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The economic cost of bulimia nervosa and binge eating disorder: a population-based study

Published online by Cambridge University Press:  17 May 2021

Wadad Kathy Tannous*
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
Phillipa Hay
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
Federico Girosi
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
Andreea I. Heriseanu
Affiliation:
School of Psychology and InsideOut Institute, University of Sydney, Camperdown, NSW, Australia
Moin Uddin Ahmed
Affiliation:
Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
Stephen Touyz
Affiliation:
School of Psychology and InsideOut Institute, University of Sydney, Camperdown, NSW, Australia
*
Author for correspondence: Wadad Kathy Tannous, E-mail: [email protected]

Abstract

Background

The most common eating disorders (EDs) are bulimia nervosa (BN) and binge eating disorder (BED), serious psychiatric illnesses that have devastating effects on the physical and psychological wellbeing of sufferers. EDs range in complexity and severity but can be life-threatening without appropriate treatment. Although it is well-known that quality of life impacts is high for ED sufferers, research regarding fiscal and related costs is severely limited. The aim of this study was to understand economic and other costs of EDs at the community level.

Method

Data were derived from 2017 household community representative structured interview of 2977 people aged ⩾ 15 years in South Australia. ED diagnoses, health systems, productivity, transaction, out-of-pocket expenses and other related costs of BN and BED were used to estimate the economic burden of EDs in South Australia.

Results

The annual total economic cost of EDs in 2018 was estimated at $84 billion for South Australia. This included $81 billion from the burden of disease as the result of years lived with disability (YLD) ($62 billion) and years of life lost ($19 billion). The health system costs, productivity and tax revenue loss to the Australian economy were estimated at $1 billion, $1.6 billion and $0.6 billion, respectively.

