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

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.

Cost-of-illness for non-underweight binge-eating disorders

“…The current estimates, whilst substantial and in line with some studies, are less than those presented in a recent report commissioned by a UK eating disorder charity [ 21 ] and those in other countries [ 5 , 16 , 22 ]. This is likely a result of several factors.…”

“…A report of societal costs to the US in 2018–2019 [ 5 ] estimated costs exceeding $64bn (equivalent to $11,808 [~ €9784] for each person with an ED). Similar estimates have been made in other countries (e.g., [ 16 , 22 ]) and outline the significant financial burden of EDs although further work is required to explore and triangulate these findings [ 22 ].…”

“…Previous societal estimates have suggested that costs of EDs range between €10,000 and €14,000 per person per year and, around a decade ago, Mitchell et al [ 23 ] estimated that individuals with EDs incur costs of around US$4000 (2005 prices) in the year preceding diagnosis, close to the current estimate (see also [ 13 ]). Costs of US$9541 [ 5 ] (~ €7946) per person per year have been attributed to BED, for example, although higher estimates have been noted (e.g., [ 16 , 17 ]).…”

“…This is likely a result of several factors. First, only ‘tangible’ costs (e.g., healthcare, productivity) were included in the current study, with no assessment of the impact on wellbeing (see [ 5 , 16 ]). Second, children with regular binge eating, individuals with anorexia nervosa, and costs to carers were not included.…”

“…Healthcare use for non-underweight individuals who report regular binge eating is higher than that for individuals without EDs [ 10 , 12 , 13 ], even when accounting for comorbidities [ 6 , 14 ]. When examining economic impact, annual healthcare costs for bulimia nervosa (BN) range from €888 to €18,823, and €1762 to €2902 for individuals with binge-eating disorder (BED) [ 15 ], with societal costs seldom reported [ 16 ] (but see [ 5 , 17 , 18 ]). Data on individuals with subthreshold EDs and those with a diagnosis of other specified feeding and eating disorder (OSFED) are notably lacking given the estimated prevalence of these syndromes and the associated impairment and cost [ 19 ].…”