Self-Harm Before and Six Months After Obesity Surgery

Obes Surg. 2024 Oct;34(10):3579-3591. doi: 10.1007/s11695-024-07439-3. Epub 2024 Aug 13.

Abstract

Purpose: Previous research on obesity surgery (OS) showed that patients do not only experience weight loss but also improvements in certain mental health outcomes (e.g., depression) after OS. However, self-harm behaviors might increase after OS. Regarding self-harm, the literature is mostly limited to studies using data from hospital or emergency room charts. This longitudinal study examined self-reported self-harm behaviors and potential psychopathological correlates before and after OS.

Materials and methods: Pre-surgery patients (N = 220) filled out a set of questionnaires before and approximately six months after OS. Self-harm behaviors were captured with the Self-Harm Inventory. The assessments further included standardized instruments to measure symptoms of depression, anxiety, eating disorders, alcohol use, and suicidal ideations.

Results: Any self-harm was reported by 24.6% before and by 25.0% after OS. No differences in the number of self-harm behaviors or prevalence of any self-harm before and after OS were found. Overall, 11.4% experienced self-harm behaviors at both times. A subset showed self-harm behaviors only before (13.2%) OS and another subset only after OS (13.6%). These two groups were about the same size. Self-harm behaviors showed strong associations with psychopathology after OS, especially with depression and suicidal ideation.

Conclusion: No increase in self-harm behaviors after OS emerged. Still, a subgroup showed self-harm behaviors after OS closely linked to further psychopathology. This mirrors the need to implement screening for self-harm before and after OS into OS care. Further studies with longer follow up periods are needed to extend these findings.

Keywords: Alcohol use; Anxiety; Depression; Eating pathology; Obesity surgery; Self-harm.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Bariatric Surgery* / psychology
  • Depression* / epidemiology
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity, Morbid* / psychology
  • Obesity, Morbid* / surgery
  • Prevalence
  • Self-Injurious Behavior* / epidemiology
  • Self-Injurious Behavior* / psychology
  • Suicidal Ideation*
  • Surveys and Questionnaires
  • Weight Loss