This is a pre-print of an article accepted for publication in the International Journal of Mental Health and Addiction. The final authenticated version will be available online at: https://doi.org/10.1007/s11469-020-00329-6. The three flaws of the ESRB and PEGI's introduction of the 'Includes Random Items' label are identified. This self-regulatory measure fails to provide sufficient information about the randomised in-game purchase mechanics; does not appropriately identify gambling as gambling and fails to guarantee minimum age ratings to protect young children; and can be circumvented with a separate line of products. Self-regulation alone is insufficient at protecting consumers from loot box-related harms. Legal restrictions on the sale of loot boxes in the short-term and the adoption of ethical game design by the industry in the long term are necessary to ensure consumer protection.