Conclusions

The YLD average cost in 2018 in South Australia was $296 649 per person. This is two-thirds of the costs borne by individuals and the wider economy. Prevention and management initiatives for EDs need to take into account these costs when assessing their potential benefits.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Agh, T., Kovács, G., Pawaskar, M., Supina, D., Inotai, A., & Vokó, Z. (2015). Epidemiology, health-related quality of life and economic burden of binge eating disorder: A systematic literature review. Eating, Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 20(1), 112.10.1007/s40519-014-0173-9CrossRefGoogle ScholarPubMed
Agh, T., Kovács, G., Supina, D., Pawaskar, M., Herman, B. K., Vokó, Z., & Sheehan, D. V. J. E. (2016). A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 21(3), 353364.10.1007/s40519-016-0264-xCrossRefGoogle ScholarPubMed
Agüera, Z., Lozano-Madrid, M., Mallorquí-Bagué, N., Jiménez-Murcia, S., Menchón, J. M., & Fernández-Aranda, F. (2020) A review of binge eating disorder and obesity. Neuropsychiatrie, 2020 Apri 28: 1-11, https://doi-org.ezproxy.uws.edu.au/10.1007/s40211-020-00346-w.Google ScholarPubMed
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): American Psychiatric Pub.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.10.1176/appi.books.9780890425596CrossRefGoogle Scholar
Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724731.10.1001/archgenpsychiatry.2011.74CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics. (2016). Census of population and housing: Socio-economic indexes for areas (SEIFA). Canberra, Australia.Google Scholar
Australian Department of Health. (2019a). Medicare Benefit Schedule Online. Canberra Retrieved from http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home.Google Scholar
Australian Department of Health. (2019b). Pharmaceutical Benefits Scheme (PBS). Canberra Retrieved from http://www.pbs.gov.au/medicine/item/8520K.Google Scholar
Australian Institute of Health and Welfare. (2017). Weight loss surgery in Australia 2014–15: Australian hospital statistics. Canberra Retrieved from https://www.aihw.gov.au/reports/overweight-obesity/ahs-2014-15-weight-loss-surgery/contents/table-of-contents.Google Scholar
Australian Institute of Health and Welfare. (2019). Health & Welfare Expenditure. Canberra Retrieved from https://www.aihw.gov.au/reports-data/indicators/healthy-community-indicators/national/all-australia/expenditure/health-welfare-expenditure.Google Scholar
Australian Institute of Health and Welfare. (2020). Australia's health 2020 data insights. Australia's health series no. 17. Cat. no. AUS 231. Canberra: AIHW.Google Scholar
Australian Taxation Office. (2019). Individual income tax rates. Canberra Retrieved from https://www.ato.gov.au/Rates/Individual-income-tax-rates/.Google Scholar
Bellows, B. K., DuVall, S. L., Kamauu, A. W., Supina, D., Babcock, T., & LaFleur, J. (2015). Healthcare costs and resource utilization of patients with binge-eating disorder and eating disorder not otherwise specified in the department of veterans affairs. International Journal of Eating Disorders, 48(8), 10821091.10.1002/eat.22427CrossRefGoogle Scholar
Birmingham, C. L., Su, J., Hlynsky, J. A., Goldner, E. M., & Gao, M. J. I. J. O. E. D. (2005). The mortality rate from anorexia nervosa, International Journal of Eating Disorders. 38(2), 143146.10.1002/eat.20164CrossRefGoogle ScholarPubMed
Burstein, R., Fleming, T., Haagsma, J., Salomon, J. A., Vos, T., & Murray, C. J. (2015). Estimating distributions of health state severity for the global burden of disease study. Population Health Metrics, 13(1), 31.10.1186/s12963-015-0064-yCrossRefGoogle ScholarPubMed
The Butterfly Foundation [TBF]. (2012). Paying the Price: The economic and social impact of eating disorders in Australia. Retrieved from Crows Nest, NSW: https://thebutterflyfoundation.org.au/assets/Uploads/Butterfly-report-Paying-the-Price-Executive-Summary.pdf.Google Scholar
