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

Paul E Jenkins

doi:10.1007/s40519-021-01277-3

Abstract

PurposeThis study examined economic costs associated with untreated eating disorders (EDs) characterised by regular binge eating in the absence of low weight. Both direct and indirect costs were assessed, reporting a limited societal perspective of economic impact as some costs were not included.MethodsOne hundred and twenty six adults seeking treatment for recurrent binge eating were asked to report impairment associated with an ED. Costs were calculated using 2017 prices, including an examination of variables associated with costs.ResultsEstimated societal costs for the year preceding assessment were £3268.47 (€3758.54) per person. In multivariate analyses, no reliable baseline associates of cost were identified.ConclusionThe economic burden of EDs characterised by regular binge eating is significant, and underscores the need for efficacious and cost-effective treatments. Individuals with binge-eating disorders report work impairment and healthcare use that may cost the United Kingdom economy upwards of £3.5 billion (€4bn) per annum. Further studies should consider academic impairment and the economic impact of EDs on families.Level of evidenceIII: evidence obtained from well-designed cohort or case–control analytic studies.

Highlights

Attention paid to the economic burden of eating disorders (EDs) has been increasing, over the last two decades [1]
Participants were 126 adults referred to one of three specialist ED services in the United Kingdom (UK), covering a population of around 1.3 million adults across Buckinghamshire, Oxfordshire, and Wiltshire. (A recent report [24] compiled a directory of 56 similar services across England.) Individuals who, at assessment with the service, met criteria for a diagnosis of bulimia nervosa (BN), binge-eating disorder (BED), or other specified feeding and eating disorder (OSFED) participated in a randomised controlled trial of guided self-help with few exclusion criteria, and data from these individuals were included in the current study
The current study reports cost-of-illness data for adults referred for treatment of recurrent binge eating in the absence of significantly low body weight

Summary

Introduction

Attention paid to the economic burden of eating disorders (EDs) has been increasing, over the last two decades [1]. 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]). Some studies have examined the influence of demographic factors, such as age and gender (e.g., [6, 11]), few have explored whether common ED symptoms, such as binge eating, are associated with costs, which can help inform both healthcare and research priorities. The current study aims to estimate societal costs in a group of non-underweight individuals referred for specialist outpatient treatment for regular binge eating, using a prevalence-based, ‘bottom–up’ approach (i.e., obtaining cost data directly from patients via self-report).

Participants

Results

Discussion