods that are high in sugar, low in fiber and injected with additives,” and that those kinds of foods “make up 60 percent of the calories we eat,” whether they come from restaurants or the grocery store. And by pretending health is a matter of choosing one fast-food sandwich over another, companies stand to profit from ensuring everything is full of high-fructose corn syrup and factory-farmed meat. You can’t choose your way out of a broken system.
To actually address diet-related illness in America, it’s going to take a complete overhaul of numerous industries. Doctors are going to need to stop assuming fat people are inherently unhealthy, the government is going to have to start allocating more than 4 percent of agricultural subsidies to fruits and vegetables, and work is going to have to change so people have more time, and money, to nourish themselves. “For 40 years, as politicians have told us to eat more vegetables and take the stairs instead of the elevator, they have presided over a country where daily exercise has become a luxury and eating well has become extortionate,” writes Hobbes.
Despite how much I hate menu calorie counts, the intention to arm consumers with information is a somewhat noble one. Menus signifying when things are vegan, gluten-free, or halal is a good thing, and though information like sugar or salt content may also trigger “health” worries, those can be useful for people who have diabetes or heart conditions. But “the constant highlighting of caloric content on menus reinforces toxic messaging around what it actually means to eat and be healthy,” says Villescas. She reiterates that weight is not a useful independent measure of health, and that “our health and overall well-being are impacted by many other things outside of just the food we eat on a daily basis.”
It’s clear that calorie counts on menus have not worked as intended, because health is much larger than the individual numbers associated with a single meal.
We have a long way to go to decouple size from health, and to ensure nutrition and exercise are not only the province of the elite. But I’d also just like to enjoy some chicken fingers without the menu suggesting I should be doing some advanced mental calculus before ordering. Whatever health looks like, that sort of worry is not it.