I have been following the news of the death of Polly Williams. Polly was one of the four women featured in Lauren Greenfield’s Emmy-nominated documentary Thin. The film documents the experiences of young women at the Renfrew Center, a residential facility for the treatment of eating disorders.
Here's an update on Polly's death:
There has been much speculation on how Polly died, with many people naturally attributing it as the result of her eating disorder. Now her family has spoken out in a news brief reprinted in the Indy Star.
Williams died from an overdose of sleeping pills, a suicide that was “a direct result of her internal battle with the eating disorder,” said her sister, Bebe W. Reed. “She said she could not fight the fight any longer.”
Doing just a quick search of the internet, shows there is a correlation between ED and suicide. Granted it is kind of a case of the chicken or the egg, but it is still linked:
A study reported in the Journal of Eating Disorders in March 2004 indicates that women with eating disorders (like anorexia, bulimia, or overeating) who attempted suicide usually were suffering from depression before the onset of their eating disorder.
67% of the patients with an eating disorder and a history of suicide attempts suffered from depression before the onset of the eating disorder, and only 3% of the patients with an eating disorder and no history of suicide attempts suffered from depression before the onset of the eating disorder.
The study thus indicates that the eating disorder may be secondary to depressive illness for those who have been or are suicidal.
Some past research, which did not include suicidal individuals, has indicated the opposite -- depression occurred as a consequence of the eating order. And this still is probably the case for non-suicidal patients.
Additionally, women in the suicidal group had a higher rate of anxiety disorders.
Women with eating disorders and a history of depression are at a high risk for suicide and need to be closely monitored.
You are probably asking yourself what that has to do with WLS.
One, I already believe strongly that most WLSers have a history of ED. Whether it is pre or post op is anyones guess.
Two, in an earlier post on mental health and WLS, I reported that mental illness is present in many of those seeking WLS:
Overall, 66.3% of subjects had a lifetime history of at least one axis I disorder and 37.8% were currently diagnosed with such a disorder. The most common lifetime axis I disorder was major depressive disorder, seen in 42% of subjects. Binge eating disorder was the most common current disorder and had a prevalence of 16.0%.In a second post on mental health and WLS, I reported that a recent study shows 1 in 5 potential surgery candidates fail to meet psych eval pre-op guidelines:
A lifetime history of an axis II disorder was noted in 28.5% of subjects, the most common being avoidant personality disorder, which was seen in 17.0%.
The most common reasons people were not allowed to go through with the procedure included overeating to cope with stress or emotional distress, having an eating disorder, and uncontrolled mental problems, such as depression.
Most patients who were deferred from bariatric surgery after their initial psychological evaluation were referred for psychiatric treatment. The researchers write that they will conduct a future study to look at how many of these patients accepted psychiatric referral and went on to have the surgery.
"The goal of the psychiatric evaluation is not to keep patients from having the surgery. Rather, the goal is to determine if there are any problems that might interfere with the success of surgery, and have the patient get treatment for these problems," says researcher Mark Zimmerman, MD, of Rhode Island Hospital, in a news release. "In so doing, the patient is more likely to have a positive outcome from surgery that is delayed to allow time to address the problems."
The final reason I feel this is all related has to do with the latest research on actual deaths seen after WLS. Sandy Szwarc, BSN, RN, CCP gave a took an in depth look at the findings.
There was an especially disturbing and unexpected finding in this study. Dr. Kuller and associates found that among the bariatric surgical patients there had been “45 deaths from traumatic causes including 16 deaths (4%) due to suicide and 14 due to drug overdoses (3%) that were not classified as suicide.” To help readers realize how extraordinarily high these suicide death rates were, the authors wrote that according to the U.S. Vital Statistics, there are approximately 7 suicides for white women and 25 for men for every 100,000 people in the population of the same age as these bariatric surgical patients. Translating these figures, the researchers had anticipated an estimated two suicide deaths would have occurred among the women and one suicide among the men during this study.
Instead they saw more than five times the expected numbers of suicides, not even counting the drug overdoses. “There is a substantial excess of suicide deaths, even excluding those listed only as drug overdose,” they wrote. “The large number of deaths due to suicide and drug overdose, in excess of what we expected, is also a cause for concern. Most of them occurred at least one year after surgery.”
Dr Livingston’s review also noted that the frequency of suicide and drug overdoses “was unexpected.” The higher suicide rates were especially significant among those 25 to 34 years of age, with death rates of 13.8 and 5.0 per 1000 persons per year for men and women, respectively, nearly ten times the rates of 1.3 and 0.6 per 1000 persons per year in the general population.
How does it all go together? I really don't know. But it is something to think about.
If you find yourself feeling suicidal or are concerned for a friend, don't hesitate to reach out for help.
Call 1-800-SUICIDE / 1-800-784-2433
Call 1-800-273-TALK / 1-800-273-8255
- Call to speak with someone who cares
- Call if you feel you might be in danger of hurting yourself
- Call to find referrals to mental health services in your area
- Call to speak to a crisis worker about someone you're concerned about
If you feel you may have an eating disorder, seek help in some of these places.