A new study suggests that people who undergo weight loss surgery have an increased risk of suicide.
Weight loss surgery is a medical intervention for people who are morbidly obese and at a very high mortality risk due to heart disease, type 2 diabetes, and hypertension. It is also considered if none of the other non-surgical treatments worked for the patient.
Although many patients are able to obtain second lease in life, a number also struggle dealing with it.
A team from the University of Toronto's Sunnybrook Research Institute conducted a cohort analysis from 2006 to 2011. They identified around 8,800 adults, of which 80% were women who were at least 35 years old. All of them had gone through gastric bypass surgery, a common surgical procedure in which the doctor creates two types of pouches from the stomach and the small intestine is modified to be attached to both. The patients' suicide and self-harm data were then compared by doing a three-year analysis before and after the weight loss surgery.
Based on the results, 111 surgery patients reported a total of 158 self-harm emergencies in the follow-up. Although self-harm was reported for 2.3 per 1,000 patients before the surgery, the number increased to almost 4 per 1,000 patients after the procedure.
Patients who were more likely to think about suicide or self-harm after the surgery were those who belonged to low-income families and who were more than 35 years old. There's also an increased chance among patients who lived in the rural areas. Many of these patients preferred intentional overdose over other methods of suicide. Interestingly, around 147 attempts occurred five years before surgery among patients who had been diagnosed with mental health issues. Overall, suicide would most likely happen three years before and after surgery.
There are a number of limitations to the study. First, the data did not include patients who self-harmed but didn't go to hospitals for treatments, as well as men and women who had completed suicide. Second, the research didn't establish causation but only a possible link between weight loss surgery and suicide or self-harm.
Nevertheless, the researchers believe that a comprehensive mental screening, especially on the possible risk of the patient to commit suicide, must be conducted even after the surgery or during follow-up.
In an interview with Wall Street Journal, American Society for Metabolic and Bariatric Surgery president John Morton notes that hospitals are required to conduct a mental health screening for at least five years after surgery, but this study might highlight the "burden of disease" brought about by obesity.
The study is now available in JAMA.