Disclosures: The authors have no competing interests.
Associations between body mass index and suicide in the veterans affairs health system
Version of Record online: 13 JUN 2013
Copyright © 2013 The Obesity Society
Volume 22, Issue 1, pages 269–276, January 2014
How to Cite
McCarthy, J. F., Ilgen, M. A., Austin, K., Blow, F. C. and Katz, I. R. (2014), Associations between body mass index and suicide in the veterans affairs health system. Obesity, 22: 269–276. doi: 10.1002/oby.20422
Author Contributions: All authors contributed to the conception and design of the study. Dr. McCarthy drafted the manuscript. All authors reviewed and provided critical input and approved the final manuscript. Ms. Austin conducted study data management and analyses.
This article is a US government work and, as such, is in the public domain in the United States of America.
- Issue online: 11 JAN 2014
- Version of Record online: 13 JUN 2013
- Accepted manuscript online: 20 MAR 2013 02:38AM EST
- Manuscript Accepted: 5 FEB 2013
- Manuscript Received: 8 DEC 2012
Associations between BMI and suicide risks and methods for individuals receiving care in the Veterans Health Administration (VHA) health system were evaluated.
Design and Methods
For 4,005,640 patients in fiscal years 2001-2002, multivariable survival analyses assessed associations between BMI and suicide, through FY2009. Covariates included demographics, psychiatric, and nonpsychiatric diagnoses, receipt of VHA mental health encounters, and regional network. Among suicide decedents, multivariable Generalized Estimating Equations (GEE) regression examined associations between BMI and suicide method.
1.3% of patients were underweight, 24.3% normal weight, 40.6% overweight, and 33.8% obese. Underweight was associated with increased suicide risk (adjusted hazard ratio [AHR] = 1.17, 95% CI: 1.01, 1.36) compared to normal. Overweight and obese status were associated with lower risk (AHR = 0.78, 95% CI: 0.74, 0.82; AHR = 0.63, 95% CI: 0.60, 0.66, respectively). Among suicide decedents, high lethality methods were most common among underweight and least common among obese individuals. Adjusting for covariates, BMI was not associated with method lethality, yet some associations were observed between BMI and specific methods.
Among VHA patients, BMI was negatively associated with suicide risks. These differences may partly relate to choice of suicide method. Low BMI offers an additional resource for clinical suicide risk assessments.