Weighing the evidence for an association between obesity and suicide risk.

Chronic illness is an important risk factor for suicidal behavior. Obesity is perhaps the most prevalent chronic disease at present, although the contribution of obesity to fatal and nonfatal suicide is controversial. Several large population-based studies have shown that obesity is independently linked to an increased risk of suicide. However, this association has been challenged by reports demonstrating a paradoxical relationship between an increasing body mass index and suicide. Recently, it has also been suggested that bariatric surgery patients are at increased risk of death by suicide postoperatively. We reviewed the heterogeneous data concerning the relationship between obesity and suicide. We also critically examined recent reports describing the incidence of fatal suicide events after bariatric surgery. From the present review, it appears that a positive association between obesity and suicide has been observed more frequently than a negative or absent association. This implies that obese individuals are indeed at an increased risk of suicide. This risk seems to persist despite treatment of obesity with bariatric surgery.