with a popular weight loss operation: Suicide in bariatric surgery. Bariatric surgery is a complex surgical procedure

concerned with causes, prevention and treatment of severe overweight known as obesity. Bariatric operations are major

gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system. In simple terms, the

stomach is made smaller so as to speed up weight loss. Some bariatric procedures are performed using general anesthesia via a

midline abdominal incision. Another method is to use laparoscopic surgical techniques, involving smaller instruments

connected to cameras through which they view the operational site.
There are two types of bariatric surgeries:

1.Restrictive - This type of surgical procedure simply reduces the size of the stomach, using staples and/or a band,

resulting in a drastic reduction in the quantity of food it can ingest.
2.Combined Restrictive and Malabsorptive ? This type of surgical procedure reduces stomach capacity and bypassing the upper

part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs.

In bariatric surgery, most studies show that the risk of dying is about 1%, and complications strike up to 40 % of obese

patients. Aside from being overweight, these patients usually have health problems, such as diabetes and heart disease,

that's why it's no wonder they also have higher death rates from natural causes.

However, nearly 17,000 weight-loss surgeries performed in Pennsylvania from 1995 to 2004 had been reviewed and the findings

were startling. Out of the 440 deaths in the group, 16 were due to suicide or drug overdose, according to the University of

Pittsburgh researchers who reviewed the data. About three cases of suicides should have occurred in the group based on the

suicide rate in the general population, the study authors say. Even more disturbing is the fact that another 14 of the drug

overdose cases that were reported are likely to include some suicides, suggesting that the real suicide rate was even higher.

?There is a substantial excess of suicide deaths, even excluding those listed only as drug overdose,'? the researchers noted.
The New England Journal of Medicine reported last August 2007 about a review of nearly 10,000 bariatric surgery patients by

Utah researchers, who compared them to a control group of obese people who had applied for a state driver's license. Although

these surgery patients had a 50% lower risk of dying from disease compared to obese people who hadn't undergone surgery,

their risk of dying in an accident or suicide was 11.1 per 10,000 people. That statistics is 58% higher than the 6.4 per

10,000 rate in the obese group. The study revealed that the suicide risk was twice as high for surgery patients than for

those who had not had surgery, though the finding wasn't statistically meaningful.

Experts are clueless as to why bariatric surgery patients seem to be at higher risk for killing themselves. Some research

suggests a connection between obesity and depression, that is why the typical surgery patient may already be at higher risk

for depression and suicide even before the operation. There is a great possibility that depressive symptoms may worsen in

patients who have unrealistic expectations about the results of surgery, or who struggle not to regain weight after the

procedure.

The Pennsylvania case review reveals that there is already a 7 percent death rate from suicide and drug overdose signals the

need for better mental health follow-up for patients who have undergone weight-loss surgery. Although many weight-loss

surgery programs require psychological evaluation prior to the procedure, most doctors seem lenient about making follow-ups

after the surgery, as well as patients who prefer to disregard follow-up counseling.