Body mass index and attempted suicide: Cohort study of 1,133,019 Swedish men

Abstract

Associations between body mass index (BMI) and attempted (nonfatal) suicide have recently been reported. However, the few existing studies are relatively small in scale, the majority cross-sectional, and results contradictory. The authors have explored BMI-attempted suicide associations in a large cohort of 1,133,019 Swedish men born between 1950 and 1976, with BMI measured in early adulthood. During a mean follow-up of 23.9 years, a total of 18,277 (1.6%) men had at least 1 hospital admission for attempted suicide. After adjustment for confounding factors, there was a stepwise, linear decrease in attempted suicide with increasing BMI across the full BMI range (per standard deviation increase in BMI, hazard ratio = 0.93, 95% confidence interval: 0.91, 0.94). Analyses excluding men with depression at baseline were essentially identical to those based on the complete cohort. In men free from depression at baseline, controlling for subsequent depression slightly attenuated the raised risk of attempted suicide, particularly in lower weight men. This study suggests that lower weight men have an increased risk of attempted suicide and that associations may extend into the "normal" BMI range.

Figure 1.

Hazard ratio and 95% confidence interval for the relation of baseline body mass index with future attempted suicide in 1,133,019 men with complete data (A) and in 1,098,700 men with complete data, free from depression at conscription, and additionally adjusted for depression during follow-up (B), for Swedish men born between 1950 and 1976. All hazard ratios are adjusted for age, conscription center, year of birth, childhood socioeconomic status, adult socioeconomic status, and educational attainment.