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Inverse association between obesity and suicidal death risk
Joonyub Lee1, Seung-Hwan Lee1, Mee-Kyoung Kim2
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
BMC Psychiatry
|January 8, 2025
Summary
Underweight individuals face a higher risk of suicidal death, while overweight and obese individuals show a decreased risk. This inverse correlation between body mass index and suicidal death risk is independent of major depressive disorder or living situations.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Suicide is a significant public health concern that is preventable.
- Body mass index (BMI) is a key health indicator, but its link to suicidal death risk requires further study, especially in non-Western populations.
- Understanding the complex relationship between BMI and suicidal death is crucial for public health interventions.
Purpose of the Study:
- To investigate the association between Body Mass Index (BMI) and the risk of suicidal death in a large adult population.
- To analyze BMI-related suicidal death risk considering potential confounding factors.
Main Methods:
- A nationwide, retrospective, observational study using Korean National Health Insurance Service data from 4,045,081 adults over 19 years old (2009).
- Participants were categorized by BMI: underweight (<18.5), normal (18.5-23), overweight (23-25), class I obesity (25-30), and class II obesity (>30).
- Multivariate Cox proportional hazard regression analyzed suicidal death risk (ICD-10 codes X60-X84), adjusting for age, sex, income, comorbidities, lifestyle factors, and mental health conditions.
Main Results:
- Underweight individuals had a 44% increased risk of suicidal death (HR 1.44, 95% CI 1.31-1.57) compared to normal weight individuals.
- Overweight (HR 0.79), class I obesity (HR 0.76), and class II obesity (HR 0.71) were associated with decreased risks of suicidal death.
- These BMI-related risk patterns persisted irrespective of major depressive disorder (MDD) or living arrangements.
Conclusions:
- Suicidal death risk is inversely correlated with BMI, independent of MDD or living arrangements.
- Physiological factors related to body mass play a significant role in suicidal death risk.
- Findings offer insights for prioritizing public health resources to mitigate suicidal death rates.
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