• Open Access

A cost effectiveness analysis of stepped care treatment for bulimia nervosa


  • The study “effectiveness of stepped care versus best available care for bulimia nervosa” is registered with CT.gov. the registration number is NCT00733525.



The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown.


To examine the cost effectiveness of stepped care treatment for BN.


Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared.


The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially.


In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)