Adversity and Suicide Attempts in Morbid Obese Adults: What’s the Reality?

Abstract

Suicide is a common cause of death in eating disorders and suicide attempts are currently associated with binge eating and obesity. Research has shown that childhood adversities predispose to suicidal behaviour and other impulsive behaviours, such as compulsive eating. The aim of this work was to characterize the relation between childhood adverse experiences and adult suicide attempts and understand in morbid obese adults.

One hundred morbid obese (bariatric surgery candidates) filled out Life History Questionnaire (Felitti & Anda, 1998; translated by Silva & Maia, 2007), an instrument that evaluates the presence of 10 different forms of childhood adversity.

88% report at least one adverse childhood experience and almost 50% report at least five.

25% of the participants report at least one suicide attempt, almost 75% from this group more than one and 30% report an injury as a result of this attempt. In a logistic regression analysis, adversity had increased odds of suicide attempts (X² (1) = 23.645, p< .000, odds ratio = 2.026).

Adverse childhood experiences and suicide attempts are prevalent in morbid obese adults. Adversity was associated with an increased risk of suicide attempts among bariatric surgery candidates. Taking in account that eating behaviour and suicide attempts can be conceptualize as impulse control problems resulting from adversity, these results should be taken in consideration in the evaluation of bariatric surgery candidates. It's also important to re-think all the selection criteria for inclusion in bariatric treatment, the follow-up of this patients and the philosophy of preventive programs.