Obesity is a chronic systemic disease with multifactorial causes that poses a substantial health and economic burden worldwide. In Korea, obesity is a significant public health concern owing to the increasing prevalence of obesity-related comorbidities and mortality. Obesity is defined as excess adiposity that poses health risks. Adiposity can be assessed using direct and indirect methods, among which body mass index (BMI) is the most widely used anthropometric measurement in epidemiological studies and clinical practice. However, limitations of BMI-centric obesity assessments have been noted in previous studies. Simple adiposity measures cannot capture obesity-related medical conditions, daily functional status, or mental health. Therefore, medical associations worldwide have increasingly emphasized the need for comprehensive obesity assessments, including the 2020 Canadian Adult Obesity Clinical Practice Guidelines, American Association of Clinical Endocrinologists/American College of Endocrinology 2023 Guidelines, 2024 European Association for the Study of Obesity diagnostic framework, and 2025 Lancet Commission’s Clinical Obesity Diagnostic Criteria. Recent perspectives have emphasized multidimensional approaches to obesity assessment to capture individuals’ overall health status. This review aims to evaluate the limitations of BMI-centric obesity diagnosis, summarize emerging recommendations from recent international guidelines, and highlight potential alternative approaches for improving the assessment of obesity and related health outcomes.

Background
The association between sleep duration and obesity risk among risky drinkers remains controversial. This study aims to investigate the relationship between adequate sleep duration and both central and overall obesity among risky drinkers in Korea, with a focus on identifying potential interventions to reduce obesity rates.
Methods
We analyzed data from 978 individuals, selected from 1,356 risky drinkers—as defined by the World Health Organization criteria—who participated in the 2019–2020 Korea National Health and Nutrition Examination Survey. Participants had no missing values and were engaged in economic activities. Demographic characteristics and key variables by obesity status were examined using frequency analysis and chi-square tests. Multivariable logistic regression analysis was performed to explore the association between sleep duration and obesity. To account for the stratified sampling design, we utilized complex sample analysis with weighted values.
Results
Risky drinkers with adequate sleep duration (7–9 hours) were less likely to be obese based on waist circumference (≥90 cm in males; ≥85 cm in females) (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.48–0.86) and body mass index (≥25 kg/m²) (OR, 0.56; 95% CI, 0.41–0.76). Trend analysis revealed a significant inverse relationship between sleep duration and obesity likelihood (P for trend <0.05). Gender-stratified analysis demonstrated that the association was significant among males and more pronounced in risky drinkers compared to the general population.
Conclusion
This study suggests that adequate sleep duration may play a key role in reducing obesity rates among Korean male risky drinkers. Further longitudinal studies are recommended to strengthen this finding.

Citations

• Cumulative circadian disruption factors and metabolic syndrome
  Jungun Lee
  Korean Journal of Family Medicine.2025; 46(3): 125.     CrossRef

Background
The relationship between weight change and quality of life remains controversial. This study aimed to investigate whether changes in body weight among participants in different baseline body mass index categories are associated with physical and mental health functioning.
Methods
We conducted an analysis involving 5,106 adults who participated in the Korean Genome and Epidemiology Study, a cohort comprising Korean adults aged 40 to 69 years. We categorized participants into three groups based on body weight change, and physical and mental health were assessed using the 12-Item Short-Form Health Survey in year 4. We employed logistic regression analysis to assess the association between body weight change and poor functioning at year 4. We also utilized a generalized estimating equation to determine the relationship between weight changes and mental component summary (MCS) scores over the study period for each weight group.
Results
Weight gain in both the normal weight (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.13–3.11; P=0.01) and overweight groups (OR, 1.75; 95% CI, 1.05–2.91; P=0.03) was associated with poor MCS. Normal weight weight-losers were associated with a greater increase (2.69 points; 95% CI, 0.50–4.88) in MCS compared to weightmaintainers. Significant differences in mean MCS were observed for overweight weight-losers, obese weight-gainers, and underweight weight-gainers when compared to weight maintainers in each respective weight group.
Conclusion
Different patterns of relationships between weight change and mental health-related quality of life were observed. Hence, it is crucial to focus on the mental health of middle-aged and older adults when assessing body weight changes.

Citations

• Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
  Joung Sik Son
  Korean Journal of Family Medicine.2025; 46(4): 215.     CrossRef