Cohort studyindependent cross-checkabstract checked I-BAR-129 standard review

US veterans: suicidal thoughts and attempts after surgery

Bariatric Surgery and Suicide Risk in Patients With Obesity.

Overview

Hung et al.. Ann Surg 2023 · PMID 36805965 · DOI 10.1097/SLA.0000000000005825

Suicide attempts were about 60% more frequent after bypass or sleeve than in similar veterans without surgery.

Does the study support the specific claim? Yes · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Suicidality after RYGB/SG
How was the study done?: Matched cohort
How many people, animals or samples were studied?: ~38,000
What was actually found?: Ideation aHR 1.21; attempts aHR 1.62
How large was the observed effect?: aHR 1.62
What do the results mean in everyday life?: Screen mental health after surgery
What are the study's limitations?: Mostly men
What does it say about Elawady's specific claim?: Supports the claim
Do the results apply to Germany and Europe?: Moderate
What can explicitly not be concluded from this study?: Causation

Authors: Hung et al.
Journal: Ann Surg
Year: 2023
Identifier: PMID 36805965 DOI 10.1097/SLA.0000000000005825
Verification: verified – PubMed efetch 2026-10-26 + Crossref API
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: COI statement (PubMed record): M.L.M. reports research grants for the National Institutes of Health (NIH) and Veterans Affairs Health Services Research and Development Service outside of the submitted work, and ownership of Amgen stock due to his spouse’s employment. D.E.A. reports research grants from NIH and PCORI outside of the submitted work. The disclosure list was shortened here; the complete statement is in the original publication.

Are 5-year rates of suicidal ideation and attempts higher after RYGB or sleeve than in matched nonsurgical controls?

Study design: Cohort study – Retrospective matched cohort (US Veterans Affairs), sequential stratification
Population: Veterans with severe obesity (78.7% men)
Country: USA
Period: FY2000-2016
Sample size: 38,199 (ideation cohort); 38,661 (attempt cohort)
Inclusion and exclusion criteria: Excluded past-year outcome events

Results: Suicidal ideation aHR 1.21 (1.03-1.41); suicide attempt aHR 1.62 (1.22-2.15). Over 40% treated for depression at baseline.
Absolute risks: not reported in abstract
Authors' conclusion: Bariatric surgery appears associated with greater risk of suicidal ideation and attempts; careful monitoring and psychological support needed.

Moderate relative increases.

Extends the suicide-risk finding to a cohort that includes sleeve gastrectomy.

US veterans.

Supports C-BAR-07.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	replicated
Consistency with the overall evidence	consistent
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	not applicable

Sleeve vs bypass difference.