Weight-Loss Surgery Carries an Increased Risk of Suicide

The newer surgeries to assist in weight loss have done so much good that it’s difficult to recognize there may be downsides.  However, a new study reported in the American Journal of Medicine indicates that the risk of suicide among bariatric surgery patients is slightly increased.  The data analyzed came from patients in the Philadelphia area who had received bariatric surgery between 1995 and 2004.  They were compared with age- and sex-matched population mortality data from Pennsylvania Department of Health.

There were 31 suicides within 3 years post-op among 16,683 operated patients – a rate of 6.6 per 10,000.  The rates were nearly 14/10,000 in men and 5.2/10,000 in women.  The ‘controls’ – Pennsylvanians in the same age bracket (35 – 64 years) – had rates of 2.4/10,000 for men and 0.7/10,000 for women.

This study confirms what individual bariatric surgeons may have suspected for some time – there’s a substantial excess of suicides in patients having bariatric surgery.  While these surgeries have well-defined side effects in the short-term, this is an association which should be investigated further.

At present, the reason for the higher suicide rate is unclear.  It’s important not to jump to the conclusion that bariatric surgery itself leads to suicides.  For instance, it may be that some bariatric surgery patients have depression, which is common among severely obese adults.  Or patients may develop mental problems after their surgery.  Further study of the database might reveal if there are pre-surgery characteristics which might be responsible for a higher risk of suicide, in which case appropriate preventive steps could be taken.  One might also determine if the amount of weight lost after surgery could be related to the likelihood of suicide; disappointingly small weight loss could lead to depression, and so on.   

 One point is clear.  Bariatric surgery centers in the US need to undertake prolonged post-surgery follow-up – much longer than the usual 6-month check-up.  There are about 225,000 bariatric surgeries a year in the USA, so the matter is quite important.