{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:00:57Z","timestamp":1794013257274,"version":"4.8.0"},"reference-count":32,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"crossref","award":["NIHR205226"],"award-info":[{"award-number":["NIHR205226"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Research Council\/Arts and Humanities Research Council\/Economic and Social Research Council Adolescence, Mental Health","award":["MR\/W002418\/1"],"award-info":[{"award-number":["MR\/W002418\/1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,2,13]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional mixed-methods study was conducted from February 2024 to March 2025. Inclusion criteria were age \u226516 years, living in England and having experienced disordered eating. In total, 1001 people participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>highly negative with avoidance<\/jats:italic>\n                      (OR 0.45 (0.30; 0.69)) or\n                      <jats:italic>highly negative without avoidance<\/jats:italic>\n                      groups (OR 0.45 (0.26; 0.78)) and a higher likelihood of belonging in the\n                      <jats:italic>neutral<\/jats:italic>\n                      (OR 1.84 (1.26; 2.69)) or\n                      <jats:italic>positive<\/jats:italic>\n                      groups (OR 2.04 (1.42; 2.93)). Thematic analysis generated four superordinate themes:\n                      <jats:italic>reassurance<\/jats:italic>\n                      ,\n                      <jats:italic>emotional distress<\/jats:italic>\n                      ,\n                      <jats:italic>criticisms<\/jats:italic>\n                      and\n                      <jats:italic>impacts on recovery<\/jats:italic>\n                      . 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003666","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:05:10Z","timestamp":1776269110000},"page":"e003666","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Views of people with disordered eating on current and alternative out-of-home calorie labelling policies in England: a mixed-methods survey"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5800-8679","authenticated-orcid":false,"given":"Nora","family":"Trompeter","sequence":"first","affiliation":[{"name":"Institute of Child Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abinaya","family":"Nadarajah","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6980-1699","authenticated-orcid":false,"given":"Helen","family":"Sharpe","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9162-9722","authenticated-orcid":false,"given":"Fiona","family":"Duffy","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland"},{"name":"NHS Lothian Child and Adolescent Mental Health Services, Royal Edinburgh Hospital, Edinburgh, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Maloney","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7257-6605","authenticated-orcid":false,"given":"Dasha","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8543-8383","authenticated-orcid":false,"given":"Lucy","family":"Serpell","sequence":"additional","affiliation":[{"name":"Department of Clinical, Educational and Health Psychology, University College London, London, UK"},{"name":"North East London NHS Foundation Trust, Rainham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1335-1937","authenticated-orcid":false,"given":"Ulrike","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Centre for Eating and Weight Disorders, King's College London, London, UK"},{"name":"Eating Disorders Outpatients Service, South London and Maudsley NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4084-7786","authenticated-orcid":false,"given":"Tom","family":"Jewell","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King\u2019s College London, London, UK"},{"name":"Psychological and Mental Health Services, Great Ormond Street Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026041509050482000_4.2.e003666.1","unstructured":"Department of Health . The calorie labelling (out of home sector) (England) regulations 2021. Houses of Parliament; 2021. Available: https:\/\/www.legislation.gov.uk\/uksi\/2021\/909\/contents\/made [Accessed 07 Sep 2022]."},{"key":"2026041509050482000_4.2.e003666.2","unstructured":"Government of Ontario . Guide to menu-labelling requirements\u2014 understanding Ontario\u2019s menu-labelling rules. 2017. Available: www.ontario.ca\/document\/guide-menu-labelling-requirements [Accessed 06 Nov 2024]."},{"key":"2026041509050482000_4.2.e003666.3","article-title":"Calorie (energy) labelling for changing selection and consumption of food or alcohol","volume":"1","author":"Clarke","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"2026041509050482000_4.2.e003666.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjph-2023-000862","article-title":"Impact of out-of-home nutrition labelling on people with eating disorders: a systematic review and meta-synthesis","volume":"3","author":"Trompeter","year":"2025","journal-title":"BMJ Public Health"},{"key":"2026041509050482000_4.2.e003666.5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1002\/erv.3007","article-title":"Individuals with restrictive eating disorders\u2019 experience of the introduction of calories on menus in England: An interpretative phenomenological analysis study","volume":"31","author":"Duffy","year":"2023","journal-title":"Eur Eat Disord Rev"},{"key":"2026041509050482000_4.2.e003666.6","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12685"},{"key":"2026041509050482000_4.2.e003666.7","doi-asserted-by":"crossref","DOI":"10.1186\/s40337-023-00738-7","article-title":"Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review","volume":"11","author":"Hay","year":"2023","journal-title":"J Eat Disord"},{"key":"2026041509050482000_4.2.e003666.8","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S2352-4642(24)00333-X","article-title":"Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study","volume":"9","author":"Ward","year":"2025","journal-title":"Lancet Child Adolesc Health"},{"key":"2026041509050482000_4.2.e003666.9","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1002\/eat.24031","article-title":"Acceptability and perceived harm of calorie labeling and other obesity policies: A cross-sectional survey study of UK adults with eating disorders and other mental health conditions","volume":"56","author":"Putra","year":"2023","journal-title":"Int J Eat Disord"},{"key":"2026041509050482000_4.2.e003666.10","doi-asserted-by":"crossref","first-page":"104382","DOI":"10.1016\/j.foodqual.2021.104382","article-title":"Attention mediates restrained eaters\u2019 food consumption intentions","volume":"96","author":"Moore","year":"2022","journal-title":"Food Qual Prefer"},{"key":"2026041509050482000_4.2.e003666.11","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/eat.22675","article-title":"The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating","volume":"50","author":"Haynos","year":"2017","journal-title":"Int J Eat Disord"},{"key":"2026041509050482000_4.2.e003666.12","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-011-0201-1"},{"key":"2026041509050482000_4.2.e003666.13","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1002\/eat.24037","article-title":"The United Kingdom Eating Disorders Genetics Initiative","volume":"57","author":"Monssen","year":"2024","journal-title":"Int J Eat Disord"},{"key":"2026041509050482000_4.2.e003666.14","unstructured":"Prolific. 2025. 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