Nutrition can seem like a very complicated topic. Looking at the ingredients label doesn’t make it any simpler. In fact, it may only make you feel intimidated. So many words, some of which you may not even know or be able to pronounce – what is mannitol or acesulfame? – may leave someone who is trying to eat healthy bewildered.
It is even more overwhelming for a person with an eating disorder, and this is a serious problem. More than 30 million Americans suffer from EDs – and they affect people of every age, gender, rand race. Anorexia nervosa is deadlier than any other psychiatric disorder, a review of nearly half a century of research confirms.
The new FDA label rules are meant to help people make more informed choices about what they are putting in their bodies. The goal is to reflect new scientific information, according to the FDA, including the link between food and chronic conditions such as obesity and heart disease, two major public health concerns in the U.S.
EDs are also a concern. What a person with the condition would typically pay most attention to is calories, “but potentially seeing grams of fat, carbohydrate or sugar could be triggering as well,” Jennifer Sommer-Dirks, MS, RD, CSSD, Nutrition Manager, Eating Recovery Center in Denver, Colorado says.
The new labels are also meant to promote mindful eating, but Sommer-Dirks disagrees this will be the end result. “In fact I think it does the exact opposite.”
Numbers often become an obsession for a person struggling with an eating disorder, so displaying them so prominently on a menu or label can fuel eating disorders or even OCD thoughts about numbers, she adds.
Mindful eating involves listening to your body and following internal hunger cues. “Seeing a label with calorie and nutrition info could potentially cause someone to override those internal cues, and make a decision based on that external information.”
For instance, patients see that the meal is a certain calorie level they may stop eating before finishing the meal, even though they are still hungry. “Leaving a meal feeling deprived or still hungry could result in ED (bingeing, then purging) later in the day, or the hunger could fuel urges to restrict (in order to keep feeling hungry),” Sommer-Dirks says. This person would’ve been better off not seeing the calories and eating until their hunger was satisfied, she adds.
It’s too early to tell what impact the new labels are having, but there is also no way of knowing that having the labels will actually help people make healthier decisions in case someone needs to lose weight for health. However, Sommer-Dirks says, they will very likely make it more difficult for eating disorder sufferers to make decisions in the best interest of their recovery.
Restaurants and food establishments that are part of a chain with 20 or more locations have to abide by new rules as well. Consumers must have access to calorie and nutrition information. “Seeing the calorie information is a big struggle, but also portion sizes at restaurants can be quite large and that can be very overwhelming as well,” Sommer-Dirks says.
“It’s sometimes hard to know how much is appropriate to eat, as restaurants often serve double what is really needed for a meal.” With eating disorder recovery, typically there are no calorie guidelines. There is, however, information about appropriate food groups and portion sizes to help navigate the meal, she adds.
Sommer-Dirks has already heard patients express concern about the new information on the labels. “I think both patients and eating disorder professionals are generally concerned about this.”
“We talk about making decisions based on what sounds good and fits the meal plan and trying to ignore the numbers, but many times a patient will come back saying they ordered the lowest calorie choice, because they could see that on the menu,” Sommer-Dirks says.
Seeing any of the numbers on the labels can be a trigger, but calories are probably the biggest concern, she says. “Many people who struggle with an eating disorder do watch sugar intake, so those numbers could be triggering (of ED thoughts) as well.”
Sommer-Dirks’ biggest concern is that people – those with and without eating disorders – will rely too much on the calorie information instead of listening to their bodies and just practicing general nutrition guidelines such as moderate portions and eating a variety of foods from all the food groups. “Especially because the calorie info may not be 100 percent accurate anyway!”
This is a concern as well. People may get too reliant on those numbers. They think they got something lower calorie at lunch and reward themselves later with a snack they wouldn’t have had if they had just ate intuitively instead of based on numbers, Sommer-Dirks says. “Or they stop eating even though still hungry because of the numbers.” Overall, she adds, eating based solely on calories is not in the best interest for anyone, but calories will be the thing people notice first on the new labels.”
So what can people struggling with an ED do? “I think if this is the way things are trending, they need to work on accepting that the numbers might be there, and commit to making the best decision for their recovery regardless of the numbers,” Sommer-Dirks says.