Definition of Obesity

Why is obesity viewed as a disease?

Excessive adipose tissue goes beyond simple storage and can affect hormones, inflammatory signals, and organ function. Obesity is type 2 diabetesandblood pressure, dyslipidemia, fatty liver, sleep apnea, joint problems, and increases the risk of various other diseases.

The WHO describes obesity as a chronic, relapsing disease resulting from a complex interaction of genetics, neurobiology, eating behaviors, access to healthy food, and market and social environments.

How is it evaluated in Korea?

For adults, BMI a BMI of 25 kg/㎡ or higher is considered obesity and is classified by stage. waist circumferenceAbdominal obesity is defined as a waist circumference of 90 cm or more for men and 85 cm or more for women. Accompanying risks such as blood pressure, fasting blood glucose, HbA1c, blood lipids, and liver enzymes are also checked.

Childhood and Adolescent Obesityuses growth curves and age/gender percentiles. Similarly, adult BMI is not interpreted simply for pregnant women, the elderly, or individuals with high muscle mass.

Why does weight change differently for every person?

Genetics, appetite regulation circuits, sleep, stress, activity environment, and economic accessibility all play a role. Certain medications, endocrine diseases, and mental health issues can also change weight.

While energy balance is the basic principle of weight change, the conditions that create intake and expenditure are complex, so it cannot be attributed solely to individual fault.

What other health issues are evaluated together?

Metabolic syndrome, diabetes, fatty liver, sleep apnea, reproductive health, and joint pain are checked. Depression, anxiety, eating disorders, and the avoidance of medical care due to weight stigma are also important evaluation items.

Not everyone receives the same tests; they are determined based on symptoms and risk factors.

How are management goals set?

Goals include not only the amount of weight loss but also waist circumference, blood pressure, blood glucose, sleep, pain, physical strength, and daily functioning. Diet, activity, and behavioral support are the foundation, and medical treatment is considered as needed.

Rather than a goal of losing a lot of weight quickly, sustainable changes and a long-term plan to respond to weight regain are more important.

When should I seek medical evaluation?

If weight increases or decreases rapidly and is accompanied by edema, shortness of breath, severe fatigue, or changes in menstruation, have the cause evaluated. Accompanying symptoms such as snoring, daytime sleepiness, thirst, polyuria, or discomfort in the upper right abdomen also require checking.

Can the severity of the condition be judged by weight alone?

Even with the same BMI, the health impact varies depending on whether fat is concentrated in the abdomen, the levels of blood pressure, blood glucose, and lipids, and whether there are pain or sleep problems. Conversely, normal test results do not mean there is a complete absence of future risk or current functional decline.

Weight and BMI are used as starting points for screening, and waist circumference, body composition, comorbidities, and daily functioning are evaluated together. It is important not to entrust the entire definition of 'healthy' and 'unhealthy' to a single number.

What conditions affect weight gain?

In addition to food intake and activity, lack of sleep, shift work, stress, depression, life changes such as pregnancy or menopause, pain, and mobility limitations can change weight trends. Certain medications, endocrine diseases, and edema may also be related to weight gain, so the starting point and speed of increase are verified.

The explanation that 'you just need to eat less and move more' cannot distinguish these conditions. It is helpful for evaluation to organize weight changes, lifestyle changes, newly started medications, and symptoms over the last 6 to 12 months in chronological order.

What it means to view obesity as a chronic disease

When weight decreases, energy requirements and appetite signals change, and returning to a previous environment can lead to weight regain. The chronic disease perspective understands this not as an individual failure, but as a biological and environmental process requiring long-term tracking and plan adjustments.

Even after weight loss, it is important to continue recording diet, activity, and sleep, and to undergo regular check-ups, while setting criteria in advance for responding when weight regain begins. The choice of treatment method must be decided during a separate medical evaluation of health status, preferences, and previous experiences.

Why weight stigma must be avoided

Judging a person's willpower or lifestyle based solely on weight can lead to avoidance of medical care, depression, and extreme dietary restrictions. In a medical setting, attributing all symptoms to weight may delay the diagnosis of other conditions.

When discussing goals, focus on verifiable health outcomes, such as pain reduction, improved sleep and physical strength, or better blood pressure and blood glucose levels, rather than appearance. If weighing is uncomfortable, you may request an explanation of the reason and necessity for the measurement, or discuss methods that avoid looking at the numbers.

Obesity evaluation goes beyond weight categories

Obesity is a chronic disease where excessive accumulation of adipose tissue can affect health, but BMI alone does not reflect an individual's entire disease burden. To determine treatment priorities, it is necessary to evaluate waist circumference, fat distribution, blood pressure, blood glucose, lipids, fatty liver, sleep apnea, joint function, current medications, and quality of life.

People with the same weight can have different complications and functional limitations, and abdominal obesity or muscle loss can occur even with a normal BMI. Stigma based on appearance or willpower can delay evaluation and access to treatment.

The goal is the reduction of health risks, not a single number

Even a small reduction in initial weight can improve blood pressure, blood glucose, sleep, and mobility. Meaningful individual results can be seen by tracking medication changes, menstruation, pain, exercise performance, and life satisfaction along with weight and waist circumference.

A general diet alone is not applied if there is rapid weight gain or loss, severe shortness of breath, edema, menstrual irregularities, depression, or binge eating. After evaluating the underlying cause, complications, and eating status, treatment options such as lifestyle changes, medication, or surgery should be discussed with medical staff.

Why must obesity and appearance evaluations be separated?

The purpose of obesity care is not to fit a specific body type, but to evaluate and reduce current and future health risks, pain, and functional impairment. Since waist circumference, muscle mass, blood pressure, blood glucose, and sleep status vary even with the same BMI, the severity of the condition cannot be determined by appearance alone.

Weight stigma can lead to delaying medical care and increasing excessive restriction and binge eating. During consultations, we confirm your preferred terms and goals, and together we set meaningful individual outcomes such as mobility, sleep, menstruation, and metabolic indicators, beyond the number on the scale.