A brief screening survey to identify teens at risk for an eating disorder could lead to earlier diagnosis and help find hard-to-detect cases, which could lower overall treatment costs and improve outcomes, Boston Children’s Hospital researchers say.

“Many cases of eating disorders go undetected for years. This may be because the stereotype that the typical teen with an eating disorder is a thin, affluent, white female. In reality, eating disorders come in all shapes and sizes and both genders, and they affect people from all racial/ethnic and socioeconomic backgrounds,” said senior study author Kendrin R. Sonneville.

Only 3 to 28 percent of teens with eating disorders receive treatment for their condition. Moreover, interventions for eating disorders, such as residential treatment and lengthy therapy, tend to be very expensive. Teens with untreated eating disorders face medical complications, hospitalization and higher risk of early death.

The combination of under diagnosis, under treatment and high treatment costs has generated support for school-based screening, which could help identify teens with eating disorders. “However, the cost-effectiveness of school-based screening for eating disorders had not been demonstrated previously,” said Sonneville.

In order to evaluate the cost-effectiveness of a school-based screening program, Sonneville and colleagues devised a computer simulation comparing annual screening of 10- to 17-year-olds to a no-screening scenario.

The researchers found the five-question survey boosted detection and treatment for eating disorders. Implementing a school-based screening program is a bargain in terms of time and money; screening costs $0.35 per student, and the survey can be scored in a few minutes.

The study, published in the American Journal of Public Health, is available here.

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