Weight loss surgery patients are at increased risk for self-harm and suicide within the first three years after having a bariatric procedure, according to a new study.
Previous research has shown therapy before and after surgery should be recommended for some patients because of the proportion of morbidly obese people with depression or other issues related to their weight.
“Even if you remove the burden of weight, you don’t remove the burden of disease,” Dr. John M. Morton, president of the American Society for Metabolic and Bariatric Surgery, told the L.A. Times. “Some of the psychological issues might still be there.”
Researchers at Sunnybrook Research Institute and the University of Toronto conducted a study of 8,815 people in Ontario, Canada, who had bariatric surgery between 2006 and 2011, following them for three years before surgery and three years after. Of the patients, 81.4 percent were women, 80.1 percent were 35 years or older, and 98.1 percent were treated with gastric bypass.
During the follow-up periods, 111 patients had 158 self-harm emergencies. The emergencies were about 1.5 times more likely to happen after surgery. Self-harm after surgery was found to be more common among patients older than 35, with a low-income status, or living in rural areas.
The increased risk for self-harm underscores “the need for screening for suicide risk during follow-up,” researchers wrote in the study, published in JAMA Surgery.
A previous study in 2013, published in the journal Obesity, raised concern for increased risk of suicide and self-harm of bariatric surgery patients. Researchers in that study noted that general population samples showed an elevated body mass index was associated with depression.
Other researchers have said issues stemming from body image to changes in spousal relationships can get worse by the second or third year after surgery — which is when most self-harm emergencies happen, researchers wrote in a commentary published in JAMA Surgery with the new study. The lack of minimum standards for psychological follow-up after bariatric surgery may be to blame, they wrote.
“Bariatric surgery follow-up is notoriously poor,” Dr. Amir Ghaferi, director of bariatric surgery at the Ann Arbor Veterans Administration Healthcare System and one of two authors of the commentary, told CBS News. “We try to maintain at least one-year follow-up with our patients, but it’s hard. Patients fall off the radar. They move, or it’s the type of operation where if they’re doing well or doing poorly, they’re not going to come see you.”