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?
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Michael: Okay, I have one but it’s bad and we might get sued.
Aubrey: [laughs] I'm listening.
Michael: Welcome to Maintenance Phase, the podcast that's about calories turning sands into the sea.
Michael: That has been stuck in my head ever since the last episode. Every time you say that word, I think, “Calories.”
Aubrey: [laughs] I have had a similar one, which is the more that I have read about this topic, the angrier I have gotten. At one point, someone drove by our house and was listening to, So Fresh, So Clean.
Aubrey: Ain’t nobody met as me, I'm just so full of rage, right?
Aubrey: It works, it works.
Michael: You definitely want us to get sued.
Michael: I'm Michael Hobbes.
Aubrey: I'm Aubrey Gordon.
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Aubrey: Yeah, hang out. Keep listening.
Michael: And today, we're talking about calories, again. Calories, Part 2.
Aubrey: So many calories. This is-
Aubrey: -the episode that I kept flagging for you/threatening to make into a three parter and [laughs] you were like, “No.”
Michael: I remember those negotiations.
Michael: Yes. [laughs]
Aubrey: I'm very excited. This time around, what we're going to talk about is, perhaps our most requested topic from UK listeners, which is menu labeling.
Aubrey: 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.
Michael: We're not talking about policies that are necessarily like this has this allergen or ingredients.
Michael: It's full on just the price is $899 and this has 600 calories. The calorie count is almost as big as the price usually or the same size.
Aubrey: Yes. And actually, that's regulated in these laws and rules.
Michael: Oh, okay.
Aubrey: They will set minimum font sizes.
Michael: If the menu item is in papyrus, the calories have to be in Comic Sans.
Aubrey: You just having my mom make the menus?
Michael: I'm familiar with these.
Aubrey: 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 Phase. What did we learn about calories?
Michael: It's all bullshit. This is what we learn every episode. It's all bullshit.
Michael: Cookbooks are fake and sometimes people aren't from the south.
Aubrey: You don't need to listen to our back catalogue anymore.
Michael: 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. We talked about calories in, calories out being much more complicated than that and how all of our clap backs are perfect and correct.
Michael: Yeah, just all of this stuff is much more complicated and conditional than a lot of people have been led to believe.
Aubrey: I feel 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.
Michael: But it's just the price we pay, destiny [singing].
Michael: I'm going to do all episode. I apologize.
Aubrey: Boy, we're about to get a Cease-And-Desist from Brandon Flowers.
Aubrey: We can only apologize and your eyeliner looks great.
Michael: We love you. We're sorry. Yes.
Aubrey: So, Mike, can we talk about where these policies come from?
Michael: Yes. I'm excited because the first I ever heard about this was during the passage of ObamaCare, where it was one of those things they just threw into ObamaCare and then they passed it and took 400 years for it to actually happen. It's still not clear to me where this is in the United States.
Aubrey: 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. It is really, really young.
Aubrey: The first municipal campaign that I found about menu labeling was 14 years ago.
Michael: Oh, okay.
Aubrey: And since then, menu labeling policies have completely taken the world by storm. There are many countries that require calorie menu labeling now, but the campaign that started at all was a campaign in New York City in 2008.
Michael: Oh, right.
Michael: This was Bloomberg’s whole thing like Mr. Public Health guy.
Aubrey: New York was the first major US jurisdiction to mandate calorie labeling on menus. You had to participate if you were a chain that had more than 15 locations nationwide.
Aubrey: Even if you only had one location in New York City, if you have the 15 nationwide, then you still had to leave all your one in New York City. There was perhaps unsurprisingly pushback from owners of restaurants and particularly owners of these 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.
Aubrey: 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.
Michael: Oh, of course.
Aubrey: Would you like to guess what the grounds were? [laughs]
Michael: Because I have a free speech right to not tell people what's in their food? Is that it?
Aubrey: Yeah, it's a violation of free commercial speech.
Michael: Oh. I've such a fetish for bad faith free speech arguments now.
Michael: This 80% of political debate in the United States now.
Aubrey: What a time to be alive for you-
Michael: I know.
