Association Between Weight Control Failure and Suicidal Ideation in Overweight and Obese Adults

A Cross-sectional Study

Yeong Jun Ju; Kyu-Tae Han; Tae-Hoon Lee; Woorim Kim; Jeong Hun Park; Eun-Cheol Park


BMC Public Health. 2016;16(259) 

In This Article


Suicide is becoming a public health issue in many countries, and even more so in Korea.[1] South Korea's suicide rate has been the highest among OECD countries for over a decade. In 2013, the rate of death by intentional self-harm in South Korea was 29.1/100,000 individuals, which was followed by the rates in Japan, Hungary, and Slovenia at nearly 20/100,000 individuals; the OECD average rate was 12/100,000 individuals.[2] Meanwhile, one previous study reported that suicidal ideation is the main thought process leading to suicide.[3] Those who do not envision suicide rarely attempt suicide, whereas 34–42 % of individuals who imagine committing suicide subsequently attempt it.[4] Hence, it is necessary to approach suicide prevention in terms of prevention and identification of the factors that influence suicidal ideation.

Previous studies to clarify the factors affecting suicidal ideation have generally considered relevant health behaviors (drinking, socioeconomic conditions, internet addiction) and mental health conditions (depression, mood disorders, anxiety).[5–7] However, there remain many issues and debates related to mental health, and suicidal problems in particular, in South Korea. Therefore, we determined it necessary to address suicidal problems from another perspective. In particular, we focused on suicidal problems related to weight control issues in the overweight and obese population of South Korea. However, few studies have examined how weight status impacts suicidal ideation.

Weight status has been classified as underweight, normal weight, overweight or obese. According to a previous study, weight status was associated with major depression, suicide attempts, and suicidal ideation.[3] Obesity is an especially important factor affecting mental health;[8,9] obese populations have a higher rate of depression and suicidal ideation than that of the normal weight population.[10] In addition, obesity has been associated with increased morbidity and mortality risks.[11,12] For that reason, many obese individuals attempt to lose weight, and weight reduction is an important aspect of obesity treatment.[13] As a result, weight control is an important issue for the obese population. Given the relationship between obesity and mental health, a study on whether weight control influences suicidal ideation is needed.

Of course, previous studies on suicidal ideation related to weight control exist. However, those studies only focused on adolescents,[14–16] while the present study focuses on middle-aged adults. The study was limited to middle-age subjects (40 years or older), because the incidence of many health problems tends to increase during this period.[17] Also, weight status and mental health problems may be different in middle-aged and older adults compared with younger adults, because functional limitations and medical comorbidities related to aging may lead to weight change and mood changes.[18] Especially, women usually experienced the menopause in middle-age, which may leads to health risks such as weight gain.[19,20] We analyzed the effects of weight control failure on suicidal ideation in the overweight and obese populations and examined the relationship between weigh control failure and suicidal ideation according to income level, household composition, and menopause status.