More than half of the UK population is overweight, and it is due to wealth inequalities and unhealthy food choices. Nudges can be used to trigger a behaviour change in the population. In this article, we question how ethical it is to manipulate one of the most personal aspects of individuals’ lives: what they want to eat.

To avoid trespassing on autonomy and individualism, nudges must be correctly developed before implementation. Autonomy and individualism hold a strong place in liberal decision-making, particularly because of Mill’s Harm Principle. Mill explains that the state must make decisions that do not impair an individual’s autonomy and individualism, reflected in its freedom of expression and opinion and freedom to act on such matters, unless it causes harm to another individual8.

With reference to the intervention ladder, we argue that only the three first ranks can be nudges, especially ethical nudges. In theory, the state could nudge its citizens toward healthier food choices if it follows the Stewardship Model (SM)7. Nonetheless, by analysing the calorie labelling regulation England put in place, I explain how:

a) the state can claim their nudge follows the SM, but,
b) they seem to fail in practice and implement measures more constraining than announced without valid consent.

First, I define the SM, the intervention ladder, and nudges. I formulate an argument allowing states to ethically nudge their citizens toward healthier food choices. Second, I discuss England’s calorie labelling regulation. I raise critics against it and point out ethical issues making the implementation of this measure inherently wrong and unethical, such as eating disorders repercussions.

I. The stewardship model

The World Health Organisation defines stewardship as a government’s responsibility to monitor, regulate, and implement policies promoting citizens’ good health14. In this model, the state plays a significant role in promoting and supporting citizens’ needs equally.

As a revised model of the liberal framework, the SM does not intend for states to enforce a moral compass on their citizens; their goals are directed towards ‘greater overall well-being and productivity7.

The model emphasises the prevention of harm done to others over self-harm by using John Stuart Mill’s Harm Principle5. Hence, they are not trying to prevent one’s autonomy and individualism.

Nonetheless, their public health programs aim to achieve higher and more equal welfare for everyone. Thus, the state can act on one’s health if one harms oneself, although done autonomously, by seeking the individual’s consent when making new regulations7.

Some of the SM goals are to: ‘pay special attention to the health of children and other vulnerable people’; ‘promote health not only by providing information and advice but also by programs to help people overcome addictions and other unhealthy behaviours’; ‘aim to reduce health inequalities’ 7 Some of the constraints the SM poses to states are:

‘Not attempt to coerce adults to lead healthy lives’; ‘minimise interventions that are introduced without the individual consent of those affected, or without procedural justice arrangements (such as democratic decision-making procedures) which provide adequate mandate'; 'seek to minimise interventions that are perceived as unduly intrusive and in conflict with important personal values’7.

The SM considers good health an inherent right by promoting equal health standards. In this sense, pushing towards its fulfilment seems ethically correct. The model bases its decisions on an intervention ladder.

The intervention ladder

This model considers Mill’s Harm Principle, meaning the state should choose the least intrusive policy possible5. However, it does not emphasise the importance of individuals' strict autonomy and freedom as much as Mill does, although the public’s consent to health regulation matters. Therefore, a state has to justify an action and collect public consent for its implementation, especially if it is intrusive7.

The ladder has eight different levels of action. From the weakest to the most decisive action, they are: ‘doing nothing’; ‘provide information'; ‘enable choice’; ‘guide choices through the changing of the default policy’; ‘guide choices through incentives’; ‘guide choices through disincentives; ‘restrict choices’; ‘eliminate choice’7. Before intervening, a state must analyse data about the issue at stake and has to satisfy the following elements at best: 'individual choice, preservation of autonomy, reduction of inequalities, protection of vulnerable groups and targeting of at-risk groups’7. All measures implemented that fall on the ladder need justification, consent, and, if implemented as a nudge, leave a sense of autonomy. The higher the measure falls on the ladder, the more explanation the state must give.7


Thaler and Sunstein define a nudge as ‘any aspect of the choice architecture that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives’13. On the intervention ladder, a nudge falls into providing information, enabling choice, and guiding choices by changing the default policy as long as it is not making it more costly for citizens. Thus, the SM offers possibilities for the state to nudge its citizens if it fits the intervention ladder’s nudge criteria. Those criteria are also fulfilling the ethical principles of autonomy and individualism.