Aubrey: -if you're into this, if this is your thing.
Aubrey: 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?” This 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 a violation of the First Amendment. Calm down.
Aubrey: This policy passes in 2008. By 2009, many, many jurisdictions had followed suit.
Michael: Oh, interesting.
Aubrey: There was a spark, and then it just caught on fire, and just went everywhere. So, I am going to send you a little quote. This is from a book coauthored by Marion Nestle called Why Calories Count.
Michael: It says, “By 2009, California, Oregon, and Maine require 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.”
Basically, it's happening everywhere. Once the restaurants realize it, the pendulum has swung against them. They're like, “Fuck this. We're going to move our lobbying up to the federal level to make sure that when Congress does a national policy on this, it's going to be as watered down as possible.” This is usually how it works.
Aubrey: Yeah, pretty much that they were just like, “Writings on the wall, this thing isn't going to stop, we have to stop fighting each of these individually, and instead focus on. We know this is going to happen federally. So, let's make it more amenable to us and to our goals.”
Aubrey: This comes up quite a bit in these public policy conversations around combating the “obesity epidemic” is that quite often those policies can include a measure of corporate accountability and it seems the response from corporations is to go, “Not only do we accept it, we champion it. We're big fans of this and we're going to put all our energy into making it happen.” Then functionally, what they do is soften the policy so much that it stops being like meaningful or useful.
Michael: Although, it's a weird place to be in this particular issue, because I agree with the Restaurant Association on this that this policy is silly and isn't going to work, but also just methodologically I don't like it when corporations do this.
Aubrey: Fucking sane.
Michael: It's like, “I don't really care that they were bad this time.”
Aubrey: Yeah [laughs].
Michael: I feel weird. I'm sitting here feeling weird.
Aubrey: Totally. I think the other thing that is 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 in their foods. There was no research on this at the time.
Aubrey: Right after New York, Multnomah County, which is where Portland is, King County, which is Seattle, the city and county of San Francisco, LA, all of these democratic strongholds on the West Coast just immediately followed suit.
Aubrey: There was not any data illustrating any effects of this, because no one had been doing.
Aubrey: 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 hope it works out, essentially, is the policy model here.
Michael: I guess, the logic was that a lot of these chains would have to make all these calculations anyway, because they were going to have to comply with the law in New York. It's like, “Well, McDonald's is going to have to do this anyway.”
Michael: 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.”
Michael: I guess, it was the logic at the time?
Aubrey: I will say, there are times when you do have to move policy in the absence of research. I think COVID is a great example. This was not one of those times.
Aubrey: Nothing was on fire. There were no immediate consequences of people not knowing the number of calories in a McGriddle.
Aubrey: It was much more of a like, “This is a decade's long trend and now is the point at which we have decided to freak out about it.”
Aubrey: It's also worth noting, these policies are passing at the time that the biggest loser is at the height of its popularity. 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.
Michael: This is also peak Brian Wansink times, too.
Aubrey: Oh, my God, the number of Brian Wansink citations in these fucking policy white papers, Michael.
Michael: Did you know smaller plates?
Aubrey: And a bunch of the policy white papers and a bunch of the popular media reporting on this, we're all like, “You know it takes 3,500 calories cut from your diet to lose a pound of fat.”
Michael: Oh, yeah, of course. Yeah.
Aubrey: 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.” Then the next paragraph is just like, “We have to label calories on menus.” I'm like, ‘Whoa, whoa, whoa. wait.”
Aubrey: You haven't established that people actually don't have enough information. You haven't established that people avail themselves of that information and then make different decisions. It yada yadas the entire link between the policy and the problem that it says, it's solving.
Michael: 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. It's like, “Let's try this wacky thing.” Then it turns out that it works in 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. 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.”
Aubrey: Yeah, I feel 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 timeframe. If we don't, then it didn't work.” 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.
Aubrey: I 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. They essentially did a compare and contrast. They put up billboards in communities that had calorie labeling. The billboards were for a campaign called iChoose600 and it was about teaching people to choose, 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 desired target audience for calorie menu labeling and they asked them if they remembered the billboards that they saw.
