Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults

남가은,박혜순 대한비만학회 2018 The Korean journal of obesity Vol.27 No.3

Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m2 and 23 kg/m2 as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m2 and 23 kg/m2, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m2 and 25 kg/m2, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.

Obesity, Body Image, Depression, and Weight-control Behaviour Among Female University Students in Korea

Eun Mi Jun,최승배 대한암예방학회 2014 Journal of cancer prevention Vol.19 No.3

Background: Obesity has become epidemic worldwide and 31.0% of Korean adults are obese. Obesity is the main cause of chronic diseases, such as diabetes, hypertension, cardiac disease, and cancer. The purpose of the study was to examine obesity, body image, depression, and weight-control behaviour among Korean female university students and investigate the differences in body image, depression, and weight-control behaviour with respect to obesity. Methods: This study examined obesity, body image, depression, and weight control in 700 female university students from 4 universities in South Korea. To evaluate obesity, both objective obesity (body mass index [BMI]) and subjective obesity (subjectively perceived) were measured. Results: There was a significant difference between objective and subjective obesity (χ2 = 231.280, P < 0.001). In addition, the objective obesity group had the lowest body image score (F = 19.867, P < 0.001) and difference in weight-control behaviour (F = 3.145, P = 0.045). Further, the subjective obesity group had the lowest body image score (F = 58.281, P < 0.001). The results revealed a statistically significant difference in body image and weight-control behaviour with respect to objective obesity. Conclusion: Objective and subjective obesity was negatively associated with body image, and no relationships between objective or subjective obesity and depression.

Association between Sarcopenic Obesity Status and Nonalcoholic Fatty Liver Disease and Fibrosis

Song Wolhwa,Yoo Sung Hwan,Jang Jinsun,Baik Su Jung,Lee Byoung Kwon,Lee Hyun Woong,Park Jong Suk 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.1

Background/Aims: There are no data regarding the association between sarcopenic obesity status and nonalcoholic fatty liver disease (NAFLD) and NAFLD-associated liver fibrosis. Therefore, we aimed to investigate the relationship between sarcopenic obesity status (sarcopenia only, obesity only, and sarcopenic obesity) and NAFLD and liver fibrosis in Korean adults. Methods: In total, 2,191 subjects completed a health checkup program, including abdominal ultrasonography and FibroScan. Subjects were classified into the following four categories: optimal body composition (nonobese and nonsarcopenic), sarcopenia only (nonobese), obesity only (nonsarcopenic), and sarcopenic obesity. Sarcopenic obesity was stratified by the skeletal muscle mass index and body fat using bioelectrical impedance analysis. NAFLD was diagnosed by ultrasonography, and liver fibrosis was assessed using transient elastography in subjects with NAFLD. Results: The prevalence of NAFLD and liver fibrosis significantly increased according to the sarcopenic obesity status. In the logistic regression analysis, after adjusting for multiple risk factors, the odds ratio (OR) for the risk of NAFLD was largest in the sarcopenic obesity group (OR, 3.68; 95% confidence interval [CI], 2.94 to 4.60), followed by the obesity only (OR, 2.25; 95% CI, 1.67 to 3.03) and sarcopenia only (OR, 1.92; 95% CI, 1.30 to 2.84) groups, when compared with the optimal group. Additionally, liver fibrosis was independently associated with sarcopenic obesity status (OR 4.69, 95% CI 1.95 to 11.29; OR 4.17, 95% CI 1.56 to 11.17; OR 3.80, 95% CI 0.86 to 16.75, respectively). Conclusions: These results demonstrated that sarcopenic obesity was independently associated with NAFLD and liver fibrosis and increased the risk of NAFLD and liver fibrosis more than obesity or sarcopenia alone.

한국인 성인 비만의 사회경제적 비용

문옥륜,김남순,강재헌,윤태호,이상이,이신재,정백근,Moon, Ok-Ryun,Kim, Nam-Soon,Kang, Jae-Heon,Yoon, Tae-Ho,Lee, Sang-Yi,Lee, Sin-Jae,Jeong, Baek-Geun 대한예방의학회 2002 예방의학회지 Vol.35 No.1

Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

고등학생에서 체질량지수에 따른 비만에 대한 인식과 생활습관의 차이에 관한 조사

김미정,최광해,이경수 대한소아과학회 2002 小兒科 Vol.45 No.12

Associations among the Degree of Nonalcoholic Fatty Liver Disease, Metabolic Syndrome, Degree of Obesity in Children, and Parental Obesity

Min-Su Oh,Sorina Kim,Joon-Hyuck Jang,Jong Yoon Park,Hyun-Sik Kang,Mu Sook Lee,Ki Soo Kang 대한소아소화기영양학회 2016 Pediatric gastroenterology, hepatology & nutrition Vol.19 No.3

Purpose: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultra-sonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. Methods: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe. Results: Of 132 patients evaluated for the degree of NAFLD and metabolic syndrome, the p-value of correlation between the two factors was 0.009. Therefore, metabolic syndrome might significantly affect the degree of NAFLD. Of 158 patients evaluated for the degree of NAFLD and the degree of obesity, the p-value of correlation between the two factors was 0.122. Of 154 patients evaluated for the degree of obesity and father’s obesity, the p-value was 0.076. Of 159 patients evaluated for the degree of obesity and mother’s obesity, the p-value was 0.000, indicating that mother’s obesity could significantly affect the degree of obesity in children. Of 142 patients evaluated for the degree of obesity and metabolic syndrome, the p-value was 0.288. Conclusion: Metabolic syndrome might significantly affect the degree of nonalcoholic fatty liver in children. In addition, mother’s obesity might be a significant factor that affects the degree of obesity in children.

