Korea leads East Asia in childhood obesity as experts urge earlier intervention

Children have fun with their teachers during a festival at a park in Songpa District, southern Seoul on Nov. 4. [NEWS1]

 
Childhood obesity has surged to alarming levels in Korea, which now has the highest rate among children and adolescents in East Asia. 

Experts warn that excess weight in adolescence can trigger chronic conditions such as high blood pressure and diabetes, and leave lasting scars on both physical health and emotional well-being. 
 

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Misconceptions such as “They'll grow out of it” or “They can lose weight by skipping meals for a few days” are not only ineffective but also hinder proper obesity treatment. 
 
The JoongAng Ilbo consulted five pediatric experts from the Korean Society for the Study of Obesity to examine overlooked gaps in childhood obesity care and explore solutions.
 
Doctors stress the importance of maintaining a healthy weight from an early age. Both underweight and overweight conditions carry risks. 
 
“Many adolescents between the ages of 12 and 18 are unaware they are overweight because of the significant physical changes that occur during puberty,” said Lee Eun-byeol, a pediatrician at Yongin Severance Hospital. 
 
Unlike adults, children and adolescents are not assessed using a fixed Body Mass Index (BMI) threshold. Instead, Korea uses BMI percentiles based on age- and sex-specific growth charts. 
 
For example, if two children gain 5 kilograms (11 pounds) in a year but one grows 5 centimeters (1.9 inches) while the other grows 10, their BMI percentiles will differ. A child is considered overweight if their BMI is in the top 15 percent for their age and sex, and obese if in the top 5 percent. By this standard, about one in three to four students in Korea falls into the overweight or obese category.
 

Third-grade students run out to play a game during the fall sports day for third and fourth graders at Incheon Bugok Elementary School in Incheon on Oct. 28. [YONHAP]

 
“We are seeing more cases of severe obesity each year,” said Hong Yong-hee, a pediatrician at Soonchunhyang University Bucheon Hospital. “By the time they seek treatment, many children already suffer from poor lifestyle habits and obesity-related chronic conditions.”
 
Obesity requires structured, early intervention. Doctors say the most effective treatment includes a comprehensive correction of lifestyle habits, covering diet, exercise and behavior. 
 
“Medical professionals should step in early to assess nutrition and increase physical activity,” said Kim Yong-hyuk, a pediatrician at Wonju Severance Christian Hospital.
 
Extreme dieting, such as sharply cutting calories, can backfire in adolescence. It reduces muscle mass and basal metabolic rate, increasing the risk of weight regain. 
 
The goal of childhood obesity treatment is not simply to reduce the number on the scale, but to maintain a healthy body composition. Focusing only on appearance or clothing size can lead to eating disorders, stunted growth and emotional issues.
 
Early treatment is essential. Doctors recommend working closely with patients to assess whether simple dietary adjustments like reducing processed foods are sufficient, or if more active interventions are needed. 
 
Screening for obesity-related complications such as high blood pressure or diabetes is also crucial. 
 

Fourth-grade students prepare for a test at Seoul Jeongmok Elementary School in Yangcheon District, western Seoul on Nov. 5, 2024. [NEWS1]

 
Experts say that individual effort alone is not enough. Childhood obesity is linked to structural issues such as rising consumption of cheap processed food, a decline in physical activity and the pressure of academic competition. 
 
“Blaming children for lacking willpower or calling them lazy only worsens their emotional burden,” said Kang Eun-gu, a pediatrician at Korea University Ansan Hospital.
 
Parents play a central role in shaping children’s habits. Mixed messages, such as encouraging weight control while modeling sedentary behavior or poor eating habits at home, can cause resistance. When families commit to healthy living together, outcomes tend to improve.
 
Expanding support programs across homes, schools and communities can also help. Many adolescents show improvement simply from consistent education about nutrition, exercise and body image. Experts recommend that schools introduce basic concepts of healthy weight through health education.
 
The current system leaves pediatric obesity largely unsupported. Government-run chronic disease management programs exclude children and adolescents. Experts argue that these programs should include youth and promote self-managed health routines. Doing so could also reduce stigma and normalize early intervention 
 
Another concern is cost. Even children with severe obesity must often pay out of pocket for treatment. Anti-obesity medications like Saxenda and Wegovy are not covered by national health insurance in Korea. 
 
“We need a system that provides early intervention before children with obesity-related diseases have to be referred to university hospitals,” said Chung So-chung, a pediatrician at Konkuk University Medical Center.


This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
BY KWON SUN-MI [paik.jihwan@joongang.co.kr]