There is no denying that eating disorders in Australia, and worldwide, are on the rise. The Butterfly Foundation (in partnership with Deloitte) recently released a report titled Paying the Price. This comprehensive report, more than a decade after the first edition in 2012, reveals the ongoing social- and economic impacts of eating disorders in Australia. It highlights an overall 21% increase in prevalence rates for eating disorders in Australia since 2012.
I thought it good to have a closer look at the numbers, to hopefully better understand the state of affairs for Western Australia.
Eating Disorders: The Difficult Estimate
Before we consider the prevalence rates and associated costs, one must understand the difficulty and complexities of undertaking the task of trying to put numbers to these types of conditions. Eating disorders by their very nature are secretive, with some not even realising they have a problem, or others being in denial, or defensive, about their eating and weight issues. Society’s negative stigma towards eating disorders also motivate those struggling to disengage from coming forward, or access treatment.
With that in mind, let’s look at how the report came to its conclusions.
The Paying the Price report was informed by multiple data sources. Primary data was collected through consultation with individuals with lived experience of eating disorders. They provided evidence of their experience with health costs, productivity losses, and other social and financial costs. Secondary data was collected through other research and literature reviews, including data from the Australian Institute of Health and Welfare (AIHW), the Australian Bureau of Statistics (ABS), the first version of the Paying the Price report (2012), and a range of academic research (e.g., Samnaliev et al. 2015 and Santomauro et al. 2021). Secondary data and preliminary findings were tested with an “Expert Advisory Panel”, who provided feedback and additional advice, data, and insights based on current research.
To derive the one-year prevalence rates of eating disorders in Australia, two key sources were used: Qian et al. (2022) and Hay et al. (2017). Hay et al. (2017) uses Australian data, and Qian et al. (2022) is the most recent meta-analyses study – hence the preference to prioritise these sources. To establish lifetime eating disorders prevalence rates, there exist limited sources and evidence within Australia. The most recent Australian source to estimate ED lifetime prevalence is from a 2012 report from NEDC (National Eating Disorders Collaboration). However, to provide more relevant and recent estimates of lifetime prevalence, the results from a review commissioned by the InsideOut Institute was used. As the review only provides ranges for each eating disorder types, and the rates vary significantly across studies, the midpoint was calculated to estimate lifetime prevalence. Also, the report did not consider those under 18 years old. For this population group, hospital admissions data provided by the Australian Institute of Health and Welfare (AIHW) for those under 18 years were benchmarked to the Udo and Grilo (2018) estimates.
As mentioned earlier, social science research in this field will always have its difficulties. Research of this nature takes a long time (in some cases years), with numerous stakeholders taking part. Even though great effort was invested in trying to establish prevalence rates (and estimated costs), one can still bring to question whether some of the figures portray all the potential cases (especially milder cases who access less intense treatment pathways). Nevertheless, I feel these statistics are our best baseline to work from, and probably present a good indication of how many people struggle with eating disorders.
Eating Disorders: The Numbers Revealed
In the Paying the Price report, it was estimated that in 2024 roughly 1.1 million Australians (4.5% of the population) currently live with an eating disorder, with approximately 2.67 million (10.5% of the population) experiencing an eating disorder at some point in their lifetime. The eating disorders considered are Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Avoidant/Restrictive Food Intake Disorder (ARFID), Other Specified Feeding or Eating Disorder (OSFED), as Unspecified Feeding or Eating Disorder (UFED).
| Australians currently living with Anorexia Nervosa | 38.711 |
| Australians currently living with Bulimia Nervosa | 125.374 |
| Australians currently living with Binge Eating Disorder | 233.948 |
| Australians currently living with other forms of Eating Disorders | 704.944 |
The National Eating Disorders Strategy (2023-2033) (NEDC) highlights that the prevalence rates for eating disorders have increased by a 21% in the last decade. In particular, women and young people remain at significantly higher risk. Women are twice as likely as men to experience an eating disorder, and 27% of people living with an eating disorder are aged 19 years or younger (an increase of 12% since 2012).
The Paying the Price report also highlights previous research findings that those with eating disorders are at a significantly increased risk of mortality, the lead cause being the associated medical complications of AN, followed by suicide. Co-morbidity with other psychiatric conditions like anxiety-, substance and alcohol abuse-, and mood disorders can result in the mortality from EDs being hidden amongst other causes. The key eating disorders prevalence rates for Australia are:
Eating Disorders in Western Australia
In the 2021 National Census (Australian Bureau of Statistics), the number of people counted as residents of Australia was 25.41 million. Residents for Western Australia were 2.7 million (10.46% of the national population).
If we use the national average, and extrapolate that figure to the population for Western Australia, we could roughly estimate prevalence rates of ~121 500 people currently living with an eating disorder, with ~283 500 people having experienced an eating disorder at some point in their lifetime.
The Economic Burden: A Hidden Price Tag
Once again, we face the reality that measuring and calculating the true financial costs of eating disorders is incredibly complex and multifaceted. Calculating accurately the ripple effect that eating disorders cause in the numerous areas of sufferers’ lives, the medical field, business and commerce in general, and the broader economy would be almost impossible. Also, consider the idea that the true emotional impact upon the individual cannot be measured in dollar amounts.
However, the Paying the Price considers many of the main components that one could expect in trying to answer this question. In short, the financial impact is staggering. In 2023, the estimated economic and social cost for eating disorders to Australian economy was $66.9 billion, a 36% increase from 2012. This figure includes direct healthcare costs, losses in productivity and efficiency, and the ripple effects on families, communities and sufferer’s wellbeing. The per-person cost of eating disorders was estimated to be ~$60 654, a 13% increase from 2012.
The Realities of Eating Disorders in Western Australia
Eating disorders don’t discriminate. They affect people of all ages, genders, and backgrounds. Paying the Price paints a clear picture of the realities we face concerning eating disorders in Western Australia, and Australia as a whole: Eating disorders are increasing in prevalence, they have serious detrimental impacts on a person’s life, and they result in immense and costly medical, psychiatric and psychosocial consequences. By understanding the true cost of eating disorders, we can work together to change these numbers and create a healthier future for all Australians.
If you, or someone you know, is struggling with an eating disorder, remember that recovery is possible, and help is available. Take the first step today. Reach out to a healthcare professional, or perhaps join our support group.
Author
Dr. Guillaume Walters-du Plooy
Clinical Psychologist