Aubrey: And more people in their target audience were like, “Yeah, I remember those billboards.” They were like, “Cool, cool. Did you use them ever?” The people were like, “Yeah, I totally use them.”
Aubrey: You remembered seeing a billboard is not the same thing as creating a measurable difference in public health outcomes.
Michael: I'm getting such a stress, nostalgia response thinking of the development projects I worked on, where it was the funder wanted some really dumb indicators and you're like, “Okay, we have to do a survey. But we know this project is dumb, because they're not giving us enough money to do it effectively or whatever.”
Aubrey: Oh, my God.
Michael: 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.
Michael: A great way to do that is to use indicators that refer to outputs rather than effects.
Michael: You'd say like, “How Any billboards did we put up?” Then you're like, “We're successful, because we put up six billboards.” But that's not what you're trying to do. You're not trying to make people see billboards.
Aubrey: Totally. That's not actually a measure of public policy or of 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.”
Michael: 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.”
Michael: “Do you intend on eating yak meat?” I'd be like, “Yeah, why not?”
Aubrey: Oh, sure.
Michael: I think people just answer yes to stuff, especially if someone is telling you to do something because it's healthy, you're like, “Yeah, yeah, I'll do that, totally.”
Aubrey: Sure, sure, sure, sure. Close enough. Yeah.
Aubrey: In 2008, New York passes its first municipal ordinance in the US. Again, this is the earliest one that I could find anywhere. By 2010, we had a federal law requiring calorie counts be published nationwide.
Michael: Oh, wow. I didn't know it was that fast.
Aubrey: Within two years, it was written into the ACA, the Affordable Care Act, also known as ObamaCare.
Aubrey: 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. This is the result of that. The Restaurant Association organizes and goes, “All right, we're just going to put all our focus into the federal one.” Part of putting all their focus into it is, make sure it doesn't go into effect for eight years. That's a pretty big win for them.
Aubrey: Basically, the press around this change in the ACA is generally really glowing. Those press responses to this and characterizations of it are like, “We're doing the right thing. Finally, someone's doing something about this “obesity epidemic.”’
Aubrey: 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, the actual numbers are wild and very different than the narrative that is being presented around those numbers. So, I am going to send you a quote from a news media piece at the time about this change in the ACA.
Michael: 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.”’ “Well, 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.
Aubrey: This whole policy is built on the idea of calories in, calories out, which as we discussed last time is way the fuck more complicated than anybody wants to think that it is. 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.
Michael: Every 70 days.
Aubrey: And what we know is that your metabolism downshifts over time and burns fewer and fewer calories. One pound in two and a half months is the most weight someone would lose and it would decrease significantly over time. What we're talking about here functionally is, two to five pounds in a year?
Michael: 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 calorie labels. The first time you notice it, you're like, “Oh, a Big Mac 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 a part of the background. It's just another thing that you ignore. I think of remember when Twitter added that thing that's like, “Do you want to read the article before you retweet this?”
Aubrey: Yeah, totally.
Michael: At first, you're like, “Oh, maybe I should read the article.” But then I was thinking about now, I don't even notice that little bar anymore.
Aubrey: 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. The first time you see it, it probably makes a big impact. Six months from then, what's the impact it creates? Five years from then, what's the impact that it creates?”
Aubrey: So, this guy, Scott Gottlieb, the FDA commissioner, in this same news media piece he says, “Well, 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.”
Michael: Okay, Scott.
Aubrey: The article to its credit immediately goes, “That's a 20-calorie difference.”
Michael: Yeah, yeah, yeah.
Aubrey: [laughs] The difference is, is there a yolk in the egg or is there not a yolk and the egg. If he made that change every single day, it would take him almost six months to lose one pound.
Aubrey: 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.”
Aubrey: I think it's worth noting that the primary supporter of this federal policy was the center for science in the public interest, which we have talked about before on the show.
Michael: Complicated feelings.
Aubrey: 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 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.
Michael: Yeah, that sounds like a resounding endorsement.
