Diagnosis of Severe Obesity in Korean Children and Adolescents

Ji-Hye Jung; Young-Gyu Cho

doi:10.15384/kjhp.2016.16.3.174

Korean J Health Promot > Volume 16(3); 2016 > Article

Jung and Cho: Diagnosis of Severe Obesity in Korean Children and Adolescents

Original Article

Korean Journal of Health Promotion 2016;16(3):174-179.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.3.174

Diagnosis of Severe Obesity in Korean Children and Adolescents

Ji-Hye Jung¹, Young-Gyu Cho^2,

¹Institute for Clinical Nutrition, Inje University, Seoul, Korea

²Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

Corresponding author: Young-Gyu Cho, MD Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 04551, Korea
Tel: +82-2-2272-0908, Fax: +82-2-2268-0971 E-mail: jacobel@hanmail.net

Received June 09, 2016 Accepted August 28, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Backgroud

Although the obesity prevalence in Korean children and adolescents has stabilized since early 2000s, it is noted that severe obesity is increasing. However, no diagnostic criteria to define severe obesity in Korean children and adolescents has not been recommended yet.

Methods

We established two kinds of diagnostic criteria of severe obesity with the 2007 Korean National Growth Charts; 1) body mass index (BMI) criteria 1: BMI≥120% of 95th percentile or 30 kg/m², whichever is lower, 2) BMI criteria 2: ≥99th percentile. We examined the prevalence of severe obesity among children and adolescents who participated in the Fifth Korea National Health and Nutrition Examination Survey, 2010–2012 based on BMI criteria 1 and 2 as well as percentage-weight-for-height (PWH).

Results

We presented the age- and sex-specific BMI cut-offs of BMI criteria 1 and 2. The prevalence of severe obesity was 1.6% and 1.7% based on BMI criteria 1 and 2, respectively. The prevalence of severe obesity based on PWH was 0.8%, which was lower than the prevalences based on BMI criteria 1 and 2.

Conclusions

Our diagnostic criteria of severe obesity can be utilized in the epidemiological surveys and researches before the recommendation of the formal diagnostic criteria.

Keywords: Child, Adolescent, Obesity, Body mass index, Prevalence

Figure 1.

The proportion of mild, moderate and severe obesity in Korean children and adolescents according to three set of different diagnostic criteria.

Table 1.

Age- and sex-specific BMI cut-offs to define severe obesity in Korean children and adolescents

Age	BMI cut-offs 1^a		BMI cut-offs 2^b
Age	Boys	Girls	Boys	Girls
2	22.98	22.73	20.18	20.15
2.5	22.41	22.18	19.78	19.68
3	22.08	21.83	19.67	19.43
3.5	21.95	21.65	19.82	19.39
4	22.00	21.64	20.18	19.52
4.5	22.20	21.76	20.67	19.78
5	22.53	21.99	21.24	20.16
5.5	22.97	22.33	21.86	20.63
6	23.50	22.75	22.51	21.17
6.5	24.11	23.23	23.20	21.76
7	25.12	24.06	24.29	22.70
8	26.55	25.27	25.78	24.01
9	28.01	26.51	27.25	25.31
10	29.38	27.70	28.62	26.50
11	30.00 (30.60)^c	28.79	29.81	27.54
12	30.00 (31.63)^c	29.72	30.79	28.37
13	30.00 (32.42)^c	30.00 (30.46)^c	31.52	28.99
14	30.00 (32.98)^c	30.00 (31.00)^c	31.99	29.37
15	30.00 (33.32)^c	30.00 (31.34)^c	32.23	29.54
16	30.00 (33.46)^c	30.00 (31.49)^c	32.24	29.54
17	30.00 (33.47)^c	30.00 (31.49)^c	32.08	29.42
18	30.00 (33.41)^c	30.00 (31.39)^c	31.80	29.26

Abbreviation: BMI, body mass index.

^a120% of 95th BMI percentile or a BMI of 30 kg/m

²whichever is lower.

^b99th BMI percentile.

^cValues in parentheses are 120% of 95th BMI percentile.

Table 2.

Trends in age-standardized prevalence (standard error) of severe obesity in Korean children and adolescents aged 7–18 years

	2001	2005	2007–2009	2010–2012	P for trend
Total
BMI criteria 1^a	1.2 (0.3)	1.9 (0.4)	1.4 (0.2)	1.6 (0.3)	0.681
BMI criteria 2^b	1.0 (0.2)	1.2 (0.3)	1.3 (0.2)	1.4 (0.2)	0.417
PWH criteria^c	0.8 (0.2)	0.6 (0.2)	0.9 (0.2)	0.9 (0.2)	0.629
Boys
BMI criteria 1^a	1.9 (0.5)	2.3 (0.7)	1.9 (0.4)	1.9 (0.4)	0.625
BMI criteria 2^b	1.3 (0.4)	0.7 (0.4)	1.3 (0.3)	1.1 (0.3)	0.691
PWH criteria^c	1.2 (0.4)	0.5 (0.2)	1.1 (0.3)	0.9 (0.3)	0.570
Girls
BMI criteria 1^a	0.4 (0.2)	1.4 (0.5)	0.9 (0.2)	1.2 (0.3)	0.143
BMI criteria 2^b	0.8 (0.3)	1.8 (0.6)	1.3 (0.3)	1.8 (0.4)	0.127
PWH criteria^c	0.3 (0.2)	0.7 (0.3)	0.6 (0.2)	1.0 (0.3)	0.090

Abbreviations: BMI, body mass index; PWH, percentage-weight-for-height.

^aBMI≥120% of 95th percentile or 30 kg/m

²whichever is lower.

^bModerate obesity: BMI≥95th percentile or 25 kg/m

²whichever is lower to <99th percentile, Severe obesity: ≥99th percentile.

^cPWH≥150%.

Table 3.

Age- and sex-specific BMI cut-offs to define very severe obesity in Korean children and adolescents

Age	BMI cut-offs^a
Age	Boys	Girls
2	26.81	26.52
2.5	26.14	25.87
3	25.76	25.46
3.5	25.61	25.26
4	25.67	25.24
4.5	25.90	25.38
5	26.29	25.66
5.5	26.80	26.05
6	27.42	26.54
6.5	28.13	27.11
7	29.30	28.07
8	30.98	29.48
9	32.67	30.92
10	34.28	32.32
11	35.00 (35.70)^b	33.59
12	35.00 (36.90)^b	34.67
13	35.00 (37.83)^b	35.00 (35.54)^b
14	35.00 (38.48)^b	35.00 (36.17)^b
15	35.00 (38.87)^b	35.00 (36.56)^b
16	35.00 (39.04)^b	35.00 (36.74)^b
17	35.00 (39.05)^b	35.00 (36.74)^b
18	35.00 (38.98)^b	35.00 (36.62)^b

Abbreviation: BMI, body mass index.

^a140% of 95th BMI percentile or a BMI of 35 kg/m

²whichever is lower.

^bValues in parentheses are 140% of 95th BMI percentile.

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