Obesity And Eating Disorders In Australia: Cost-Effectiveness Analysis Of An Intervention Program

Obesity and Eating Disorders: Australian Medical Association

The perspective of the study

Discuss about the Obesity and Eating Disorders for Australian Medical Association.

Today, obesity and eating disorder has become one of the most prevalent lifestyle diseases across the world, especially among developed economies. Obesity in Australia is one of the biggest public health challenges facing the country’s population. According to a 2017 survey, approximately more than half of the adults in the country have a body weight that poses significant health risks. Additionally, more than 60 percent of the adults in Australia are obese, while 10 percent is severely obese. The statistics also indicate that at least a quarter of children and adolescents in the country are obese or overweight (Australia’s Obesity, 2018). In a 2012 survey, the number of people in the country diagnosed with an eating disorder was estimated at about 4 percent of the total population (Overview, 2013). Among these people, about 47 percent have a binge eating disorder, 3 percent have anorexia nervosa, 12 percent have bulimia nervosa and the remaining 38 percent have other eating disorders. Further, statistics indicate that at least 15 percent of women in the country experience an eating disorder at one point in their lifetime (Overview, 2013).   By and large, this poses significant health risks to both the individuals and their families. Mainly, this is because 70 percent of those diagnosed with obesity have been afflicted with at least one chronic health condition such as stroke, heart disease, diabetes type 2, and musculoskeletal disease or impaired social functioning (Australia’s Obesity, 2018). As a result, the Australian Medical Association (AMA) has advised the country’s government to initiate a strategy that will work towards addressing the issue of obesity in the country. In this case, the government may intervene by initiating an eating disorder screening in schools across Australia to help identify the risks of eating disorders and obesity among students at an early stage in order to intervene early before it becomes chronic. Therefore, this paper provides a cost-effectiveness analysis of the proposed project as well as evaluates the potential benefits of the suggested intervention to the students as well as the entire Australian society. 

As noted earlier, childhood eating disorders and obesity has reached epidemic levels across the country. It is worth noting that the disorders not only pose significant health risks to the individual, it is also associated with great impacts on both the physical and psychological health of the child. Over the years, it has been noted that overweight and obese children have a high chance of being obese for the rest of their adult life too. Particularly, this implies that childhood obesity can significantly affect the child’s physical health, social and emotional well-being. The disorder affects the self–esteem of the individual, and may even result in poor academic performance in the child’s school work. What is more, studies have shown that in severe cases, it may significantly lower the quality of life experienced by the child. Therefore, obesity and eating conditions are associated with significant costs to the child suffering from the condition. 

The intervention time-frame

Furthermore, research has shown that body image and other related disorders have profound effects on the individual, families and society as a whole. Mainly, this can be attributed to the fact that how a people perceive themselves and their bodies predisposes them to how they interact with the people close to them and the rest of the world. It is worth that these views are often reinforced by the current ethos of the society where the mass media has reaffirmed that the ideal body type should be thin, youthful and attractive (Eating Disorders, 2015). Therefore, for a youth who is obese suffers from dire consequences associated with body shaming based on these societal self-image expectations. In turn, this may affect their mental health and social welfare. Additionally, eating disorders and obesity can have significant effects on the affected youth, their parents and the community at large because their behaviors and outward results impact on all those around. As such, it may result in an emotional toll on family and friends.

On top of the social and emotional costs, the consequences associated with the disorder may also be financial in nature. Primarily, this is because the medical expenses associated with the treatment for the condition is significantly high. In addition, the care for patients with the disorder is also expensive. Mainly, this is because the treatment often requires seeing a team of specialist on a weekly basis. These specialists include physicians, psychiatrists and nutritionists. On average, a residential program for the treatment costs about $30,000 per month (Parker-Pope, 2010). Yet, the treatment may take up to more than three months. Even after the treatment, the individual requires many more years of follow up care. Thus, this implies that the financial costs of treating obesity are significantly high and can take a toll on the financial position of the family.

