Patients who undergo various types of bariatric surgery for weight loss may be more likely to commit suicide or other non-fatal self-harms, according to the findings of new research.
In a study published last week in the medical journal Lancet Diabetes & Endocrinology, Swedish researchers report that patients who underwent weight loss surgery committed suicide or self-harm at a much higher rate than those who did not.
Researchers studied two groups of patients in Scandinavia who underwent different types of bariatric surgery. The first was a non-randomized prospective study, the Swedish Obese Subjects (SOS) study. Patients who underwent bariatric surgery were compared with control patients who underwent non-surgical obesity treatment.
The study involved a total of more than 68,000 person-years. Overall, patients in the SOS study group who underwent bariatric surgery had a higher rate of suicides and non-fatal incidents of self-harm. In the surgical weight loss group 9 patients committed suicide and 78 committed self-harm. In the non-surgical group, 3 patients committed suicide and 46 patients committed self-harm.
The increased risk was among all patients who had any type of weight loss surgery in that group, which included gastric bypass, gastric banding, and vertical-banded gastroplasty.
Patients who had weight loss surgery also faced a higher risk of substance abuse. Researchers noted 48% of surgical weight loss patients had substance misuse reported at their follow-ups. Comparatively, 28% of patients in the non-surgical weight loss group had substance misuse reported at their follow-ups.
A similar study published in 2015 indicated weight loss surgery increased a patient’s risk of attempting suicide. That research concluded bariatric surgery patients were 50% more likely to attempt suicide after the procedure.
The second study consisted of patients from the Scandinavian Obesity Surgery Registry (SOR). These patients either underwent gastric bypass surgery or were treated with intensive lifestyle modification measures to help with weight loss.
In this study group, patients who underwent surgical weight loss intervention also had more suicides and incidences of self-harm than the patients who underwent lifestyle modification.
Gastric bypass patients had a total of 33 suicides, while lifestyle modification patients had 5 suicides.
Comparing substance abuse, 51% of gastric bypass patients of this study reported substance misuse at followup appointments. Among the lifestyle modification group, 29% reported substance misuse.
Another study pushed in 2012 indicated weight loss surgery patients were more prone to substance abuse issues. Patients who underwent weight loss surgery had a 50% increase in the frequency of drug use, alcohol use, or cigarette smoking two years after the surgery.
A similar study linked bariatric surgery to increased risk of abuse of opioid painkillers, like OxyContin or Vicodin.
In both Swedish studies patients were matched for BMI, age, sex, education level, diabetes, cardiovascular disease, history of self-harm, substance misuse, antidepressant use, anxiolytics use, and psychiatric health-care contacts.
Researchers determined that weight loss surgery was associated with a higher risk of suicide and non-fatal self harm, but the “absolute risks” were low. Study authors said the risk of suicide and self-harm should not discourage people from bariatric surgery as an option for weight loss, as that may help improve other serious health conditions.
They recommended more thorough preoperative psychiatric history assessments, in addition to focused information given to weight loss surgery patients on the increased risk of suicide and self-harm following surgery. Increased effort toward postoperative surveillance and a focus on mental health should also be established in weight loss surgery patients, they concluded.