Weight Loss Surgery May Increase Risk of Suicide Attempts: Study

Individuals undergoing weight loss surgery may have a higher risk of attempting suicide, according to the findings of new research. 

In a study published online by the medical journal JAMA Surgery on October 7, researchers from the Sunnybrook Research Institute at the University of Toronto found that patients who undergo bariatric surgery are 50% more likely to attempt suicide after the procedure.

Researchers evaluated data on nearly 9,000 patients who underwent bariatric surgery from 2006 to 2011, and followed them for up to three years before and after the surgery. The team focused on suicide emergencies before and after bariatric surgery.

A total of 111 patients had 158 suicide attempts during the study period. One-third of the emergencies occurred before patients had surgery, however two-thirds of the suicide attempts occurred after bariatric surgery.

The study did not have data on any completed suicide attempts or incidents that occurred outside of a hospital and not treated by a hospital. Therefore, authors caution that this is most likely an underestimate.

Suicide attempts following weight loss surgery were found to be significantly higher across the board, but more likely to occur among patients who are over the age of 35. A total of 80% of the patients studied were 35 years or older.

Among people of low-income and living in a rural area, suicide attempts were also more common. The most common suicide mechanism was intentional overdose.

A total of 147 attempts occurred in patients diagnosed as having mental health disorders during the five years before the surgery.

Other Weight Loss Surgery Concerns

Popular bariatric procedures, including gastric bypass and lap band surgeries, were performed nearly 200,000 times last year in the United States. The procedures may often provide patients significant weight loss, reduction in Type 2 diabetes, hypertension and sleep apnea.

A small group of patients experience worsening depression, substance abuse, eating disorders and increased risk of suicide. Some experience vitamin deficiency, including calcium, iron and vitamin D, causing weak bones, night blindness and severe iron deficiency.

A study published in 2013 by the Journal of the American Medical Association found that many patients who undergo bariatric surgery also have an increased risk of becoming chronic users of narcotic painkillers. The study showed 77% of chronic opioid painkiller users before surgery continued to use the drugs after surgery. Drugs include pain medications like Vicodin, OxyContin and Norco.

Bariatric surgery is a life changing procedure that patients must adapt to, and these adaptations can be stressful, researchers warn. These surgeries can affect the level of hormones and neurotransmitters in the stomach that regulate mood, appetite and satiety.

The surgeries also require patients to change their eating habits; however some patients may be substituting food for alcohol or other substances. Patients who had gastric bypass were at a much higher risk of substance abuse and alcohol addiction, one study found.

Another study published by the Journal of the American Medical Association (JAMA) revealed gastric bypass often leads to increased risk of alcohol abuse. Researchers found a 10% increase in alcohol abuse among people who received bariatric surgery.

Researchers of the newest study did not say if patients who attempted suicide had regained the weight or struggled with other issues.

All who attempted suicide were diagnosed with major depression before the surgery and most of the attempts occurred between two and three years after surgery, which highlights the need for suicide screening before surgery, longer follow-up care and counseling after undergoing such a life changing surgery.