The Butterfly Foundation [TBF]. (2018). The National Agenda for Eating Disorders 2017 to 2022. Retrieved from Crows Nest, NSW: https://thebutterflyfoundation.org.au/assets/Uploads/National-Agenda-for-Eating-Disorders-2018.pdf.Google Scholar
Byford, S., Barrett, B., Roberts, C., Clark, A., Edwards, V., Smethurst, N., & Gowers, S. G. (2007). Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents. The British Journal of Psychiatry, 191(5), 436440.10.1192/bjp.bp.107.036806CrossRefGoogle ScholarPubMed
Campbell, J. A., Hensher, M., Davies, D., Green, M., Hagan, B., Jordan, I., … Palmer, A. J. (2019). Long-Term inpatient hospital utilisation and costs (2007–2008 to 2015–2016) for publicly waitlisted bariatric surgery patients in an Australian public hospital system based on Australia's activity-based funding model. PharmacoEconomics – Open, 3(4), 599618. doi:10.1007/s41669-019-0140-5.CrossRefGoogle Scholar
Da Luz, F., Sainsbury, A., Mannan, H., Touyz, S., Mitchison, D., & Hay, P. (2017). Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015. International Journal of Obesity, 41(7), 11481153.10.1038/ijo.2017.79CrossRefGoogle ScholarPubMed
Deloitte Access Economics. (2011). Re-awakening Australia: The economic cost of sleep disorders in Australia, 2010. Retrieved from Blacktown, NSW: https://www.sleephealthfoundation.org.au/pdfs/news/Reawakening%20Australia.pdf.Google Scholar
Dickerson, J. F., DeBar, L., Perrin, N. A., Lynch, F., Wilson, G. T., Rosselli, F., … Striegel-Moore, R. H. (2011). Health-service use in women with binge eating disorders. International Journal of Eating Disorders, 44(6), 524530.10.1002/eat.20842CrossRefGoogle ScholarPubMed
Erskine, H. E., Whiteford, H. A., & Pike, K. M. (2016). The global burden of eating disorders. Current opinion in psychiatry, 29(6), 346353.10.1097/YCO.0000000000000276CrossRefGoogle ScholarPubMed
Fairburn, C. G., Cooper, Z., & O'Connor, M. (1993). The eating disorder examination. International Journal of Eating Disorders, 6, 18.Google Scholar
Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000-2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 14021413.10.1093/ajcn/nqy342CrossRefGoogle ScholarPubMed
Gatt, L., Jan, S., Mondraty, N., Horsfield, S., Hart, S., Russell, J., … Essue, B. (2014). The household economic burden of eating disorders and adherence to treatment in Australia. BMC Psychiatry, 14(1), 338.10.1186/s12888-014-0338-0CrossRefGoogle ScholarPubMed
Grenon, R., Tasca, G. A., Cwinn, E., Coyle, D., Sumner, A., Gick, M., & Bissada, H. (2010). Depressive symptoms are associated with medication use and lower health-related quality of life in overweight women with binge eating disorder. Women's Health Issues, 20(6), 435440.10.1016/j.whi.2010.07.004CrossRefGoogle ScholarPubMed
Hart, L. M., Granillo, M. T., Jorm, A. F., & Paxton, S. (2011). Unmet need for treatment in the eating disorders: A systematic review of eating disorder specific treatment seeking among community cases. Clinical Psychology Review, 31(5), 727735.10.1016/j.cpr.2011.03.004CrossRefGoogle ScholarPubMed
Hay, P. (2003). Quality of life and bulimic eating disorder behaviors: Findings from a community-based sample. International Journal of Eating Disorders, 33(4), 434442.10.1002/eat.10162CrossRefGoogle ScholarPubMed
Hay, P., Girosi, F., & Mond, J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. Journal of Eating Disorders, 3(1), 19.10.1186/s40337-015-0056-0CrossRefGoogle ScholarPubMed
Hay, P., Mitchison, D., Collado, A. E. L., González-Chica, D. A., Stocks, N., & Touyz, S. (2017). Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. Journal of Eating Disorders, 5(1), 21.10.1186/s40337-017-0149-zCrossRefGoogle ScholarPubMed
Henderson, J. (2012). Costs of eating disorders in England: economic impacts of anorexia nervosa, bulimia nervosa and other disorders, focussing on young people, 2012. Retrieved from.Google Scholar
Hudson, J. I., Hiripi, E., Pope, H. G. Jr & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348–358.10.1016/j.biopsych.2006.03.040CrossRefGoogle Scholar
