"We were really surprised and encouraged to see how protective Planet Health was for eating disorder symptoms in girls," says Austin, the study's senior author. "When we found the same protective effect cutting the risk for girls in half -- in a different set of middle schools several years later, we knew we were on to something important."
Bulimia typically develops in adolescence, and often begins with a few behaviors, such as using diet pills or purging to control weight. Full-blown bulimia is a life-threatening disorder that carries a variety of medical complications such as electrolyte imbalances, dehydration, metabolic alkalosis (an imbalance in the body's acid/base balance), heart rhythm disturbances, tooth erosion and bowel dysfunction.
"Eating disorders cause an enormous amount of suffering," says Austin. "They can also be chronic and expensive to treat, which is often a big financial burden on individuals, their families, and society. That's what led us to want to do the economic study."
In their economic analysis, Austin and Wang first estimate that 3.4 percent of girls receiving the Planet Health intervention would be prevented from developing disordered weight-control behaviors by the age of 13 , based on numbers from the original randomized study (7 of 254 girls in the Planet Health schools, or 2.8 percent, developed these behaviors, versus 14 of 226 controls, or 6.2 percent). Based on current knowledge about the progression of eating disorders, they calculate that, in turn, 1 case of bulimia would be prevented by the age of 17 among the 254 girls.
Factoring in typical treatment costs -- which can be tens of thousands of dollars over a decade -- and known rates of remiss
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