Thousands of patient records had been reviewed and yielded an alarming discovery about a previously unknown risk associated with a popular weight-loss operation: Suicide in bariatric surgery. Bariatric surgery is a complex surgical procedure concerned with the causes, prevention, and treatment of severe overweight known as obesity. Bariatric operations are major gastrointestinal procedures that alter the capacity and/or the anatomy of the digestive system. In simple terms, the stomach is made smaller so as to speed up weight loss. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision. Another method is to use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site.
There are two types of bariatric surgeries:
1. Restrictive – This type of surgical procedure simply reduces the size of the stomach, using staples and/or a band, resulting in a drastic reduction in the quantity of food it can ingest.
2. Combined Restrictive and Malabsorption – This type of surgical procedure reduces stomach capacity and bypassing the upper part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs.
In bariatric surgery, most studies show that the risk of dying is about 1%, and complications strike up to 40 % of obese patients. Aside from being overweight, these patients usually have health problems, such as diabetes and heart disease, that’s why it’s no wonder they also have higher death rates from natural causes.
However, nearly 17,000 weight-loss surgeries performed in Pennsylvania from 1995 to 2004 had been reviewed and the findings were startling. Out of the 440 deaths in the group, 16 were due to suicide or drug overdose, according to the University of Pittsburgh researchers who reviewed the data. About three cases of suicides should have occurred in the group based on the suicide rate in the general population, the study authors say. Even more disturbing is the fact that another 14 of the drug overdose cases that were reported are likely to include some suicides, suggesting that the real suicide rate was even higher. There is a substantial excess of suicide deaths, even excluding those listed only as drug overdose, the researchers noted.
The New England Journal of Medicine reported last August 2007 about a review of nearly 10,000 bariatric surgery patients by Utah researchers, who compared them to a control group of obese people who had applied for a state driver’s license. Although these surgery patients had a 50% lower risk of dying from the disease compared to obese people who hadn’t undergone surgery, their risk of dying in an accident or suicide was 11.1 per 10,000 people. That statistic is 58% higher than the 6.4 per 10,000 rate in the obese group. The study revealed that the suicide risk was twice as high for surgery patients than for those who had not had surgery, though the finding wasn’t statistically meaningful.
Experts are clueless as to why bariatric surgery patients seem to be at higher risk for killing themselves. Some research suggests a connection between obesity and depression, that is why the typical surgery patient may already be at higher risk for depression and suicide even before the operation. There is a great possibility that depressive symptoms may worsen in patients who have unrealistic expectations about the results of surgery, or who struggle not to regain weight after the procedure.
The Pennsylvania case review reveals that there is already a 7 percent death rate from suicide and drug overdose signals the need for better mental health follow-up for patients who have undergone weight-loss surgery. Although many weight-loss surgery programs require a psychological evaluation prior to the procedure, most doctors seem lenient about making follow-ups after the surgery, as well as patients who prefer to disregard follow-up counseling.