Inverse association between obesity and suicidal death risk.

Inverse association between obesity and suicidal death risk.

Publication date: Jan 08, 2025

Suicide is a significant yet preventable public health issue. Body mass index (BMI) is a readily measurable indicator associated with various health outcomes. However, the relationship between BMI and suicidal death risk is complex and warrants further investigation, particularly within contemporary, non-Western contexts with consideration of potential confounders. The purpose of this study was to investigate the relationship between BMI and the risk of suicidal death. This study was nationwide, retrospective, observational study based on Korean National Health Insurance Service database. We analyzed 4,045,081 participants who were aged > 19 years and underwent national health surveillance in 2009. The participants were categorized according to their BMI (underweight: < 18. 5 kg/m^2, normal weight: 18. 5-23 kg/m^2, overweight: 23-25 kg/m^2, class I obesity: 25-30 kg/m^2, and class II obesity: > 30 kg/m^2). The primary outcome was the death events caused by suicide which was defined by International Classification of Disorders (ICD-10) codes (X60-X84) and death records documented by the Korea National Statistical Office. Multivariate Cox proportional hazard regression analysis was performed to estimate the risk of suicidal death with respect to BMI categories after adjusting for potential confounders (age, sex, income, diabetes, hypertension, dyslipidemia, smoking, drinking, exercise, self-abuse, waist circumference, schizophrenia, bipolar disorder, eating disorder, cancer, anxiety, and substance use disorder). Underweight individuals had an increased risk (hazard ratio [HR] 1. 44, 95% confidence interval [CI] 1. 31-1. 57) while overweight (HR 0. 79, 95% CI 0. 76-0. 83), class I (HR 0. 76, 95% CI 0. 71-0. 80) and class II obesity (HR 0. 71, 95% CI 0. 63-0. 81) were associated with decreased risks of suicidal deaths compared to those of the normal weight individuals (BMI 18. 5-23). This trend was consistent regardless of the presence of major depressive disorder (MDD) or the type of living arrangements of the participants. Suicidal death risk was inversely correlated with BMI categories, independent of MDD or living arrangements. Our data suggests the importance of physiological factors associated with body mass in understanding suicidal death risk. Furthermore, these data provide valuable insights to where the public health resources should be invested to reduce suicidal death rates.

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Concepts Keywords
Diabetes Body mass index
Eating Completed
Korea Depressive disorder
Overweight Major
Suicide Obesity
Suicide

Semantics

Type Source Name
disease MESH obesity
disease MESH death
disease MESH Suicide
disease MESH underweight
disease MESH overweight
disease MESH hypertension
disease MESH dyslipidemia
disease MESH schizophrenia
disease MESH disorder eating
disease MESH cancer
disease MESH anxiety
disease MESH substance use disorder
disease MESH major depressive disorder
pathway REACTOME Physiological factors
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease MESH bipolar disorder
disease MESH migraine
disease MESH sleep apnea
disease MESH insomnia
disease MESH social stigma
disease MESH lifestyle
disease MESH Completed suicide
drug DRUGBANK Methionine
disease MESH Depressive disorder
disease MESH Abdominal obesity
disease MESH Anxiety disorder
drug DRUGBANK Cholesterol
drug DRUGBANK Ethanol
disease MESH bullying
drug DRUGBANK Indoleacetic acid
drug DRUGBANK Esomeprazole
disease MESH causality
disease MESH mental illnesses
drug DRUGBANK Amitriptyline
drug DRUGBANK Olanzapine
drug DRUGBANK Clozapine
drug DRUGBANK Phentermine
drug DRUGBANK Topiramate
disease MESH Diabetes Mellitus
pathway REACTOME Metabolism
disease MESH mood disorders
disease MESH Depression
disease MESH attempted suicide
disease MESH weight loss
drug DRUGBANK Silver
drug DRUGBANK Dextrose unspecified form
drug DRUGBANK Leptin
disease MESH sarcopenia
disease MESH suicidal ideation
disease MESH Cardiovascular risk factors
disease MESH weight gain

Original Article

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