Aubrey: It sounds like a resounding meh to me.
Michael: Yeah. [laughs].
Aubrey: Oh, you do what you want.
Aubrey: 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.
Michael: Ah, see. Yeah, that's interesting.
Aubrey: Functionally, as this stuff plays out, you're like, “Man, the people who are most invested in are people who make like more than a 100 Grand a year.”
Michael: No offense to Scott Gottlieb, but if you're running the FDA, you're probably an educated guy, you're probably a wealthy guy, your statistical life expectancy if you're Scott Gottlieb is probably 84. Those really aren't the people who like, “We need to really worry about their mortality rates.”
Aubrey: Ditto for federal policymakers working on the hill.
Aubrey: 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. It's interesting that this is also a policy that's being pursued without any real science behind it. At the same time that Democrats are developing this identity around like, “We're the party of science.”
Michael: There's something very unscientific about acting as if providing people information will change their behavior in any meaningful way.
Aubrey: It is also deeply condescending.
Aubrey: I don't think people mean it to be, but the idea is like, “Oh, hey, you just don't know enough.”
Aubrey: [laughs] It's not that you're making choices for yourself, it's not that you know where to get information. It's a very enlightenment era approach. Again, what we know from political research is that those facts and figures don't actually change people's behaviors.
Michael: It's also interesting that anti-fatness really does span the ideological spectrum. And yet, Republicans have no interest to actually do anything about it, which is interesting.
Aubrey: Yes, totally.
Michael: They want to be able to make fun of fat people, but they don't actually want to do anything to solve the “obesity epidemic.” But then, it seems the Democrats also subtly make the same point in that they want these 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 going to do this one weird trick and then everybody's going to lose weight.”
Aubrey: I think on this issue, honestly, and I feel I will be struck down for saying this, I would prefer doing nothing.
Michael: I agree and I'm doing the opposite of striking you down. I'm balling you up.
Aubrey: [laughs] I looked at a handful of meta-analyses on this topic that one of them-- We'll talk about a 2014 literature review that looked at 39 studies on this that happened between 2008 and 2013. Then we'll talk about one from 2021 that looked at a cohort study of 59 restaurant chains. Here is a quote from the findings of that 2014 literature review.
Michael: Oh. It says, “We find that while there are some positive results reported from studies examining the effects of calorie labeling. Overall, the best design 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 do that instead before you pass a bunch of policies.
Aubrey: 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.”
Michael: Oh, God, okay.
Aubrey: 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 calorie information. [laughs]
Michael: Yeah, that’s dark.
Aubrey: It's dark, dude.
Michael: Yeah. That's the President's physical fitness research where it's like, “This hasn't worked forever, but it might.”
Aubrey: [laughs] Totally. It's dark, right?
Aubrey: And on top of all of this, 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. Also, all of these calorie labels are deeply misleading. Unless, you're getting the exact same size of scoop of chicken at one Chipotle as an another, you're not necessarily actually getting actionable information about the number of calories.
Michael: Well, this is my thing is that restaurant portions differ fairly significantly. Maybe you're eating it somewhere that's super-duper regimented and everything's in 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 grabbing a thing of fettuccine and of Alfredo, might say 800 calories on the thing, but it might be 900 or it might be 700. If what we're talking about is, people choosing 50 calories less a day, the margins are so small here and the differences are so big. I think people are deeply in denial about the fact that you just don't know how many calories people are eating.
Aubrey: Right. The difference in calories of this idea of cutting 20 or 50 calories, 20 or 50 calories is like a tablespoon or two of sour cream at Chipotle or whatever.
Aubrey: You know what I mean?
Aubrey: It takes so little to correct for even the big claims of “success” that are coming with calorie menu labeling. Over time, those arguments around menu labeling started to shift in subtle ways that I think most people didn't track particularly closely. Initially, it was like, “We'll provide more information, consumers will make more indifferent and better decisions.” And by better in this case, we mean less caloric. Over time that shifted to, “Actually, this is going to provide pressure from consumers on to businesses and the businesses will have to offer less caloric thing.”
Michael: 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.
