Document Type


Publication Date

January 2010

Journal or Book Title

Journal of Consulting and Clinical Psychology







Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating compared to treatment as usual (TAU).


Participants were 123 adult members of an HMO (mean age = 37.2, 91.9% female, 96.7% non-Hispanic White) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination (EDE, Fairburn & Cooper, 1993). Participants were randomized either to treatment as usual (TAU) or TAU plus CBT-GSH. The clinical outcomes were binge-free days and quality-adjusted life years (QALYs); total societal cost was estimated using costs to patients and the health plan, and related costs.


Compared to the group receiving TAU only, those who received TAU + CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $427 over 12 months following the intervention (incremental CEA ratio -$20.23 per binge-free day or −$26,847 per QALY). Lower costs in the TAU + CBT-GSH group were due to reduced use of TAU services in that group, resulting in lower net costs for the TAU + CBT group despite the additional cost of CBT-GSH.


Findings support CBT-GSH dissemination for recurrent binge-eating treatment.

Keywords: cost-effectiveness analysis, binge eating, cognitive behavior therapy, guided self-help, evidence-based treatment programs

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