Independent Hospital Pricing Authority. (2016). National Hospital Cost Data Collection, Public Hospitals Cost Report, Round 18 (Financial year 2013–14). Retrieved from https://www.ihpa.gov.au/publications/australian-public-hospitals-cost-report-2013-2014-round-18.Google Scholar
Johannesson, M., Jönsson, B., Jönsson, L., Kobelt, G., & Zethraeus, N. (2009). Why should economic evaluations of medical innovations have a societal perspective? IDEAS Working Paper Series from RePEc, 51, 132.Google Scholar
Khaodhiar, L., McCowen, K.C., & Blackburn, G. (1999). Obesity and its comorbid conditions. Clinical Cornerstone, 2(3), 1731.10.1016/S1098-3597(99)90002-9CrossRefGoogle ScholarPubMed
Le, L. K.-D., Hay, P., & Mihalopoulos, C. (2018). A systematic review of cost-effectiveness studies of prevention and treatment for eating disorders. Australian & New Zealand Journal of Psychiatry, 52(4), 328338.10.1177/0004867417739690CrossRefGoogle ScholarPubMed
Le, L. K. D., Hay, P., Wade, T., Touyz, S., & Mihalopoulos, C. (2017). The cost-effectiveness of cognitive behavioral therapy for bulimia nervosa in the Australian context. International Journal of Eating Disorders, 50(12), 13671377.10.1002/eat.22790CrossRefGoogle ScholarPubMed
Ling, Y. L., Rascati, K. L., & Pawaskar, M. (2017). Direct and indirect costs among patients with binge-eating disorder in the United States. International Journal of Eating Disorders, 50(5), 523532.10.1002/eat.22631CrossRefGoogle ScholarPubMed
Lynch, F. L., Striegel-Moore, R. H., Dickerson, J. F., Perrin, N., DeBar, L., Wilson, G. T., & Kraemer, H. C. (2010). Cost-effectiveness of guided self-help treatment for recurrent binge eating. Journal of Consulting Clinical Psychology Review, 78(3), 322333.10.1037/a0018982CrossRefGoogle ScholarPubMed
Madden, S., Morris, A., Zurynski, Y. A., Kohn, M., & Elliot, E. J. (2009). Burden of eating disorders in 5–13-year-old children in Australia. Medical Journal of Australia, 190(8), 410414.10.5694/j.1326-5377.2009.tb02487.xCrossRefGoogle ScholarPubMed
Mangweth-Matzek, B., Hoek, H. W., Rupp, C. I., Lackner-Seifert, K., Frey, N., Whitworth, A. B., … Kinzl, J. (2014). Prevalence of eating disorders in middle-aged women. The International Journal of Eating Disorders, 47(3), 320324.10.1002/eat.22232CrossRefGoogle ScholarPubMed
Mathers, C., Vos, T., & Stevenson, C. (1999). The burden of disease and injury in Australia. Retrieved from Canberra: https://www.aihw.gov.au/getmedia/6bd85f38-dcb4-44fa-9569-c48045634841/bdia.pdf.aspx?inline=true.Google Scholar
Mitchell, J. E., Myers, T., Crosby, R., O'Neill, G., Carlisle, J., & Gerlach, S. (2009). Health care utilization in patients with eating disorders. International Journal of Eating Disorders, 42(6), 571574.10.1002/eat.20651CrossRefGoogle ScholarPubMed
Mitchison, D., & Mond, J. (2015). Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: A narrative review. Journal of Eating Disorders, 3(1), 20.10.1186/s40337-015-0058-yCrossRefGoogle ScholarPubMed
Mitchison, D., Mond, J., Slewa-Younan, S., & Hay, P. (2013). Sex differences in health-related quality of life impairment associated with eating disorder features: A general population study. The International Journal of Eating Disorders, 46(4), 375380.10.1002/eat.22097CrossRefGoogle ScholarPubMed
Mond, J. M. (2016). Optimizing prevention programs and maximizing public health impact are not the same thing. Eating Disorders, 24(1), 2028.10.1080/10640266.2015.1113824CrossRefGoogle Scholar
National Eating Disorders Collaboration. (2017). Eating Disorders & Obesity Treatments: A systematic review of the physical, psychological and eating disorders outcomes from obesity treatments. Retrieved from http://nedc.dev.blissmedia.com.au/assets/NEDC-Publications/Obesity-Review-electronic-copy-cover2.pdf.Google Scholar
Office of Best Practice Regulation. (2018). Best Practice Regulation Guidance Note: Value of statistical life. Retrieved from Canberra: https://pmc.gov.au/resource-centre/regulation/best-practice-regulation-guidance-note-value-statistical-life.Google Scholar
