National Eating Disorders Association

What "Treatment as Usual" Costs in Australia

Caitlin Hamilton, Media & Communications Manager

The Butterfly Foundation, an Australian organization that provides support for Australians who suffer from eating disorders, recently released findings from their report, Investing in Need: cost effective interventions for eating disorders. This report is an analysis of the costs associated with “treatment as usual” for eating disorders and of the benefits of implementing a new standardized “optimal treatment” in the country. 

In Australia, a country with a population of more than 23 million, approximately 200,000 new cases of eating disorders appeared in 2014. Only between 5-15% of people affected by an eating disorder in Australia receive treatment. Based on these (and many other) numbers, the study found that if “optimal treatment” were implemented, the country could save upwards of $50 billion over the next ten years.

Highlights from the Report:

  • It can cost more than $100,000 to appropriately treat a person with anorexia.
  • If someone has anorexia for a decade (which happens often, since EDs are long lasting and debilitating conditions), the costs of their foregone productivity and other financial costs could be larger than $200,000.
  • The total cost, if “treatment as usual” occurs, for those who develop an eating disorder in 2014, is equivalent to $103.2 billion, but the total cost, if “optimal treatment” occurs, is equivalent to $49.9 billion (Net present value over 10 years).
  • Best practice treatment was found to be up to 50% more cost-effective than standard practice.
  • Best practice would increase recovery rates from 5 to 8% initially (where almost nobody receives best practice treatment), up to 50 to 80%

What would “Optimal Treatment” Look Like?

“Treatment as usual” (which only 5-15% of those affected receive) is typically not long enough; often hospital based (focused primarily on physical health only) and will not follow through to sustainable recovery. “Optimal treatment” means that evidence-based best practices would be identified and implemented country-wide. 

“In 2012, the National Eating Disorders Collaboration (NEDC) identified a suite of evidence-based treatment options and delivery mechanisms, which features:

  • a focus on early intervention
  • a range of delivery options, from general practitioners and online self-help, through intensive outpatient and residential programs, to full inpatient hospitalization
  • a “stepped care” approach, realizing that patients might need to progress both up and down (sometimes repeatedly) through delivery levels
  • long-term follow up, to prevent relapse”

Why This Is So Important:

NEDA has long advocated for this kind of economic analysis and we are so thrilled to see that the Butterfly Foundation has released this information in Australia. Our Congressional National Eating Disorders Awareness Caucus has encouraged the U.S. Government Accountability Office (GAO) to analyze the prevalence, mortality rate and economic impact of eating disorders in the United States. The study is currently underway, and we hope this economic analysis will help our case as we work toward further reforms for the treatment and prevention of eating disorders in the United States. 

Kudos to the Butterfly Foundation, NEDC and their allies in the Australian government! We hope that this report will be a catalyst for policy change in Australia and will serve as an example to government leaders here in the United States.

» Read the full Report now (PDF).