Canadian researchers find weight-loss surgery tied to higher suicide risk

Severely obese people who undergo weight-loss surgery may have an increased risk for self-harm behaviors, including suicidal ideation and attempts, a study said Wednesday.

Previous studies have found self-harm behaviors are frequent in morbidly obese patients, but it's unclear whether these behaviors are mitigated or aggravated by bariatric surgery, which can lead to an estimated 60 percent to 80 percent reduction in excess weight within one year of surgery.

Junaid Bhatti of the Toronto-based Sunnybrook Research Institute and colleagues studied 8,815 Canadian adults who underwent bariatric surgery.

For each patient, they examined medical records three years before and three years after surgery.

The results, published in the U.S. journal JAMA Surgery, showed that 111 patients had 158 self-harm emergencies during follow-up.

Although a few patients had self-harm emergencies, the risk of these emergencies increased by approximately 50 percent after surgery, they said.

Nearly all of these patients had a history of a mental health disorder, and intentional self-poisoning by medications was the most common mechanism of attempted suicide.

"These adverse events undermine the overall benefits of bariatric surgery," the researchers wrote. "Overall, these findings imply that more work is needed to understand why self-harm behaviors increase in the postoperative period and how these risks might be reduced."

An accompanying editorial noted the identification of patients with an increased risk of such adverse outcomes "remains an elusive goal."

"The study by Bhatti and colleagues underscores the unique vulnerability of patients undergoing bariatric surgery and forces us to look closely at why suicide rates are more than four times higher in these patients than the general population," it wrote. "Bariatric surgery is more than just an operation -- it is time we recognize and treat it is as such." Endit