Suicidal Behavior in Adolescents: Relationship to Weight Status, Weight Control Behaviors, and Body Dissatisfaction

Objective: Suicide is associated with full syndromal eating disorders, but it is unclear whether subsyndromal eating disorders carry the same risk. This study examined associations between suicidal behaviors and extreme and less extreme weight control behaviors (EWCB and LWCB, such as fasting, vomiting, meal skipping, etc.), body dissatisfaction, and weight status in adolescents.

Method: Data on body dissatisfaction, depressive symptoms, suicidal ideation and attempts, and body mass index (BMI) were drawn from Project EAT, a survey of 4,746 7th-12th grade students. Multivariate logistic regression examined associations between eating- and weight-related variables and suicidality.

Results: Suicidal ideation and suicide attempts were more commonly observed in adolescents with EWCB (boys: ideation OR = 2.12, attempts OR = 4.10; girls: ideation OR = 1.66, attempts OR = 2.29), LWCB (boys: ideation OR = 1.33, attempts OR = 1.76; girls: ideation OR = 1.77, attempts OR = 1.80), as well as body dissatisfaction (boys: ideation OR = 1.75, attempts OR = 2.23; girls: ideation OR = 1.77, attempts OR = 1.81), even after controlling for depressive symptoms. No association was observed between BMI and suicidal attempts or ideation.

Conclusion: Thus, it appears that suicidal behavior in adolescents is associated even with low-level eating disorder symptoms.