{
  "abstract": "Introduction Out-of-home calorie labelling was introduced in England as part of public health policy to address obesity. We examined the acceptability and perceived impacts of the policy on individuals with disordered eating. Additionally, potential alternative nutritional label policies were explored. We hypothesised that individuals with binge eating would view the policy more favourably compared with individuals without binge eating.Methods A cross-sectional mixed-methods study was conducted from February 2024 to March 2025. Inclusion criteria were age ≥16 years, living in England and having experienced disordered eating. In total, 1001 people participated.Results Latent profile analyses revealed five distinct groups of people based on policy acceptability, perceived impacts and avoidance of calorie labels: (1) highly negative with avoidance (n=202, 20.2%); (2) highly negative without avoidance (n=112, 11.2%); (3) moderately negative (n=183, 18.3%); (4) neutral (n=241, 24.1%) and (5) positive (n=263, 26.3%). Current binge eating was associated with lower likelihood of belonging in the highly negative with avoidance (OR 0.45 (0.30; 0.69)) or highly negative without avoidance groups (OR 0.45 (0.26; 0.78)) and a higher likelihood of belonging in the neutral (OR 1.84 (1.26; 2.69)) or positive groups (OR 2.04 (1.42; 2.93)). Thematic analysis generated four superordinate themes: reassurance, emotional distress, criticisms and impacts on recovery. When ranking different nutritional label policies, optional calorie labels were the most popular policy, with 63.6% ranking the policy in their top three options.Conclusions People with disordered eating hold diverse opinions on out-of-home calorie labels. Our findings shed new light on which demographic groups are negatively or positively impacted by such labels and suggest that optional calories on menus would be the preferred policy choice of people with disordered eating.",
  "authors": [
    {
      "affiliations": [
        "Institute of Child Health, University College London, London, UK"
      ],
      "name": "Nora Trompeter"
    },
    {
      "affiliations": [
        "Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King’s College London, London, UK"
      ],
      "name": "Abinaya Nadarajah"
    },
    {
      "affiliations": [
        "Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland"
      ],
      "name": "Helen Sharpe"
    },
    {
      "affiliations": [
        "Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland",
        "NHS Lothian Child and Adolescent Mental Health Services, Royal Edinburgh Hospital, Edinburgh, Scotland"
      ],
      "name": "Fiona Duffy"
    },
    {
      "affiliations": [
        "Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland"
      ],
      "name": "Ellen Maloney"
    },
    {
      "affiliations": [
        "Department of Brain Sciences, Imperial College London, London, UK"
      ],
      "name": "Dasha Nicholls"
    },
    {
      "affiliations": [
        "Department of Clinical, Educational and Health Psychology, University College London, London, UK",
        "North East London NHS Foundation Trust, Rainham, UK"
      ],
      "name": "Lucy Serpell"
    },
    {
      "affiliations": [
        "Centre for Eating and Weight Disorders, King's College London, London, UK",
        "Eating Disorders Outpatients Service, South London and Maudsley NHS Foundation Trust, London, UK"
      ],
      "name": "Ulrike Schmidt"
    },
    {
      "affiliations": [
        "Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King’s College London, London, UK",
        "Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Tom Jewell"
    }
  ],
  "title": "Views of people with disordered eating on current and alternative out-of-home calorie labelling policies in England: a mixed-methods survey",
  "uid": "f6f23122-4d80-5e04-b007-e063aea564de"
}