Trends in the relationship between suicide behaviors and obesity among adolescents in the United States from 1999 to 2019

Previous studies indicate that obesity is a risk factor of suicide behaviors among adolescents. Whether this association has remained consistent during the ongoing obesity epidemic remains unknown. The time trends of the obesity–suicide association were examined using the 1999–2019 biannual Youth Risk Behavior Survey data (n = 161,606). Prevalence odds ratio of suicide behaviors among adolescents with obesity (vs. adolescents with no obesity) for each survey year and time trends using National Cancer Institute Joinpoint regression analysis was calculated. For each year post-baseline, there was a significant increase of prevalence odds ratio of 1.4 (1.2–1.6)–1.6 (1.3–2.0) for suicide ideation, 1.3 (1.1–1.7) –1.7 (1.4–2.0) for plan, and 1.3 (1.0–1.7) –1.9 (1.5–2.4) for an attempt, except for the 2013 survey for attempt (1.19 [0.9–1.6]). Significant positive trends were found from1999 to 2019 for ideation and plan, with biannual %-changes of + 0.92 and + 1.22%, respectively. Adolescents with obesity have consistently higher odds of engaging in suicide behaviors than their peers without obesity since the beginning of the United States obesity epidemic, and this association grew stronger as the obesity epidemic continued.