Having realized the significant social, emotional and financial costs associated with obesity and eating disorders, it is imperative for the government to set up an intervention program. This intervention will go a long way in reducing the prevalence of diabetes among school going children as the national screening program will help to diagnose the risks of getting the disorder at an early stage and therefore help in preventing it. In turn, this would save the individual and their families a lot money as well as ensure inner peace.

At the moment, the intervention program is designed to take place annually across schools in Australia. Therefore, the intervention program is most likely to a continued process over a long period of time. The program start up phase is estimated will take about three months. The first step will involve sending out registration information about the program to schools to invite them to enroll in the program. This will take about one month. The second step would involve conducting a survey of schools around the country and prepare the screening questionnaires for students to fill in. The second phase involves distributing the questionnaires to schools for them to be administered to the students. These questionnaires will comprise of Eating Attitude Tests (EAT-26) to capture the eating habits of the students (Austin, Ziyadeh, Forman, Prokop, Kelifer, & Jacobs, 2008). This process will take about 1 week after which the schools are expected to send back the results for analysis. Given the large number of questionnaires, analyzing them may take up to 4 weeks before conclusive results are sent back to schools. These results are then combined with the students BMI report cards and evaluated to determine the risk of eating disorders or obesity. For students found to have high risks of eating disorders, their parents will be informed in order to take immediate action to prevent further development of the disorder.

The Analysis time frame

Table 1: Intervention time frame

After the intervention has begun, it will take about 6 months before actual results begin to show among students with high risk of obesity and eating disorders. Mainly, this is because the intervention process involves a total turn around in the lifestyle and eating habits of the individual. What is more, it takes time for the body to start adjusting to the new lifestyle, and cause significant changes in the body mass index of the student. Nonetheless there are certain short term benefits as well as log term ones that will be realized among the individual.

The short term benefits and outcomes of the intervention may include a reduction in the rate of  binge eating among students as they are now aware of the negative effects of the habit. Tin addition, there will also be an improvement in the lifestyle of the children who will take up exercises as a means to be healthy. On the other hand, the long term benefits of the intervention program would fundamentally be based on the fact that it will significantly reduce the probability and risk of the individual suffering from obesity. In addition, sustained weight loss will be very beneficial to the student as it will significantly reduce the risks of suffering from weight related diseases such as cardiovascular risks, hypertension and even diabetes.  Thus, all in all, the program will have significant benefits,

It is imperative to note that the national screening and intervention program will be very costly and expensive to implement. Mainly, this is because it will be very costly for the government to purchase the BMI machines for each and every school to allow for easy assessments within each school (Stuhldreher, Konnopka, Herzog, Zipfel, Lowe, & Konig,  2012).  In addition, taking the surveys and analyzing the data collected will require experts who charge very high rates for their services. The costs of the program wil further be increased when the government has to hire specialist to help students who are at risk to change their lifestyle into healthy ones (Wright, Austin, Noh, Jiang, & Sonneville,2014). These specialists include nutritionist, psychiatrists, and physicians. In some cases, it may also be prudent to hire a physical trainer to guide the students through physical exercise that help them reduce their weight. Fundamentally, all these expenses are significantly costly.

Table 2: Costs likely to be incurred in the implementation of the program

It is imperative to note that the intervention program will bring about significant improvements in the health outcomes of students who were at risk of being obese or having eating disorders. These health outcomes can be grouped into either short term, medium term or long term outcomes. It is not difficult to obtain data on the outcomes over the short term period as the results can be collected through the BMI measurement program for as long as the student still attends the school. However, it will be extremely difficult to establish the exact outcome of the intervention over the long term period as the students would no longer be members of the school and tracking them down is impossible.

The impact of the program is very limited over a short-term period of say 6 months.  Mainly, this is because at this point, the individual is barely adjusting into the new lifestyle pattern and the body is still reacting to the changes. Therefore, the outcomes are minimal.

Imperatively, most of the outcomes of the intervention program are realized over the medium term period. At this point, significant changes in the BMI can be recorded. According to a study by Singh, Paw, Brug and Mechelen (2007), significant differences were recorded in favor of the intervention group indicating changes due to a similar intervention program. Specifically, there were reductions in hip and waist circumference of individuals that took part in the intervention program.