Michael: That was the little parable that went around and it's like, “Ah, once you force them to disclose how many calories, they'll change how many calories are in it.”
Aubrey: Right. It transformed after its passage into corporate responsibility and you're like, “Well, that's not what it was before, but okay.” That idea was explored in a 2021 cohort study that came out of Harvard School of Public Health, another frequent flyer on Maintenance Phase.
Michael: Friend of the pod.
Aubrey: They did this large cohort study looking at 59 restaurant chains. So, there's a quote from the findings of that cohort study out of Harvard.
Michael: 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 introduce new stuff, there's 25% fewer calories.
Aubrey: If you believe that people need to cut calories, this sounds pretty good, right? It sounds like this is doing what it's designed to do.
Aubrey: 25% reduction in calories, sounds pretty good.
Michael: We're on our way team. Yeah.
Aubrey: No, Michael, we're not on our way.
Aubrey: 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?” 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 that there was a decrease in calories, this 25% decrease in calorie, so, 113 fewer calories per new menu items. Anything that was introduced that was new, that was only true at fast food chains.
Aubrey: 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 and went down 15 calories to 17 calories is the range that they offer. You have a whole meal at Applebee's. Black Angus, think about how big that meal would be, think about how caloric it would be. Now, imagine that it has 16 fewer calories.
Michael: Now I want a baked potato.
Aubrey: In fast casual chains, places like Chipotle, or Panera, or Qdoba, the calories actually went up on new menu items.
Aubrey: So, they're saying, “Whoa, 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 establishment that is governed by this policy, either had their calories stay the same or go up.
Michael: 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.
Aubrey: Yeah, absolutely.
Michael: I have no idea. But I feel most people go to McDonald's probably get a quarter pounder or a Big Mac or something, fries, milkshakes, something like fairly standard. It's actually a pretty big deal that it doesn't affect their continuously offered items.
Michael: Also, 2012 to 2019 has also appeared where there's just a lot of wellness diet stuff happening. There's been a trend especially among fast food corporations to have more healthy menu items. To say that this is all due to menu labeling also seems a little bit superficial.
Aubrey: Oh, Michael?
Michael: Or that I predicted.
Michael: Did I spoil it?
Aubrey: I love it when you queue up a quote.
Aubrey: This is a slightly longer quote. This is from Eater, the website, Eater, did a round up on like, “Here is the impact of these policies and here is their--" They did a great little summary. Michael, here's what we know.
Michael: It says, “It's true, the average Americans 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 well, diners change 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.”
Aubrey: People paid attention for a little while, it didn't change their behavior, and no one is less fat.
Michael: In other words, we did it.
Aubrey: Nailed it.
Michael: Nailed it.
Aubrey: And there's another quote also from that Harvard study where they say, “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 very shallow downward slope in calories. Basically, this was already happening, and then we made a bunch of policies, and the policies don't appear to have had an effect.
Michael: I do think that it's telling that I don't know if there's menu labeling in America. [laughs] I think I just either we have it and I've completely tuned it out or we don't have it.
Aubrey: We have it and you have completely downplayed. [laughs]
Michael: Last time when we went to Panera, were there numbers on the menu? I guess, there were and I just completely edited them out.
Aubrey: Yeah. 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, coffee shops, and all of that stuff, right?
Michael: Yes. And 400 people emailed us and we're like, “You should do an episode on it.”
Aubrey: So many people-
Aubrey: -emailed us. [laughs]
Michael: Do you have a sense of like, “Why the UK did this?” Because there's this whole trend of like, evidence-based policymaking and data driven, ma, ma, ma, ma. Did they say like, “This is why we're doing this.”
Aubrey: The interesting thing about this policy in the UK is that it's being presented in two separate frames. One is combating the obesity epidemic and the other interestingly is as a COVID strategy.
Michael: Oh. Oh, fuck off.
Michael: Oh, fuck off. It is rich for the UK to be doing this. Oh, the reason why our COVID deaths are so high is fucking fat people.
Aubrey: Yes. [laughs]
Michael: Mister, having a party during lockdown, fuck off.
