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The costs of eating disorders in New Zealand

A 2020/2021 Summer Studentship research project

Student: Shistata Dhakal
Supervisors: Dr Jennifer Jordan, Professor Lois Surgenor
Sponsor: Canterbury Medical Research Foundation


The aim of this summer studentship is to establish the range of direct and indirect financial costs experienced by 1) a cohort of those with a history of a clinically significant eating disorder, and 2) a cohort of those who have been carers for someone with an eating disorder


his study builds on our existing platform of research into eating disorders. Our previous summer studentship (2016-17) funded the setting up of the study and allowed preliminary data analysis of a subset of those with AN (6). That also contributed to our track record for a successful Lottery Health grant application to examine the experience of eating disorders in Māori (7).

Aside from that summer studentship, to the best of our knowledge, this will be the first study in New Zealand to conduct a health economics analysis of those directly affected by EDS. These findings will be of interest to treatment funders and providers, and carer organisations and may contribute to planning of services and provision of support. The research addresses important research priorities listed in the Future Directions for Eating Disorders Services in New Zealand; that of including service user experiences (8). Replication of an existing survey (adapted for the New Zealand context) allows comparability with the relatively few international studies so will be very publishable.


Data collection dates: December 2016 to June 2020.

Participants were those living in New Zealand those with either a lifetime history of eating disorders (ED) (n=504) or those who have been carers / support people for someone who has had an ED (n=140). EDs included those with self-reported diagnoses of anorexia nervosa, bulimia nervosa, binge-eating disorder, or other clinically significant specified or unspecified eating disorders (DSM-IV- EDNOS; or DSM-5 OSFED categories).

Measures: The anonymous online survey replicated content (with permissions) from two surveys conducted by national eating disorder support organisations in the United Kingdom (BEAT) Pro Bono Economics, 2012 #588} and Australia (Butterfly Foundation)(2). Parallel versions of the online survey in REDCAP were available for those with an eating disorders (ED) history and for carers of someone with an ED history.

Questions relevant to this project included demographic information, diagnostic criteria, illness duration and severity, initial and repeated access to health services, extra costs of health care outside the publically funded system, impact of the eating disorder on education and occupation (attendance, days lost, productivity, whether it changed their potential career path), effects on physical health, relationships and family life, time taken to access treatment and other aspects of the patient journey, direct costs of treatment over and above any public funding, indirect costs such a transport, needing to move closer for treatment, needing to take out loans for treatment costs.
Costs of types of contacts will be calculated using information obtained from health authorities and the diagnostic related groups (DRG) codes for hospital admissions. Economic costs including burden of disease will be calculated.

Student researcher’s component of the study

The student will finalise preparation of the databases for analyses and obtain key reference information from health agencies. After a training session and with ongoing supervision, the student will calculate the direct and indirect costs, and will participate in the preparation of a manuscript.

Student prerequisites

We have a student in mind. Shistata Dhakal is a UO undergraduate doing a BA in Psychology who has an interest in mental health research and excellent statistical skills.