Body Mass Index and Risk of Suicide Among Men

Department of Health Policy and Management , Harvard University, Cambridge, Massachusetts, United States
Archives of Internal Medicine (Impact Factor: 17.33). 03/2007; 167(5):468-75. DOI: 10.1001/archinte.167.5.468
Source: PubMed


Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) has been linked to depression and the risk of suicide attempts and deaths in conflicting directions.
In a prospective cohort study of 46 755 men free of cancer enrolled in the Health Professionals Follow-up Study, participants reported their height, weight, diet, and physical activity on repeated occasions beginning in 1986 and were followed up until death or until February 2002. A subsample of 1829 men reported their mental health-related quality of life with the Mental Component Summary Scale of the 36-Item Short-Form Health Survey in 1998.
A total of 131 men died from suicide during follow-up. A higher BMI was related to a graded decline in the suicide mortality rate, from 52 per 100 000 person-years among men with a BMI of less than 21 to 13 per 100 000 among men with a BMI of 30 or higher; the adjusted hazard ratio per 1-U BMI increment was 0.89 (95% confidence interval, 0.84-0.95; P<.001). The relationship was consistent when baseline or updated measures of BMI were used and with adjustment for medical illness, dietary factors, antidepressant use, physical activity, or social support. Height and physical activity were not strongly associated with risk. Analyses of mental health-related quality of life showed a similar positive relationship with BMI.
Among men, risk of death from suicide is strongly inversely related to BMI, but not to height or to physical activity. Although obesity cannot be recommended on the basis of its detrimental effects, further research into the mechanisms of lower risk among overweight and obese men may provide insights into effective methods of suicide prevention.

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    • "Abdominal obesity has been shown to be associated with impaired health, impaired quality of life, and psychiatric disorders [5, 8, 49, 50]. However, results of a previous study showed that waist-hip ratio was not a predictor of suicide mortality among 46,755 male participants in the Health Professionals Follow-up Study [12]. Results of the present study demonstrated that both waist circumference and waist-height ratio were positively associated with suicidal ideation among US adult women irrespective of having either chronic conditions or current depression; however, as shown for BMI, these associations appeared to be confounded jointly by chronic conditions and current deperssion. "
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    ABSTRACT: Obesity is associated with increased risks for mental disorders. This study examined associations of obesity indicators including body mass index (BMI), waist circumference, and waist-height ratio with suicidal ideation among U.S. women. We analyzed data from 3,732 nonpregnant women aged ≥20 years who participated in the 2005-2008 National Health and Nutrition Examination Survey. We used anthropometric measures of weight, height, and waist circumference to calculate BMI and waist-height ratio. Suicidal ideation was assessed using the Item 9 of the Patient Health Questionnaire-9. Odds ratios with 95% conference intervals were estimated using logistic regression analyses after controlling for potential confounders. The age-adjusted prevalence of suicidal ideation was 3.0%; the prevalence increased linearly across quartiles of BMI, waist circumference, and waist-height ratio (P for linear trend <0.01 for all). The positive associations of waist circumference and waist-height ratio with suicidal ideation remained significant (P < 0.05) after adjustment for sociodemographics, lifestyle-related behavioral factors, and having either chronic conditions or current depression. However, these associations were attenuated after both chronic conditions and depression were entered into the models. Thus, the previously reported association between obesity and suicidal ideation appears to be confounded by coexistence of chronic conditions and current depression among women of the United States.
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    • "This is because BMI is perceived quite differently in males than in females. Indeed for males an increase in weight is actually associated with less depression and suicidality (Mukamal, 2007; Palinkas, Wingard, & Barrett-Connor, 1996). Moreover, as noted above, the interlocking relationships between psychiatric illnesses, psychotropic medications, and BMI are different in women than they are in men. "
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    ABSTRACT: We examined the relationship between cumulative body mass index (BMI) and symptomatic, psychosocial, and medical outcomes in patients with borderline personality disorder (BPD). Two hundred female borderline patients were weighed and measured during their index admission. They were subsequently interviewed at six-, eight-, and 10-year intervals. Over 10 years of prospective follow-up, increases in cumulative BMI were significantly associated with self-mutilation and dissociation (but not suicide attempts). Increases in cumulative BMI were also significantly associated with having no life partner, a poor work or school history, being on disability, being rated with a GAF score in the fair or poor range, and having a low income. In addition, increases in BMI were related to having two or more other medical conditions and using costly forms of health care. Increases in cumulative BMI may be a marker for adverse symptomatic, functional, and medical outcomes in patients with BPD.
    Preview · Article · Aug 2011 · Journal of personality disorders
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    • "Suicide risk among the elderly could be a consequence of increased terminal illness, disability, and depression[6,22,23]. With regard to other suicide risk factors that have been suggested in prior studies [7,13,24,25], although we found significant associations between BMI, employment and education with suicide, these were not significant after adjustment. In addition, we document residence in north China as a risk factor and found that smoking and drinking habits were not related to suicide. "
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