Abstract
Purpose of Review
Body mass index (BMI) outside of the “normal” range is commonly cited as a predictor of adverse health outcomes and has been identified as a potential risk factor for suicidal thoughts and behaviors (STBs). This meta-analysis provides a descriptive and quantitative summary of the literature evaluating the longitudinal relationship between BMI/weight status and STBs.
Recent Findings
The longitudinal literature examining the relationship between BMI/weight status and STBs is small and methodologically constrained. Within the existing literature, BMI and weight status are generally weak or nonsignificant risk factors for STBs. It is possible that body weight has a complex relationship with physical and mental health, including STBs, which may not be possible to accurately capture with a singular metric such as BMI.
Summary
BMI and weight status do not appear to robustly predict STBs, at least within the methodological constraints of the existing literature.
Similar content being viewed by others
Availability of Data and Material
Data are available upon reasonable request to the corresponding author.
Code and Software Availability
Comprehensive meta-analysis software can be purchased online at https://www.meta-analysis.com. R software can be freely downloaded online at https://www.r-project.org.
References
Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. The Lancet. 2011;377:557–67.
World Health Organization. Obesity and overweight, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (2020, Accessed 28 Mar 2021).
Fryar C, Carrol M, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. 2020.
Dietz WH. The response of the US centers for disease control and prevention to the obesity epidemic. Annu Rev Public Health. 2015;36:575–96.
GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377:13–27.
Dong C, Li W-D, Li D, et al. Extreme obesity is associated with attempted suicides: results from a family study. Int J Obes. 2006;30:388–90.
Falkner NH, Neumark-Sztainer D, Story M, et al. Social, educational, and psychological correlates of weight status in adolescents. Obes Res. 2001;9:32–42.
Mather AA, Cox BJ, Enns MW, et al. Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample. J Psychosom Res. 2009;66:277–85.
Schneider B, Lukaschek K, Baumert J, et al. Living alone, obesity, and smoking increase risk for suicide independently of depressive mood findings from the population-based MONICA/KORA Augsburg cohort study. J Affect Disord. 2014;152–154:416–21.
World Health Organization. Suicide data. Mental Health and Substance Use. https://www.who.int/teams/mental-health-and-substance-use/suicide-data. (Accessed 26 Jul 2021).
Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192:98–105.
Heneghan HM, Heinberg L, Windover A, et al. Weighing the evidence for an association between obesity and suicide risk. Surg Obes Relat Dis. 2012;8:98–107.
Crow S, Eisenberg ME, Story M, et al. Are body dissatisfaction, eating disturbance, and body mass index predictors of suicidal behavior in adolescents? A longitudinal study. J Consult Clin Psychol. 2008;76:887–92.
Klinitzke G, Steinig J, Blüher M, et al. Obesity and suicide risk in adults—A systematic review. J Affect Disord. 2013;145:277–84.
Gonzalez MC, Correia MITD, Heymsfield SB. A requiem for BMI in the clinical setting. Curr Opin Clin Nutr Metab Care. 2017;20:314–21.
Nuttall FQ. Body Mass Index: Obesity, BMI, and Health A Critical Review. Nutr Today. 2015;50:117–28.
Kraemer HC, Kazdin AE, Offord DR, et al. Coming to term with the terms of risk. Arch Gen Psychiatry. 1997;54:337–43.
Bjerkeset O, Romundstad P, Evans J, et al. Association of adult body mass index and height with anxiety, depression, and suicide in the general population: the HUNT study. Am J Epidemiol. 2008;167:193–202.
Kaplan MS, Huguet N, McFarland BH, et al. Suicide among male veterans: a prospective population-based study. J Epidemiol Community Health. 2007;61:619–24.
Magnusson PKE, Rasmussen F, Lawlor DA, et al. Association of body mass index with suicide mortality: a prospective cohort study of more than one million men. Am J Epidemiol. 2006;163:1–8.
Mukamal KJ. Body mass index and risk of suicide among men. Arch Intern Med. 2007;167:468.
Mukamal KJ, Rimm EB, Kawachi I, et al. Body mass index and risk of suicide among one million US adults. Epidemiology. 2010;21:82–6.
Zhang J. RE: Association of body mass index with suicide mortality: a prospective cohort study of more than one million men. Am J Epidemiol. 2006;164:398–9.
Amiri S, Behnezhad S. Body mass index and risk of suicide: a systematic review and meta-analysis. J Affect Disord. 2018;238:615–25.
Perera S, Eisen RB, Dennis BB, et al. Body mass index is an important predictor for suicide: results from a systematic review and meta-analysis. Suicide Life Threat Behav. 2016;46:697–736.
Finkelstein EA, Strombotne KL. The economics of obesity. Am J Clin Nutr. 2010;91:1520S-1524S.
Salas XR, Forhan M, Caulfield T, et al. A critical analysis of obesity prevention policies and strategies. Can J Public Health. 2017;108:e598–608.
Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity. 2006;14:1802–15.
Daly M, Robinson E, Sutin AR. Perceived overweight and suicidality among US adolescents from 1999 to 2017. Int J Obes. 2020;44:2075–9.
