Effective eating disorders treatment is cost-effective in the long run.

1. Strober M., Freeman R., and Morrell W. The Long-Term, Course of Severe Anorexia Nervosa in Adolescents: Survival Analysis of Recovery, Relapse, and Outcome Predictors Over 10-15 Years in a Prospective Study. International Journal of Eating Disorders. 1997; 22:339-60.
   • "The course of anorexia nervosa is protracted" 76% of their sample, followed for 10-15 years after initial admission, eventually met criteria for full recovery, but time to recovery ranged from 57-74 months. An additional 10% met criteria for partial recovery.
     
     
2. Garfinkel, PE Eating Disorders. In H.I. Kapper, F. (2000). The Changing epidemiology of hospitalized eating disorder patients. Paper presented at Academy of Eating Disorders, NY, May 4-7, 2000.
   • Treatment is effective! Of those with anorexia nervosa followed 5-10 years, 50% of the sample had recovered, 25% improved with some residual symptoms, and 25% remain ill or die.
     
     
3. Baran SA, Weltzin TE, Kaye WH. Low Discharge Weight and Outcome in Anorexia Nervosa. Am J Psychiatry. 1995; 152:1070-1072.
   • Anorexic patients who were discharged while still underweight reported higher rates of re-hospitalization (> 50% re-hospitalized) and more symptoms (abnormal eating behavior, malnutrition, and mood symptoms) than patients who achieved a normal weight before discharge (< 10% re-hospitalized).
     
     
4. Howard WT, Evans KK, et al. Predictors of Success or Failure of Transition to Day Hospital Treatment for Inpatients with Anorexia Nervosa. Am J Psychiatry. 1999; 156:1697-1702.
   
   • Patients admitted to inpatient treatment with a body mass index (BMI) of less than 16.5 or discharged from inpatient treatment below (BMI) of 19 had a greater risk of treatment failure, higher rates of inpatient RE-admission, longer duration of illness, and higher cost of treatment. Patients discharged from inpatient treatment at less than 90% of “normal” body weight had an 11.7-fold increase in the risk of treatment failure after discharge (and requiring re-admission).
     
     
5. Halmi K. & Licino E. Outcome of a Hospital Program for Eating Disorders. Presented at the 142nd Annual Meeting of American Psychiatric Association, Washington, D.C. 1989
   
   
   • Over a 14 year period (1984-1998), the change in eating disorders hospital treatment (from long-term treatment of a disorder to stabilization of acute episodes) was accompanied by a decrease in the average body mass index (BMI) of discharged patients and an increase in hospital readmissions. Discharge BMI dropped from 19.3 (nearly normal) to 17.7 (severely underweight) and the rate of hospital readmissions rose 27%. During this 15 year period the overall cost of inpatient, hospital treatment more than doubled.
     
     
6. American Psychiatric Association. Treatment Recommendations for Patients with Eating Disorders. Am J Psychiatry. 2006; 163(7 suppl):1-54.
   
   • "In general, the closer a patient is to his or her healthy body weight before discharge, the less the risk he/she has of relapsing and being re-admitted"
     
     
7. Rome ES, Ammerman S, Rosen DS, at al. Children and Adolescents with Eating Disorders: The State of the Art. Pediatrics. 2003; 111:e98-e108.
   
   • "...Weight restoration for patient with AN helps to facilitate the recovery process. Premature discharge from the hospital below a healthy weight predicts poorer outcomes."
     
     
8. Crow SJ and Nyman JA. Cost-Effectiveness of Anorexia Nervosa Treatment. International Journal of Eating Disorders. 2004; 35:155-160.
   
   • "Assuming an approach consisting of inpatient weight restoration followed by treatment of gradually diminishing intensity, incremental cost effectiveness ratios were calculated and compared with a "limited intensity" usual care model. Relative to many other medical interventions, the comprehensive treatment of AN appears to be quite cost-effective in terms of cost per year of life saved."
9. Su JC & Birmingham CL. Anorexia Nervosa: The cost of Long-term Disability. Eating and Weight Disorders. 2003; 8:76-79.
   
   • "In the population studied [AN patients in the Canadian province of British Columbia] the cost of disability payments for AN patients is 0.75 to 30 times greater than the overall cost of tertiary care treatment."