A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder.

Purpose: To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).
Methods: A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro.
Results: Sixty-nine studies were included. Data on HRQoL were reported in 41 studies (18 for AN, 17 for BN, and 18 for BED), on healthcare utilization in 20 studies (14 for AN, 12 for BN, and 8 for BED), and on healthcare costs in 17 studies (9 for AN, 11 for BN, and only 2 for BED). Patients' HRQoL was significantly worse with AN, BN, and BED compared with healthy populations. AN, BN, and BED were associated with a high rate of hospitalization, outpatient care, and emergency department visits. However, patients rarely received specific treatment for their eating disorder. The annual healthcare costs for AN, BN, and BED were €2993 to €55,270, €888 to €18,823, and €1762 to €2902, respectively.
Conclusions: AN, BN, and BED have a serious impact on patient's HRQoL and are also associated with increased healthcare utilization and healthcare costs. The burden of BED should be examined separately from that of BN. The limited evidence suggests that further research is warranted to better understand the differences in long-term HRQoL and economic burdens of AN, BN, and BED.
Competing Interests: Compliance with ethical standardsFundingThis research was financially supported by Shire Development LLC (Lexington, MA, USA).Conflicts of interestTamás Ágh, Gábor Kovács, and Zoltán Vokó are employees of the Syreon Research Institute. Dylan Supina was an employee of Shire at the time this research was conducted and holds stock and/or stock options in Shire. Manjiri Pawaskar was an employee of Shire at the time this research was conducted and is now an employee of Merck; she holds stock and/or stock options in Shire and Merck. Barry K. Herman is an employee of Shire and holds stock and/or stock options in Shire Development LLC. David V. Sheehan has served as a consultant to Shire and is the creator of a scale that measures functional impairment (Sheehan Disability Scale).Ethical approvalThis article does not contain any studies with human participants or animals performed by any of the author.Informed consentFor this type of study, formal consent is not required.