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

Disclosures

BMC Public Health. 2016;16(259) 

In This Article

Results

In our study, a total of 6621 participants were included to assess the association between weight control failure and suicidal ideation (overweight: 2439; obese: 4182). Table 1 and Table 2 show the characteristics of the study population by sex. Among the obese population, suicidal ideation was higher in females than males. Suicidal ideation was noted in 195 (9.4 %) males and 432 (20.6 %) females. Similar trends were demonstrated in the overweight population (10.0 % in males, 17.5 % in females). Weight control failure was more frequent in the obese group. Among the obese, weight control failure was higher in females than males (16.3 % in males, 29.6 % in females). Among the overweight, 9.1 % of males versus 23.4 % of females reported that they experienced weight control failure. Notably, subjects in both the obese and overweight populations who experienced weight control failure were more likely to report suicidal thoughts. Regarding subjective body perception, among overweight males, 379 (34.0 %) reported being fat, whereas obese males reported being fat (n = 1656; 79.6 %). Conversely, most females responded as being fat weight regardless of weight status (64.7 % in overweight, 88.9 % in obese).

Table 3 shows the results of the logistic regression analysis for the association between weight control failure and suicidal ideation after multivariable adjustment. Weight control failure was significantly associated with suicidal ideation in the obese females. Among obese females, those with weight control failure were at 1.70-fold higher risk of suicidal ideation compared with those with weight control success or maintenance (OR = 1.70, 95 % CI 1.21–2.39), but this association was not significant in males of the obese or overweight group. In addition, among obese females, those with a low-income status were at a 2.11-fold higher risk of suicidal ideation compared with those with a mid- to high-income status (OR = 2.12, 95 % CI 1.35–3.32); similar trends were evident in obese males (OR = 1.79, 95 % CI 1.02–3.14). Obese females at menopause were at a 1.65-fold higher risk of suicidal ideation compared with obese females who had not yet reached menopause (OR = 1.65, 95 % CI 1.02–2.65), whereas this association was not significant in overweight females. Stress awareness and depression mood were associated with suicidal ideation among all participants. The Hosmer-Lemeshow test was non-significant (P = 0.4263 in overweight male group, P = 0.3487 in overweight female group, P = 0.3573 obese male group and P = 0.4730 in obese female group) indicating adequate goodness-of-fit. In addition, All VIFs are below 2, indicating a lack of multicollinearity. The maximum VIF identified in our models was 1.83 (for obese male – age group).

The subgroup analysis results are shown in Table 4. Subgroup analysis showed significant differences in each group, even though modifying effects were not significant in the tests for interaction. Among obese males and females, those who had experienced weight control failure showed a trend towards a greater magnitude of suicidal ideation if they were of low, but not high, income status. Among obese females, there was a trend towards a greater magnitude of suicidal ideation if they lived on their own or in a two-generation household, but not if they lived with more family members. Among obese females experiencing menopause, those who had experienced weight control failure showed a trend towards a greater magnitude of suicidal ideation.

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