According to a study by the World Cancer Research Fund International, school-based health promotion programs such as this one has long term effects on the prevalence of overweight issues, co-morbidities and lifestyle variables (Roon, Gemert, Peeters, Schuit, & Monninkhof, 2017). As such, it is expected that the eating disorder screening and intervention will have long term effects on the lifestyle of the individuals in the program long after they have finished schools (Muller, 2012). Statistics indicate that although intention has minor effects on long term changes in BMI, the results are very favorable. They help individuals shape their lifestyle habits into healthy dietary patterns and physical activity.

Conclusions

Obesity in Australia is one of the biggest public health challenges facing the country’s population. Therefore, it is important to initiate an intervention program that will help in detecting and preventing the occurrence of obesity and eating disorders among students in the country. Such a program will go a long way in improving the health outcomes of young people in the country by reducing the probabilities of them having eating disorders or being obese. Therefore, the government should ensure the program is implemented within schools in Australia.

After a careful analysis and evaluation of the intervention program, the following recommendations are made.

1. The screening intervention is the first step towards reducing the incidence of eating disorders and obesity among young people, and the government should ensure that the program is executed and implemented well in order to achieve the best results.
2. A follow up program will be required to ensure that the students who benefit from the program do not relapse in their lifestyles, in order to ensure that the intervention program works.

References

Austin,B. S.,  Ziyadeh, N. J., Forman, S.,  Prokop, L.,  Kelifer, A.,  & Jacobs, D. (2008).  Screening High School Students for Eating Disorders: Results of a National Initiative. Preventing Chronic Disease, 5(4), 1-5.

Australia’s Obesity Statistics in 2017 (2018). Education Conference 2018.  Retrieved 27 May 2018, https://eatingdisordersaustralia.org.au/australias-obesity-statistics-2017/

Eating Disorders: Impact on Individuals, Families, Communities and Society. (2015). IT Magazine.  Retrieved 27 May 2018, https://itmagazine.org/eating-disorders-impact-on-the-individual-families-communities-and-society/

Muller, J. M. (2012). Long-term effectiveness of school-based obesity prevention: 8-year follow-up data of the Kiel Obesity Prevention Study (KOPS). World Cancer Research Fund International.  Retrieved 27 May 2018, https://www.wcrf.org/int/research-we-fund/what-we-re-funding/long-term-effectiveness-school-based-obesity-prevention-8

Obesity & Eating Disorders. National Eating Disorder Collaboration.  Retrieved 27 May 2018, https://www.nedc.com.au/eating-disorders/eating-disorders-explained/obesity-and-eating-disorders/

Overview of eating disorders today (n.d.). Eating Disorders Victoria.  Retrieved 27 May 2018, https://www.eatingdisorders.org.au/key-research-a-statistics

ParkePope, T. (2010). The Cost of an Eating Disorder. the New York Times.  Retrieved 27 May 2018, https://well.blogs.nytimes.com/2010/12/03/the-cost-of-an-eating-disorder/

Roon, M., Gemert, W. A., Peeters, P. H., Schuit, A. J., and Monninkhof, E. M.  (2017 ). Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: A randomized trial. IT Magazine. Preventive Medicine Reports, 5, 118-123.

Singh, A., Paw, M., Brug, J., & Mechelen, W. (2007). Short-term Effects of School-Based Weight Gain Prevention Among Adolescents. Arch of Pediatric Adolescent Medical, 1(1), 32-45.

Stuhldreher, N., Konnopka, A., Herzog, W., Zipfel, S., Lowe, B., & Konig, H.  (2012).  Cost-of-Illness Studies and Cost-Effectiveness Analyses in Eating  Disorders: A Systematic Review. International Journal of Eating Disorders 45(4), 476–491

Wright, D. R., Austin, B.S., Noh, L., Jiang., & Sonneville, K.R.  (2014).  The Cost-Effectiveness of School-Based Eating Disorder Screening. American Journal of Public Health, 104(9), 1774-1782.

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