Bariatric surgery is associated with elevated risk for suicide and nonfatal self-harm, according to findings reported in the Lancet Diabetes & Endocrinology.
In one cohort, researchers compared outcomes in 2000 obese patients undergoing bariatric surgery and matched controls who chose not to undergo surgery. During a median 18 years’ follow-up, the incidence of suicide or nonfatal self-harm was significantly higher with bariatric surgery (4.3% vs. 2.4%).
In another cohort, 20,000 patients having bariatric surgery were matched to 16,000 who received intensive lifestyle modification. During a median 4 years’ follow-up, suicide and nonfatal self-harm events were again more common in bariatric surgery patients (1.7% vs. 0.5%).
In a subgroup free of psychiatric illness at baseline, bariatric surgery remained associated with suicide and self-harm.
The authors conclude: “The absolute risks were low and do not justify a general discouragement of bariatric surgery. The findings indicate a need for thorough preoperative psychiatric history assessment along with provision of information about increased risk of self-harm following surgery. Moreover, the findings call for postoperative surveillance with particular attention to mental health.”