여고생들의 비만도 및 비만과 관련된 사회심리적 요인 분석

김경원,김영아,김정희 대한지역사회영양학회 1997 대한지역사회영양학회지 Vol.2 No.4

The purpose of this study was to investigate the dietary intake, obesity index and psychosocial factors influencing obesity among 200 high school girls in Seoul. The Social Cognitive Theory provided the Conceptual basis for this study. A cross-sectional survey was conducted to examine factors related to obesity, including self-efficacy for controlling overeating, social support for eating behavior, perception of body image and weight control, nutrition knowledge, and attitudes toward obesity. The data were analyzed using t-test and multiple logistic regression. The results of this study are as follows : 1) The mean age of the girls was 16.4 years, and the rate of overweight and obesity(measured by obesity index) was 27.0$\%$. 2) The mean energy intake of subjects was 1832.3$\pm$384.0kcal. The energy derived from carbohydrates, proteins and fats was 62.7$\%$, 13.8$\%$, and 23.5$\%$, respectively. There was no significant difference between the obese and the comparison group in energy intake. 3) The result of multivariate analysis indicated that obesity had a significant relation to the perception of ideal body image, social support for eating behavior, and self-efficacy for controlling overeating(p〈0.01). As subjects preferred thinner body images(OR=0.39) and received less social support(OR=0.93), the odds of being classified as obese increased. The odds of being obese were also associated with self-efficacy, however, the relation was not strong(OR=1.04). 4) Specific social support was related to obesity among adolescent girls. As subjects received more support from family member, the odds of being obese decreased. The emotional support as well as family member's positive nutrition behavior plays a significant role. In addition, instrumental support from friends was associated with obesity. With repect to self-efficacy, the odds of being obese were increased as subjects felt less confident in controlling overeating when tempting food was placed in front of them or after an argument. In contrast, the obese group felt more confident in controlling overeating for the rest of the specific situations examined. These findings suggest that educational interventions for weight control should incorporate strategies to help participants realize their degree of obesity, to reduce the discrepancy between current and ideal body image, to elicit and maintain social support from friends and family, and to increase the self-efficacy for changing eating behaviors. (Korean J Community Nutrition 2(4) : 496-504, 1997)

Obesity, obesity-related diseases and application of animal model in obesity research An overview

( Byung Sung Park ),( N K Singh ),( Am M T Reza ) 한국유화학회 2013 한국응용과학기술학회지 Vol.30 No.4

The multi-origin of obesity and its associated diseases made it’s a complex area of biomedical science research and severe health disorder. From the 1970s to onwards this health problem turned to an epidemic without having any report of declining yet and it created a red alert to the health sector. Meanwhile, many animal models have been developed to study the lethal effect of obesity. In consequence, many drugs, therapies and strategies have already been adopted based on the findings of those animal models. However, many complicated things based on molecular and generic mechanism has not been clarified to the date. Thus, it is important to develop a need based animal model for the better understanding and strategic planning to eliminate/avoid the obesity disorder. Therefore, the present review would unveil the pros and cons of presently established animal models for obesity research. In addition, it would indicate the required turning direction for further obesity and obesity based disease research.

Exposure and Exercise Training in Hypoxic Conditions as a New Obesity Therapeutic Modality: A Mini Review

Park, Hun-Young,Kim, Jisu,Park, Mi-Young,Chung, Nana,Hwang, Hyejung,Nam, Sang-Seok,Lim, Kiwon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.2

<P>Obesity is an important health problem caused by positive energy balance. Generally, low calorie dietary intake combined with regular exercise is the most common modality to lose bodily fat in obese people. Although this is the first modality of choice for obesity treatment, it needs to be applied to obese patients for at least 12 weeks or more and it does not provide consistent results because it is difficult to suppress increased appetite due to exercise. Recently, many researchers have been applying hypoxic conditions for the treatment of obesity, as many studies show that people residing in high altitudes have a lower percentage of body fat and fewer obesity-related illnesses than people living at sea level. Hypoxic therapy treatment, including hypoxic exposure or hypoxic exercise training, is recommended as a way to treat and prevent obesity by suppression of appetite, increasing basal metabolic rate and fat oxidation, and minimizing side effects. Hypoxic therapy inhibits energy intake and appetite-related hormones, and enhances various cardiovascular and metabolic function parameters. These observations indicate that hypoxic therapy is a new treatment modality for inducing fat reduction and promoting metabolic and cardiovascular health, which may be an important and necessary strategy for the treatment of obesity. As such, hypoxic therapy is now used as a general medical practice for obesity treatment in many developed countries. Therefore, hypoxic therapy could be a new, practical, and useful therapeutic modality for obesity and obesity-related comorbidities.</P>

Evaluation and Treatment of Obesity and Its Comorbidities: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity

김경곤,함지희,김범택,김은미,박정환,이상열,전언주,강은구,남가은,구혜연,임정현,정조은,김종희,김종원,박정하,홍준화,Sang Eok Lee,민세희,김승준,김선영,김양현,이연지,조윤정,이영준,김연희,강지현,이창범,대한비만학회 진료지침위원회 대한비만학회 2023 Journal of obesity & metabolic syndrome Vol.32 No.1

The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.