Heightened Suicide Risk After Weight-Loss Surgery
Heightened Suicide Risk After Weight-Loss Surgery
By Amy Norton
NEW YORK (Reuters Health) Sep 28 - Severely obese people who undergo weight-loss surgery may have a higher-than-average risk of suicide in the years following the procedure, a new study finds.
The report, published online September 14th in The American Journal of Medicine, adds to earlier evidence of this trend. But whereas most earlier studies came out of single institutions, the current one looked at data for all bariatric surgeries performed in the state of Pennsylvania over a 10-year period.
Among 16,683 patients who had bariatric surgery between 1995 and 2004, 31 had committed suicide by the end of 2006, the researchers found. The data translate into a suicide rate of nearly 14 per 10,000 men per year, and five per 10,000 women each year.
Those numbers are substantially higher than the suicide rates among Pennsylvanians in the same 35-to-64 age range, during the same period. Among all men in the state, the suicide rate in 2005 was 2.5 per 10,000, while the rate among women was 0.6 per 10,000.
Overall, 30% of suicides in the surgery group occurred within two years of the procedure, and 70% occurred within three years.
For now, the reasons for the higher suicide risk are unclear, according to lead researcher Dr. Hilary A. Tindle of the University of Pittsburgh in Pennsylvania. Her group's study, based on death certificate data, could not examine details surrounding the individual suicides.
But the study does not imply that bariatric surgery itself leads to suicides -- something that is "critical" for patients to understand, she told Reuters Health in an e-mail.
Rather, she said, it may be that some bariatric surgery patients have depression or other mental health problems before the procedure -- or develop them afterward -- and that, in turn, increases their overall suicide risk.
Depression is common among severely obese adults, including those who seek weight-loss surgery, Dr. Tindle and her colleagues point out. One study of surgery candidates found that two-thirds had, at some point in their lives, experienced depression, anxiety disorders, eating disorders and/or substance abuse.
More research, according to Dr. Tindle's team, is needed to understand why bariatric surgery patients show an increased suicide risk. If there are pre-surgery characteristics connected to a higher risk, then some suicides might be prevented by more careful monitoring and treatment, the researchers say.
Also unclear is whether suicide risk depends on how much weight a person loses after surgery. It's possible, Dr. Tindle's team speculates, that any pre-existing psychological distress could be exacerbated if patients have disappointing weight-loss results -- or if their overall quality of life does not improve as they had hoped.
Dr. Tindle says the findings indicate a general need for longer term monitoring of patients after surgery. Bariatric surgery centers across the U.S. do post-surgery monitoring, with the recommended follow-up being six months. But "most of the suicides among individuals in this study occurred later than the time post-surgical follow up usually ends," Dr. Tindle said.
About 225,000 Americans are now having bariatric surgery each year, according to the American Society for Metabolic and Bariatric Surgery. Given those numbers, Dr. Tindle said, it will become increasingly important to understand the factors that contribute to patients' heightened suicide risk.
Am J Med. Posted online September 14, 2010. Abstract
Reuters Health Information © 2010 http://www.medscape.com/viewarticle/729589?src=mpnews&spon=12&uac=25102SR
By Amy Norton
NEW YORK (Reuters Health) Sep 28 - Severely obese people who undergo weight-loss surgery may have a higher-than-average risk of suicide in the years following the procedure, a new study finds.
The report, published online September 14th in The American Journal of Medicine, adds to earlier evidence of this trend. But whereas most earlier studies came out of single institutions, the current one looked at data for all bariatric surgeries performed in the state of Pennsylvania over a 10-year period.
Among 16,683 patients who had bariatric surgery between 1995 and 2004, 31 had committed suicide by the end of 2006, the researchers found. The data translate into a suicide rate of nearly 14 per 10,000 men per year, and five per 10,000 women each year.
Those numbers are substantially higher than the suicide rates among Pennsylvanians in the same 35-to-64 age range, during the same period. Among all men in the state, the suicide rate in 2005 was 2.5 per 10,000, while the rate among women was 0.6 per 10,000.
Overall, 30% of suicides in the surgery group occurred within two years of the procedure, and 70% occurred within three years.
For now, the reasons for the higher suicide risk are unclear, according to lead researcher Dr. Hilary A. Tindle of the University of Pittsburgh in Pennsylvania. Her group's study, based on death certificate data, could not examine details surrounding the individual suicides.
But the study does not imply that bariatric surgery itself leads to suicides -- something that is "critical" for patients to understand, she told Reuters Health in an e-mail.
Rather, she said, it may be that some bariatric surgery patients have depression or other mental health problems before the procedure -- or develop them afterward -- and that, in turn, increases their overall suicide risk.
Depression is common among severely obese adults, including those who seek weight-loss surgery, Dr. Tindle and her colleagues point out. One study of surgery candidates found that two-thirds had, at some point in their lives, experienced depression, anxiety disorders, eating disorders and/or substance abuse.
More research, according to Dr. Tindle's team, is needed to understand why bariatric surgery patients show an increased suicide risk. If there are pre-surgery characteristics connected to a higher risk, then some suicides might be prevented by more careful monitoring and treatment, the researchers say.
Also unclear is whether suicide risk depends on how much weight a person loses after surgery. It's possible, Dr. Tindle's team speculates, that any pre-existing psychological distress could be exacerbated if patients have disappointing weight-loss results -- or if their overall quality of life does not improve as they had hoped.
Dr. Tindle says the findings indicate a general need for longer term monitoring of patients after surgery. Bariatric surgery centers across the U.S. do post-surgery monitoring, with the recommended follow-up being six months. But "most of the suicides among individuals in this study occurred later than the time post-surgical follow up usually ends," Dr. Tindle said.
About 225,000 Americans are now having bariatric surgery each year, according to the American Society for Metabolic and Bariatric Surgery. Given those numbers, Dr. Tindle said, it will become increasingly important to understand the factors that contribute to patients' heightened suicide risk.
Am J Med. Posted online September 14, 2010. Abstract
Reuters Health Information © 2010 http://www.medscape.com/viewarticle/729589?src=mpnews&spon=12&uac=25102SR
Take Care, 
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
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