Eaton DK, Lowry R, Brener ND, et al. Associations of body mass index and perceived weight with suicide ideation and suicide attempts among US high school students. Arch Pediatr Adolesc Med. 2005;159:513.
Franklin JC, Ribeiro JD, Fox KR, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull. 2017;143:187–232.
Smith AR, Velkoff EA, Ribeiro JD, et al. Are eating disorders and related symptoms risk factors for suicidal thoughts and behaviors? A meta-analysis. Suicide Life Threat Behav. 2019;49:221–39.
R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2020.
Ribeiro JD, Franklin JC, Fox KR, et al. Letter to the Editor: suicide as a complex classification problem: machine learning and related techniques can advance suicide prediction - a reply to Roaldset (2016). Psychol Med. 2016;46:2009–10.
Franklin JC. Psychological primitives can make sense of biopsychosocial factor complexity in psychopathology. BMC Med. 2019;17:187.
Borenstein M, Hedges L, Higgins J, et al. Comprehensive meta-analysis version 3. Englewood, NJ: Biostat. 2013.
Jackson D, Turner R. Power analysis for random-effects meta-analysis: power analysis for meta-analysis. Res Synth Methods. 2017;8:290–302.
Borges G, Nock MK, Haro Abad JM, et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J Clin Psychiatry. 2010;71:1617–28.
Ribeiro JD, Franklin JC, Fox KR, et al. Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies. Psychol Med. 2016;46:225–36.
Ribeiro JD, Huang X, Fox KR, et al. Predicting imminent suicidal thoughts and nonfatal attempts: The role of complexity. Clin Psychol Sci. 2019;7:941–57.
Faerstein E, Winkelstein W. Adolphe Quetelet: Statistician and More. Epidemiology. 2012;23:762–3.
Müller MJ, Bosy-Westphal A, Krawczak M. Genetic studies of common types of obesity: a critique of the current use of phenotypes: genetics of obesity. Obes Rev. 2010;11:612–8.
Hunger JM, Smith JP, Tomiyama AJ. An evidence-based rationale for adopting weight-inclusive health policy. Soc Issues Policy Rev. 2020;14:73–107.
Logel C, Stinson DA, Brochu PM. Weight loss is not the answer: a well-being solution to the “obesity problem”: a well-being solution to the “obesity problem.” Soc Personal Psychol Compass. 2015;9:678–95.
Tomiyama AJ, Hunger JM, Nguyen-Cuu J, et al. Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012. Int J Obes. 2016;40:883–6.
Wildman RP. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999–2004). Arch Intern Med. 2008;168:1617.
Longo M, Zatterale F, Naderi J, et al. Adipose tissue dysfunction as determinant of obesity-associated metabolic complications. Int J Mol Sci. 2019;20:2358.
Grabowski DC, Ellis JE. High body mass index does not predict mortality in older people: analysis of the longitudinal study of aging. J Am Geriatr Soc. 2001;49:968–79.
Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. 2011;13.
Robison J. Health at every size: toward a new paradigm of weight and health. MedGenMed Medscape Gen Med. 2005;7:13.
Provencher V, Bégin C, Tremblay A, et al. Health-at-every-size and eating behaviors: 1-year follow-up results of a size acceptance intervention. J Am Diet Assoc. 2009;109:1854–61.
Provencher V, Bégin C, Tremblay A, et al. Short-term effects of a “health-at-every-size” approach on eating behaviors and appetite ratings*. Obesity. 2007;15:957–66.
Rapoport L, Clark M, Wardle J. Evaluation of a modified cognitive–behavioural programme for weight management. Int J Obes. 2000;24:1726–37.
Lowe MR, Piers AD, Benson L. Weight suppression in eating disorders: a research and conceptual update. Curr Psychiatry Rep. 2018;20:80.
Mehta T, Smith DL, Muhammad J, et al. Impact of weight cycling on risk of morbidity and mortality: weight cycling and mortality risk. Obes Rev. 2014;15:870–81.
Strohacker K, McFarlin BK. Influence of obesity, physical inactivity, and weight cycling on chronic inflammation. Front Biosci Elite Ed. 2010;2:98–104.
Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82:222S–225S.
Carter G, Milner A, McGill K, et al. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br J Psychiatry J Ment Sci. 2017;210:387–95.
Huang X, Funsch KM, Park EC, et al. Anticipated consequences as the primary causes of suicidal behavior: evidence from a laboratory study. Behav Res Ther. 2020;134:103726.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors have no relevant financial or nonfinancial interests to disclose.
Human and Animal Rights and Informed Consent
Not applicable; data were drawn from previously published studies in which informed consent was obtained by investigators.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Psychological Issues
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Harris, L.M., Broshek, C.E. & Ribeiro, J.D. Does Body Mass Index Confer Risk for Future Suicidal Thoughts and Behaviors? A Meta-analysis of Longitudinal Studies. Curr Obes Rep 11, 45–54 (2022). https://doi.org/10.1007/s13679-022-00468-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13679-022-00468-y