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Obesity and Suicidality in Youth

Regular readers of these pages will recall previous posts highlighting the importance of mental health problems as promoters of and barriers to weight management.

A paper by Lisa van Wijnen and colleagues from the National Institute for Public Health and Environment in Bilthoven, The Netherlands, published in the latest issue of OBESITY, examines the relationship between weight status, psychological health, suicidal thoughts and suicide attempts in Dutch adolescents.

Data were analysed from the 2003 E-MOVO project, a population-based study of 21,730 adolescents who responded to a classroom-based internet questionnaire.

Obese boys were around 5-times and obese girls were about 3-times more likely to be “psychologically unhealthy” compared to normal weight subjects.

Obese boys and girls were 3 to 4 times more likely to report suicidal thoughts in the past 12 months and 4 to 7 times more likely to report lifetime suicide attempts.

As the authors point out, this remarkable relationship between obesity in adolescents and psychopathology, including suicidality, serves to remind us that prevention and treatment of obesity should not focus solely on the medical complications of this disorder but also on the psychological consequences of excess weight.

Edmonton, Alberta

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van Wijnen LG, Boluijt PR, Hoeven-Mulder HB, Bemelmans WJ, & Wendel-Vos GC (2010). Weight status, psychological health, suicidal thoughts, and suicide attempts in Dutch adolescents: results from the 2003 E-MOVO project. Obesity (Silver Spring, Md.), 18 (5), 1059-61 PMID: 19834472


  1. Dear Dr. Sharma,
    I respectfully submit these thoughts:
    I wonder about this phrase “the psychological consequences of excess weight” — to what extent is the suicidality a result of stigma and bullying? That is, are the mental health issues connected directly to the obesity, and/or to the way obesity is perceived and obese people (especially adolescents and children) are treated
    Given that some amount of obesity exists within a healthy population — it would make sense to address bias and stigma just as we attempt to do with other minorities in a healthy population.
    Is there an assumption that ALL obesity is preventable?
    As a girl and teen, I was convinced that I would have no future as a fat adult, I would not have friends or find love or be healthy, and this is what I was being told at every turn. Feeling suicidal was an understandable response.
    I was also told that if I was a fat child or teen, I would grow up to be a fat adult, and that was not something I should want to be. The reality? I’m now a fat adult — a highly social, productive, healthy, strong, loving and loved, contributing and valued member of my family and community, and a great mom myself.

    I am interested in heading off health problems for children, but telling them that being fat is entirely preventable, and will cause them to have no future happiness isn’t the way to go. (I know you aren’t doing this, but this is how what adults say is often heard by children — those who are fat and those who bully and those who internalize fat hatred and live in fear of becoming fat).

    I think a holistic message that lets children and teens know that they can’t control their genetic inheritance, but they can engage in healthy behaviors and avoid unhealthy ones, and that regardless of size or appearance, they are valued and loved and expected to be great members of their families and communities is a direction I would like to see pursued when it comes to promoting the best mental and physical health for children of all weights and sizes.

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  2. I quite agree with AcceptanceWoman. Another point, though, is that I think that as usual, confusion between correlation and causation is a problem. In many cases, mental illness causes the obesity. Correlation studies are worse than misleading; people draw unwarranted conclusions based on their biases, often totally opposing conclusions.

    Let’s look for and actually run longitudinal studies that actually identify mental illness in very young children and see if weight issues result. This would include excessive thinness, obsession, anorexia, having to eat only self-defined “healthy” foods and having contempt for those who eat “unhealthy” foods, etc.

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  3. I agree with acceptancewoman desire to be accepted but disagree with societies acceptance of obesity. I was once very obese and discovered a method of weight management that brought me self efficacy, strength and a new lease on life. Weight is not the right approach to health as it lamely exhibits an external factor and until weight becomes a thing of the past we will all suffer to define ourselves.

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