Body Mass Index Is an Important Predictor for Suicide: Results from a Systematic Review and Meta-Analysis.
Public health concerns for the independent management of obesity and suicidal behavior are rising. Emerging evidence suggests body weight plays an important role in quantifying the risk of suicide. In light of these findings, we aimed to clarify the association between body mass index (BMI) and suicidal behavior by systematically reviewing and evaluating the literature. Studies were identified by searching MEDLINE, EMBASE, PsycINFO, and CINAHL from inception to January 2015, supplemented by hand and grey literature searches. Study screening, data extraction, and risk of bias assessment were conducted in duplicate. We included 38 observational studies. Meta-analyses supported an inverse association between BMI and completed suicide. Pooled summary estimates demonstrated that underweight was significantly associated with an increased risk of completed suicide (HR = 1.21, 95% CI 1.07 to 1.36, p = .002), and obesity (HR = 0.71, 95% CI 0.56 to 0.89, p = .003) and overweight (HR = 0.78, 95% CI 0.75 to 0.82, p < .0001) were significantly associated with a decreased risk of completed suicide relative to normal weight. A qualitative summary of the literature demonstrated conflicting evidence regarding the association between BMI and attempted suicide and revealed no association between BMI and suicidal ideation. BMI may be used to aid the assessment of suicide risk, especially that of completed suicide. However, unmeasured confounders and systematic biases of individual studies limit the quality of evidence.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Stefan
S
Perera
MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.
Rebecca B
RB
Eisen
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Brittany B
BB
Dennis
MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.
Monica
M
Bawor
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Meha
M
Bhatt
Health Sciences Library, McMaster University, Hamilton, ON, Canada.
Neera
N
Bhatnagar
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, ON, Canada.
Lehana
L
Thabane
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada.
Russell
R
de Souza
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada.|Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Zainab
Z
Samaan
D015992:Body Mass Index; D006801:Humans; D009765:Obesity / Q000175:diagnosis / Q000523:psychology; D011379:Prognosis; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data