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Sleeve Gastrectomy in Mice using Surgical Clips

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Bariatric Surgery and Suicide Risk in Patients With Obesity.

Anna Hung^1,2,3, Matthew L Maciejewski^1,2,3, Theodore S Z Berkowitz¹

¹Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC.

Annals of Surgery

|February 22, 2023

Summary

Bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy, was linked to increased risks of suicidal ideation and attempts in Veterans. Careful monitoring and psychological support are crucial post-surgery for individuals with severe obesity.

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Area of Science:

Medical research
Surgical outcomes
Mental health

Background:

Bariatric surgery offers significant health benefits for severe obesity.
However, bariatric procedures have been linked to adverse mental health outcomes.
The specific impact on suicidal ideation and attempts requires further investigation.

Purpose of the Study:

To compare 5-year rates of suicidal ideation and suicide attempts between Veterans undergoing bariatric surgery and matched nonsurgical controls.
To assess the association between bariatric surgery and mental health outcomes in a large Veteran cohort.

Main Methods:

A large multisite cohort of Veterans undergoing Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy was compared to matched nonsurgical controls.
Five-year rates of suicidal ideation and suicide attempts were analyzed using cumulative incidence functions and Cox regression.
Cohorts included 38,199 for ideation and 38,661 for attempts, excluding recent events.

Main Results:

Surgical patients had a significantly higher risk of suicidal ideation (adjusted hazard ratio=1.21).
The risk of suicide attempts was also significantly higher in surgical patients (adjusted hazard ratio=1.62).
The study included a large cohort with detailed demographic and clinical data.

Conclusions:

Bariatric surgery is associated with an increased risk of suicidal ideation and attempts compared to nonsurgical treatment for severe obesity.
Veterans undergoing bariatric surgery require vigilant monitoring for suicidal ideation.
Enhanced psychological support is recommended for patients post-bariatric surgery.