Orygen. (2016). Nip it in the bud: Intervening early for young people with eating disorders. Retrieved from https://www.orygen.org.au/Policy/Policy-Reports/Young-people-and-eating-disorders/ORYGEN-Nip-it-in-the-bud?ext=.Google Scholar
Pawaskar, M., Witt, E. A., Supina, D., Herman, B. K., & Wadden, T. A. (2017). Impact of binge eating disorder on functional impairment and work productivity in an adult community sample in the United States. International journal of clinical practice, 71(7), e12970.10.1111/ijcp.12970CrossRefGoogle Scholar
Preti, A., de Girolamo, G., Vilagut, G., Alonso, J., de Graaf, R., Bruffaerts, R., Demyttenaere, K., Pinto-Meza, A., Haro, J. M., Morosini, P., & ESEMeDWMH Investigators (2009). The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project. Journal of Psychiatric Research, 43(14), 11251132.10.1016/j.jpsychires.2009.04.003CrossRefGoogle Scholar
Smith, D. E., Marcus, M. D., Lewis, C. E., Fitzgibbon, M., & Schreiner, P. (1998). Prevalence of binge eating disorder, obesity, and depression in a biracial cohort of young adults. Annals of Behavioral Medicine, 20(3), 227232.10.1007/BF02884965CrossRefGoogle Scholar
Sockalingham, S., Tehrani, H., Taube-Schiff, M., Van Exan, J., Santiago, V., & Hawa, R. (2017). The relationship between eating psychopathology and obstructive sleep apnea in bariatric surgery candidates. The International Journal of Eating Disorders, 50(7), 801807.10.1002/eat.22701CrossRefGoogle Scholar
Stuhldreher, N., Konnopka, A., Wild, B., Herzog, W., Zipfel, S., Löwe, B., & König, H. H. (2012). Cost-of-illness studies and cost-effectiveness analyses in eating disorders: A systematic review. International Journal of Eating Disorders, 45(4), 476491.10.1002/eat.20977CrossRefGoogle ScholarPubMed
Stuhldreher, N., Wild, B., König, H. H., Konnopka, A., Zipfel, S., & Herzog, W. (2015). Determinants of direct and indirect costs in anorexia nervosa. International Journal of Eating Disorders, 48(1), 139146.10.1002/eat.22274CrossRefGoogle ScholarPubMed
Toulany, A., Wong, M., Katzman, D. K., Akseer, N., Steinegger, C., Hancock-Howard, R. L., & Coyte, P. C. (2015). Cost analysis of inpatient treatment of anorexia nervosa in adolescents: Hospital and caregiver perspectives. CMAJ Open, 3(2), E192.10.9778/cmajo.20140086CrossRefGoogle ScholarPubMed
Villarejo, C., Fernández-Aranda, F., Jiménez-Murcia, S., Peñas-Lledó, E., Granero, R., Penelo, E., … Montserrat-Gil de Bernabé, M. (2012). Lifetime obesity in patients with eating disorders: Increasing prevalence, clinical and personality correlates. European Eating Disorders Review, 20(3), 250254.10.1002/erv.2166CrossRefGoogle ScholarPubMed
Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Charlson, F., … Borges, G. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the global burden of disease study 2013. The Lancet, 386(9995), 743-800.10.1016/S0140-6736(15)60692-4CrossRefGoogle Scholar
Wang, L. Y., Nichols, L. P., & Austin, S. B. (2011). The economic effect of planet health on preventing bulimia nervosa. Archives of Pediatrics Adolescent Medicine, 165(8), 756762.10.1001/archpediatrics.2011.105CrossRefGoogle ScholarPubMed
Ward, Z. J., Rodriguez, P., Wright, D. R., Austin, S. B., & Long, M. W. (2019). Estimation of eating disorders prevalence by age and associations with mortality in a simulated nationally representative US cohort. JAMA Network Open, 2(10), e1912925.10.1001/jamanetworkopen.2019.12925CrossRefGoogle Scholar
Watson, H. J., Jangmo, A., Smith, T., Thornton, L. M., von Hausswolff-Juhlin, Y., Madhoo, M., … Larsson, H. (2018). A register-based case-control study of health care utilization and costs in binge-eating disorder. Journal of Psychosomatic Research, 108, 4753.10.1016/j.jpsychores.2018.02.011CrossRefGoogle ScholarPubMed
World Health Organization. (2018). The ICD-11 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Retrieved from: https://www.who.int/classifications/icd/en/.Google Scholar
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