Therefore, nudging citizens can be done by educating people on balanced diets, such as making fruits free in canteens. A study shows that adding free fruits in university food halls enhanced fruit consumption among the participants4. They do not constrain individualism and autonomy, thanks to their suggestive and educational aspects. It promotes the state's interests, i.e., the promotion of healthy food habits and reducing inequalities.

We can infer a theoretical argument favouring the state nudging its citizens with three premises, p1, p2, and p3, that I assess as a mild SM.

p1) if the state aims to: ‘pay special attention to the health of children and other vulnerable people’; ‘promote health not only by providing information and advice but also by programs to help people overcome addictions and other unhealthy behaviours’; ‘aim to reduce health inequalities’7.

p2) if it does not: ‘not attempt to coerce adults to lead healthy lives’; ‘minimise interventions that are introduced without the individual consent of those affected, or without procedural justice arrangements (such as democratic decision-making procedures) which provide adequate mandate’; ‘seek to minimise interventions that are perceived as unduly intrusive and in conflict with important personal values’7.

p3) and if nudges consist of providing information, enabling choices, or changing the default policy without affecting economic incentives or disincentives.

Conclusion: Then the state can ethically nudge its citizens toward healthier food choices.

Hereafter, I discuss England’s new nudge: calorie labelling on menus. I assess whether it fits the mild SM and the intervention ladder to evaluate how ethical it is and whether the state can nudge its citizens toward healthier food choices ethically.

II. Calorie labelling on menus: an unethical nudge

The obesity rate in England is the highest in Europe after Turkey, with 27.8% of adults being obese15. In April 2022, the Public Health Ministry put a new regulation for large businesses such as cafes, restaurants, and takeaways, requiring them to label calories on menus. Jo Churchill, the public health minister, said:

‘Our aim is to make it as easy as possible for people to make healthier food choices for themselves and their families, both in restaurants and at home. That is why we want to make sure everyone has access to accurate information about the food and drink we order.’1

Public Health England (PHE) outlined ‘Strategies for Encouraging Healthier ‘Out of Home’ Food Provision A toolkit for local councils working with small food businesses’ 9. These strategies include nudges aiming to influence behaviour change towards healthier food choices. Calorie labelling on menus is part of those strategies. They use the Nuffield Council of Bioethics’ intervention ladder to rank different policy choice9. This toolkit does not consider providing information and healthier catering schemes as nudges, qualifying calorie labelling as an educational purpose. I feel obliged to see such interventions as nudges from the government, considering Thaler and Sunstein’s definition given previously. Furthermore, they define nudges as ‘strategies to influence behaviour change’ 9 and I hereafter explain how calorie labelling can positively and negatively trigger a behavioural change in individuals.

The idea and the stewardship model

Calorie labels on menus fulfil aims mentioned by the SM, especially ‘pay special attention to the health of children and other vulnerable people’ and ‘aim to reduce health inequalities’7, which fits premise one. As an informational nudge, it does not coerce adults to eat healthily, and it is not necessarily intrusive as it affects restaurants and not households. PHE asked 1061 adults aware of calorie counting if adding calorie labels on menus would help citizens have a healthier lifestyle10. A majority agreed, with 79% in favour. Consequently, the implementation of this regulation in April 2022 is, arguably, under citizens’ consent.

Furthermore, the SM supports the importance of promoting good health among citizens. People in obesity or overweight situations are more at risk of developing diabetes or cardiovascular disease. The state believes that by sharing calorie information and education about calorie intake, people can make responsible food choices. It is also a way to tackle health inequalities. Studies showed that, similarly to obesity cases, fast food restaurants are more prominent in deprived areas127. Therefore, the government tries to promote good health among all socioeconomic classes and trigger a behaviour change by providing more information, which does not seem ethically wrong.

III. Ethical issues

The stewardship model claims to be based on a liberal framework and uses Mill’s Harm principle to emphasise the importance of preventing harm done to others over self-harm to retain citizens’ autonomy and individualism.

The SM stresses that states need to be careful not to harm some groups by trying to help others7. States would take a utilitarian approach2 if they favoured the greater good, leaving some individuals behind, as utilitarianism seeks to achieve good health for the greatest number7.

