Self-Starvation May Predict Suicide Attempt

Suicide prevention requires picking up on the early warning signs

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) People who starve themselves due to an imagined body flaw are likely to view suicide as less painful than the pain they already experience.

Early treatment from properly trained professions may help.

A new study reveals the reasoning behind suicide attempts by people with food-restrictive body dysmorphic disorder. In-depth suicide screenings may help identify those at high risk.

"See a therapist immediately if you are self-starving!"

Tracy K. Witte, PhD, from Auburn University, Elizabeth R. Didie, PhD, from the department of psychiatry at Rhode Island Hospital and Katherine A. Phillips, MD, director of the Body Dysmorphic Disorder Program at Rhode Island Hospital, teamed up to understand the relationship between physically painful BDD and suicide attempts.

Body dysmorphic disorder (BDD) is classified as a chronic mental illness where a person cannot stop thinking about a—real or imagined—flaw in their physical appearance. People with BDD are constantly occupied by this ‘flaw’ throughout their waking hours to the point of obsession.

This obsession can be debilitating and make living a normal life impossible.

Suicide attempts are relatively common in people with BDD. About 25 percent have actually tried and 75 percent have considered it. Physically painful BDD could mean: starvation, over-exercise, BDD-related cosmetic surgery, self-mutilation and compulsive skin picking.

Researchers interviewed 200 people with BDD aged 14-64 that had attempted suicide anywhere up to 25 times. Seventy-eight percent of those in the group had thought about suicide.

Results revealed that the group of people who restricted their food intake due to their BDD had nearly double the suicide attempts of any other BDD group. An important finding in the study is that the suicide attempts were unrelated to suicidal thoughts and fantasies.

On the flip side, the group that over-exercised had half the suicide attempts.

Dr. Phillips proposes,” Significantly limiting food intake can be physically painful. It goes against our natural instincts to feed our bodies and respond to the physical pain that comes with extreme hunger. The results of this study suggest the importance of assessing individuals with BDD for restrictive eating behaviors to identify suicide risk, even if they have not previously been diagnosed with an eating disorder.”

This suggests that those with BDD that are capable with tolerating the pain associated with starving themselves are unlikely to be afraid of the pain of suicide and may consider it a relief instead.

Didie reasons, “While some of the other BDD-related behaviors may seem outwardly more painful—such as undergoing repeated cosmetic procedures, or compulsive skin picking, the level of pain associated with excessive dieting could significantly increase a person’s pain tolerance. This study suggests that those who are capable of enduring such physical discomfort and pain from restrictive eating also may be capable of enduring the physical discomfort required to inflict self harm.”

This study was published in the journal Suicide and Life-Threatening Behavior, June 2012. Funding for this study was provided grants from the National Institutes of Health, Rhode Island Hospital and the Lifespan health system; no conflicts of interest were found.

Reviewed by: 
Review Date: 
June 15, 2012
Last Updated:
October 25, 2012