Bariatric Surgery and Self-Harm: Is There a Link?

Bariatric surgery is associated with an increased risk of suicide and non-fatal self-harm, according to the results of a recent study.

While bariatric surgery helps to reduce mortality risk, its effects on mental health are less well understood.
____________________________________________________________________

RELATED CONTENT
Bariatric Surgery May Normalize Brain Function, Too
Bariatric Surgery: Does Pre-Surgery Weight Loss Predict Post-Surgery Weight Loss?
____________________________________________________________________

For their study, researchers collected data on suicide and non-fatal self-harm from 2 cohorts from nationwide Swedish registers. The non-randomized, prospective Swedish Obese Subjects (SOS) study compared bariatric surgery with usual care, while the Scandinavian Obesity Surgery Registry (SOReg) compared bariatric surgery with intensive lifestyle modification.

Over 68,528 person-years in the SOS study, individuals who underwent bariatric surgery procedures had a higher risk of suicide or non-fatal self-harm than did the control group. When researchers examined the risk by procedure type, suicide and self-harm risk were elevated for gastric bypass, gastric banding, and vertical=banded gastroplasty, compared with controls. Substance misuse was recorded in 48% of those in the surgery group and 28% in the control group.

During 149,582 person-years in the SOReg cohort, more suicide and self-harm events occurred in patients who underwent bariatric surgery than those in the intensive lifestyle group. Substance misuse was reported in 51% of those in the surgery group and 29% of those in the lifestyle group.

“Bariatric surgery was associated with suicide and non-fatal self-harm. However, 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.”

—Michael Potts

Reference:

Neovius M, Bruze G, Jacobson P, et al. Risk of suicide and non-fatal self-harm after bariatric surgery: results from two matched cohort studies [published online January 9, 2018]. Lancet Diabetes Endocrinol. doi: http://dx.doi.org/10.1016/S2213-8587(17)30437-0.