Aubrey: 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?”
Michael: Really, this was their basis?
Aubrey: 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 menu.”
Michael: Oh, my God.
Aubrey: That seems pretty promising. And never looked at, 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. 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 therefore subject to this law.”
Aubrey: Some of those are hundred calories less than they used to be. So, we're really doing it team, like, no.
Michael: Right. 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 any way. But the indicator was never, will new menu items be smaller at restaurants? No one said that in 2008 when they were passing this stuff.
Aubrey: No jurisdiction has reduced its rates of fatness or fat people at a population level. It's not happening.
Michael: 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.” [laughs]
Aubrey: I will say, you know I love to find a fun tidbit in the research that doesn't really have any bearing of what we talk about.
Michael: You love your titbits. You are all about the titbits.
Aubrey: I love my little 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 sent you a quote in the Zoom.
Michael: Okay. It says, “The concept of offering diners, a less calorific meal is not a new one. But decade ago, PizzaExpress launched its Leggera 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.”
Michael: They made a fucking pile of arugula, and put a pizza halo on it, and called it a less calorie pizza.
Aubrey: They cut a hole in the middle of a pizza, and then filled the hole with arugula, and were like, “It's less calories.” [laughs] I love it in part because the image that it is in a Wile E. Coyote cartoon, Wile Coyote might dig a big deep hole, and then cover it up with leaves, and wait for the roadrunner to fall through the hole. It feels this is the pizza equivalent of that. [laughs]
Michael: But the policy passed, right? The policy is now in place.
Aubrey: It is in effect.
Michael: I can get my little rocket hat.
Michael: My little bitter disc. I can get my bitter disc. It sounds like we don't have any good evidence that these policies “work.” But is there any evidence of the harms that they're causing?
Aubrey: 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?
Aubrey: 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. 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 good about themselves, and then go in and see those calorie counts, and just spiral.
The other thing that it's not really asking is, what are the social impacts of a policy like this? 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. 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.
Michael: Oh, so, people have actually mentioned the fucking number to you?
Aubrey: Yes, absolutely.
Michael: Oh, fuck off.
Aubrey: When you erase any social context around this stuff, you're erasing arguably one of its biggest impacts.
Michael: 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 800 calories or something” Or you can look at all the items on a menu and be like, “Oh, this guy just ordered the one with the most calories.”
Aubrey: Yeah, I was 100% in line at a fast casual place. It was in fact at Chipotle. The person behind me in line leaned over and was like, “You know, there's actually a lower calorie option.” I had gotten the salad bowl thing and I think they thought I was getting the salad bowl thing, because I didn't want to get fatter or something.
Michael: Oh, my fucking God.
Aubrey: It really does invite these fucking gremlins to tell you unbidden what they think about what you're doing.
Michael: Do you remember what you said in that moment?
Aubrey: What I said to them was, “I picked what I wanted to order.”
Aubrey: To me internally, I felt my response was extremely aggressive. I feel I had a lot of energy behind that response. I don't know if it came off that way, but I definitely had a very strong response as both a fat person and a person who's had an eating disorder. 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.
Michael: Oh, it's so patronizing.
Aubrey: So, patronizing.
Michael: Oh, my God.
Aubrey: So dick-ish, just so utterly dick-ish. That’s not just a person being a jerk, right?
Aubrey: 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 of that stuff, can genuinely mess with my physical and mental health.”
Michael: Yeah, it's awful.
Aubrey: 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 lawmakers and public health policy people.
Michael: [laughs] The Harvard School of Public Health.
Michael: Gets held to a higher standard. Agreed.
Aubrey: But as it stands, it doesn't. Honestly, even the research here doesn't get held to a higher standard of like, “Hey, wait a minute, it seems somebody is having a hard time with this one. Let's check in with that.” Very significantly large group of people.
Michael: I would also love it if random bystanders by-stood into situations like that.
Aubrey: Fucking me, too.
Michael: I was like, “Hey, can you fuck off and leave this lady alone please?”
Michael: 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.”
Aubrey: 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-
Michael: It’s awful, it’s awful.
