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Body Mass Index and Risk of Suicide Among One Million US Adults

Mukamal, Kenneth J.a; Rimm, Eric B.b,c,d; Kawachi, Ichirod,e; O'Reilly, Eilis J.b; Calle, Eugenia E.f†; Miller, Matthewg

doi: 10.1097/EDE.0b013e3181c1fa2d
Mental Illness: Brief Report

Background: Body mass index (BMI) has been linked with both increased and decreased risk of suicide attempts and deaths.

Methods: In a prospective cohort study of 1.1 million adults, participants reported their anthropometric and other characteristics in 1982. Participants were followed for cause-specific mortality through 2004.

Results: A total of 2231 participants died of suicide during 21.6 million person-years of follow-up. Compared with a BMI of 18.5–22.9 kg/m2, adjusted hazard ratios for completed suicide were 0.99 (95% confidence interval = 0.72–1.37), 0.78 (0.69–0.88), 0.73 (0.65–0.82), 0.72 (0.62–0.83), 0.77 (0.65–0.92), and 0.55 (0.36–0.83) for BMI values <18.5, 23.0–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, and ≥35.0 kg/m2, respectively. The relationship was consistent among men and women and across geographic regions, but was limited to married individuals (test for interaction, P = 0.009).

Conclusions: The risk of death from suicide is inversely related to BMI in middle-aged and older adults.

Author Information

From the aDivision of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA; Departments of bNutrition and cEpidemiology, Harvard School of Public Heath, Boston, MA; dChanning Laboratory, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; and eDepartment of Society, Human Development, and Health, Harvard School of Public Heath, Boston, MA; fAmerican Cancer Society, Atlanta, GA; and gDepartment of Health Policy and Management, Harvard School of Public Health, Boston, MA.

Submitted 30 January 2009; accepted 7 May 2009; posted 10 November 2009.

Supported by American Cancer Society.


Correspondence: Kenneth J. Mukamal, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 1309 Beacon St, 2nd Floor, Brookline, MA 02446. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.