The Relationship Between Body Mass Index and Suicide by Hanging: A Retrospective Forensic Assessment Based on Autopsies in Türkiye

This retrospective forensic autopsy study investigated the association between body mass index (BMI) and suicide by hanging in Türkiye. Autopsy records from 15,014 cases examined between 2019 and 2021 were reviewed, and 994 confirmed hanging deaths with reliable anthropometric measurements were included. BMI values were calculated using autopsy-derived height and weight measurements and classified according to World Health Organization criteria. The distribution of BMI categories among hanging cases was compared with age- and sex-matched national population data. The majority of cases were male (79%), with a mean age of 41.6±15.8 years. Normal and overweight BMI categories predominated, whereas obesity was significantly underrepresented compared with the general population. Statistical analyses demonstrated a progressive decrease in the likelihood of suicide by hanging with increasing BMI in both sexes. In men, hanging was significantly more frequent in low and normal BMI categories, while obesity was associated with a reduced risk. In women, a significant association was observed only in the normal BMI group. These findings indicate that BMI may influence suicide method selection and should be considered in forensic and public health evaluations of suicidal behavior.