Aubrey: -than being publicly shamed or humiliated, and having nobody say or do anything, or even acknowledge that it happened. That happened to me at one point I was reseated on a plane, like absolutely no one said or did anything.
Michael: Oh, no. Yeah that’s-- [crosstalk]
Aubrey: It is the quickest way to feel fully worthless as a person.
Michael: The baller move in that situation is to 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-- [crosstalk]
Aubrey: [laughs] I'm going to come back in with a giant five very fancy shopping bags in each hand and what have one of them be a hat box that just be like, “Big mistake, huge.”
Michael: [laughs] That’s what you’ve reached for. The Julia Roberts.
Aubrey: Just the full Julia Roberts, Pretty Woman.
Michael: The revenge. Yeah.
Aubrey: I don't know why it would matter to the dude at Chipotle that I went shopping.
Michael: It’s like this lady has shopping bags, but whatever. I feel owned for some reason, it’s not clear to me why.
Aubrey: [laughs] Yeah, I don't know why, but listen, I handled it.
Aubrey: It just feels there is a categorical disinterest in, “What if this isn't good?”
Aubrey: “Much less, what if there are people for whom this is harmful to them?”
Aubrey: In the UK, they made some placating 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.
Michael: Oh, in much smaller font and you have to go out of your way to get it, basically.
Aubrey: You have to go ask somebody.
Aubrey: Again, if you think about going into 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. 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 will have an active eating disorder in their lifetime. That is not an insignificant number of people.
Aubrey: There is this categorical disinterest in anything that seems to indicate that maybe this policy wouldn't be universally helpful and good.
Michael: There's also something-- It's so good you host a show with a thin person, Aubrey.
Aubrey: [laughs] [crosstalk] Tell my why.
Michael: This is the insights that I bring into 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. 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.
Aubrey: Well, and it's just more information. What could that hurt?
Aubrey: There was a piece in Bloomberg writing up the UK change that said, “Surveys suggest 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."
Aubrey: And then a bunch of people go, “Oh, it does hurt though. For me, it hurts. Is there another way we could do it?” They're like, “Nope, couldn't hurt.”
Aubrey: In order to get to that point, you already have to be irrationally invested in a policy that had no data behind it and no, has bad data behind it, right?
Aubrey: If you're like, “We can make it work for everyone,” I'm like, “But even when it “works,” it doesn't fucking work.”
Michael: Right. It’s like, “Look, I know you hate this, but on the other hand, it's not achieving any of its goals.”
Michael: Have you considered it's not working for anyone else?
Aubrey: It makes people feel nothing or terrible. [laughs]
Michael: Well, I think one of the central dilemmas here, too, is that the “benefits of this policy,” this weak shit about 113 fewer calories or whatever of new menu items, that's quantitative. That's a number. Policymakers 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.
Aubrey: Yeah, no, no, no, no.
Michael: At best, it's neutral. I can't imagine a scenario in which it doesn't add to weight stigma. But that's really hard to quantify.
Aubrey: Oh, yeah.
Michael: The harms of it either haven't been studied or they're so hard to quantify that you can't really put them in a pros and cons column against 113 fewer calories versus contributes to this inchoate thing called weight stigma that kind of nobody really cares about anyway.
Aubrey: Yeah. We don't create the research around it, we don't fund the research around it, and then we go, “Well, you don't have any numbers, too bad, pack it in.”
Aubrey: We just refuse to pay attention, because it's not quantified and conveniently ignore the fact that collectively we refuse to quantify it, right?
Aubrey: 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 checkmark 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 healthcare costs and all of the things that we say matter to us about reducing fatness.
I think a great example is, 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 functionally a diet.
Michael: 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 that's functionally taking a backseat.
Aubrey: It's totally about weight loss. I don't feel 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 really important information to have. That's not what these policies are doing.
Aubrey: These are ways that we calm ourselves down, that 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 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.
Aubrey: 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.
Michael: We just need to empower consumers to open up my eager eyes.
Aubrey: Nope, nope, nope. Mike, I'm out.
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