‘We should be focusing on why we eat, what we eat and how it makes us feel, not how many calories it has’: a photovoice study exploring young people’s views on the out-of-home calorie labelling policy in England and their priorities for changing the

Obesity is a complex problem, a perpetual challenge for governments to address. In 2022 as part of a government obesity strategy, a mandatory calorie labelling policy for out-of-home food sectors was implemented in England. Little is known about the impact of this policy on young people; therefore, this study explored young people views on the policy and their priorities for change in their local food environments. We conducted a participatory, qualitative study using Photovoice with 20 young people (12–17 years old) living in two communities in areas of high deprivation in England, a coastal town and an inner-city neighbourhood. Young people were involved in photography-led focus groups, a photo ‘walkabout’ in their local highstreets, and a local community photography exhibition. A textual-visual thematic analysis framework was used to analyse textual and visual data. Young people described challenges with navigating complex out-of-home food environments and reflected on whether the policy was effective in addressing these challenges. Three themes were identified: (1) Relevance of calories for informing healthy eating. Few found calories alone helpful to gauge whether something was healthy. However, some expressed surprise at the energy content of drinks and found calorie information useful for understanding ‘liquid calories’. (2) Commercial influences on food choices. Participants were aware of how commercial activities shaped their food environments, often in unequal ways, and how targeted marketing/advertising for young people can be more influential than calorie information on menus and food labels. (3) Value placed on the relational aspects of food. Young people recognised food as more than fuel, valuing its social and cultural significance and believing it should be produced and sold ethically and sustainably. Young people viewed calorie labelling as unhelpful for making healthy eating choices, emphasising instead the need to address structural barriers and support for them to navigate increasingly complex and inequitable food systems. They demonstrated their role as informed food citizens by exercising social responsibility to shape their food environments. It is therefore vital to amplify their voices in public discourse and support their participation in shaping food policy and governance.