I argue that utilitarian states cannot nudge their citizens toward healthier food choices because they would favour the predominant part of the population whilst potentially hurting another smaller part. The domino effect the calorie labelling nudge has is considerable and puts the state’s choice under a utilitarian umbrella. Hereafter, I highlight how PHE did not correctly rank this measure on the intervention ladder and explain its consequences.

More than an informational nudge

The state should not get involved in individuals' diets directly, as it risks creating blame and guilt. Whilst encouraging businesses to offer healthier options without raising prices, for instance, through subsidies, seems subtle and ethical, calorie labelling raises a considerable issue.

The Nuffield Council stresses that government actions’ should ‘pay special attention to the health of children and other vulnerable people’7. Even if one believes that calorie labelling on menus is a way to pay attention to the health of vulnerable people and children, it does put other vulnerable people at risk. Hence, through this regulation, the state follows a utilitarian approach as opposed to the SM.

As the Nuffield Council explains in their report: ‘The statement ‘there is no evidence that x is harmful to human health’ prompts the question, 'Is the absence of evidence of harm the same as evidence of absence?’’ 7. Here, we have evidence that, although calorie labelling is promoted as preventing harm to human health e.g., reducing obesity, it may harm people with Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorders (BED)3.

The results show that individuals with AN or BN are likely to order fewer calories with labelled menus than they usually would, which is already substantively lower than individuals without those disorders. Individuals with BED are likely to order more food with labelled menus3.

Thus, the calorie labelling nudge has been portrayed as an informational nudge, despite proving here that it offers choice incentives, and disincentives, to individuals with AN, BN, and BED. Choice incentives and disincentives are much higher on the intervention ladder than providing information. There are 5.1 deaths per 1000 people a year due to AN disorder6. Therefore, it seems ethically wrong for the government to implement this nudge, as it did not fully consider its impact.

Additionally, it is uncertain whether citizens’ consent was correctly collected for this regulation. First, we do not know if the population in this consent poll was representative, e.g., individuals with eating disorders. Further, English citizens have greater concerns about mental health (43%) than obesity (39%)11. As the implementation of calorie labelling on menus can trigger groups of individuals with mental health issues, the government should review how consensual citizens are toward this nudge.

Finally, this nudge pushes individuals to increase self-harm, hence going against the SM. Self-harm can be prevented if consent is rightfully collected, however, it is not ethical for the state to nudge its citizens toward healthier food choices if it results in more self-harm. In addition, the state takes a utilitarian approach, promoting good health to a greater number of people to the detriment of others. Therefore, labelled menus are not an ethical nudge and are not based on the SM.


PHE’s nudge on calorie-labelled menus is unethical. The state tried and failed to promote healthier food choices. Although their nudge justification fits the SM that I have argued as being ethical under the argument presented earlier, its implementation does not satisfy the theory. The state cannot help a part of the population to the detriment of another, especially if they try to focus on reducing inequalities.

It is challenging to find measures that can resolve all concerns, which is why nudging citizens toward healthier food choices can be controversial. Nonetheless, it does not mean the state cannot nudge its citizens toward healthier food choices. The state needs to consider the nudge they implement and its scope. Following the SM strictly and not overstepping the ‘changing the default policy’ rank, unless all citizens consent, could provide the government with good and ethical tools to nudge its citizens toward healthier food choices.

They must better justify their choices and gain valid consent from the population. Providing information and educating citizens is acceptable and mandatory to help all individuals have healthy diets. The state needs to take an effective steward position and strongly monitor nudges’ implementation to ensure they are taken positively and do not create further problems, such as reinforcing eating disorders.


1 Department of Health and Social Care and Churchill MP, J. (2021). Calorie labelling on menus to be introduced in cafes, restaurants and takeaways.
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4 Lachat, C.K., Verstraeten, R., De Meulenaer, B., Menten, J., Huybregts, L.F., Van Camp, J., Roberfroid, D. and Kolsteren, P.W. (2009). Availability of free fruits and vegetables at canteen lunch improves lunch and daily nutritional profiles: a randomised controlled trial. British Journal of Nutrition, 102(7), pp.1030–1037.
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