Background: This study aimed to analyze the medical expenses covered by the Korean National Health Insurance Service (KNHIS) according to body mass index (BMI) in Korean adults. Methods: We included 1,170,464 adults (623,498 men and 546,966 women) aged ≥19 years from the KNHISNational Sample Cohort database (2016 to 2019) after excluding individuals with cancer. Average annual medical expenses per person and average annual medical expenses (Korean won [KRW], 1 United States dollar=1,292 KRW) by BMI classification were assessed according to age and sex. Medical expenses comprised those for medication and combined outpatient department (OPD) and hospitalization services. Means and 95% confidence intervals were analyzed using a two-part model. Results: Average annual medical expenses increased in higher BMI quintile groups (P for trend <0.001). Average annual medical expenses per person increased significantly as BMI increased in women but not in men. Average annual medical expenses were highest in the highest quintile of BMI among women and in all age groups.While BMI showed a U-shape association with medical expenses for OPD and hospitalization in young individuals, medical expenses for medication in all age groups and those for OPD and hospitalization in middle-aged individuals increased sharply in the highest BMI quintile. Conclusion All types of average annual medical expenses increased in higher BMI groups in Korean adults, particularly in women. Individuals with the highest BMI quintile incurred the greatest medical expenses among women and across all age groups. Strategies for preventing and managing obesity are warranted to reduce the burden of obesity-related medical expenses.

Obesity is a chronic disease associated with substantial health consequences, including cardiovascular disease, type 2 diabetes, and certain cancers. Although lifestyle modifications remain foundational to treatment, pharmacotherapy has become a crucial strategy, particularly for patients unable to achieve sustained weight loss. This review aims to provide an updated overview of long-term anti-obesity medications, discussing their mechanisms of action, efficacy, safety profiles, clinical applicability, and future perspectives on emerging therapeutic agents.Current Concepts: Recent pharmacological advancements have substantially transformed obesity management. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (2.4 mg) and the dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist tirzepatide (15 mg) have demonstrated significant weight loss effects (15–21%) and have shown benefits across various obesity-related comorbidities, including type 2 diabetes, cardiovascular disease, and heart failure with preserved ejection fraction. Additionally, investigational agents such as CagriSema, retatrutide, and oral GLP-1 receptor agonists hold promise for enhanced efficacy and improved patient convenience. These developments underscore a shift toward personalized, mechanism-based pharmacotherapy.Discussion and Conclusion: Despite encouraging outcomes, significant challenges remain. Issues such as weight regain after discontinuation, limited long-term safety data, and access barriers due to high treatment costs continue to present obstacles. In Korea, the absence of insurance reimbursement for most anti-obesity medications severely restricts patient access, even among high-risk populations. Given the recognition of obesity as a chronic, relapsing disease, treatment strategies should incorporate the individual patient's comorbidity profile and personal needs. Alongside pharmacologic advancements, healthcare policies must evolve to ensure equitable medication access and optimize clinical outcomes.

Background: This study aimed to analyze the medical expenses covered by the Korean National Health Insurance Service (KNHIS) according to body mass index (BMI) in Korean adults. Methods: We included 1,170,464 adults (623,498 men and 546,966 women) aged ≥19 years from the KNHISNational Sample Cohort database (2016 to 2019) after excluding individuals with cancer. Average annual medical expenses per person and average annual medical expenses (Korean won [KRW], 1 United States dollar=1,292 KRW) by BMI classification were assessed according to age and sex. Medical expenses comprised those for medication and combined outpatient department (OPD) and hospitalization services. Means and 95% confidence intervals were analyzed using a two-part model. Results: Average annual medical expenses increased in higher BMI quintile groups (P for trend <0.001). Average annual medical expenses per person increased significantly as BMI increased in women but not in men. Average annual medical expenses were highest in the highest quintile of BMI among women and in all age groups.While BMI showed a U-shape association with medical expenses for OPD and hospitalization in young individuals, medical expenses for medication in all age groups and those for OPD and hospitalization in middle-aged individuals increased sharply in the highest BMI quintile. Conclusion All types of average annual medical expenses increased in higher BMI groups in Korean adults, particularly in women. Individuals with the highest BMI quintile incurred the greatest medical expenses among women and across all age groups. Strategies for preventing and managing obesity are warranted to reduce the burden of obesity-related medical expenses.

Obesity is a chronic disease associated with substantial health consequences, including cardiovascular disease, type 2 diabetes, and certain cancers. Although lifestyle modifications remain foundational to treatment, pharmacotherapy has become a crucial strategy, particularly for patients unable to achieve sustained weight loss. This review aims to provide an updated overview of long-term anti-obesity medications, discussing their mechanisms of action, efficacy, safety profiles, clinical applicability, and future perspectives on emerging therapeutic agents.Current Concepts: Recent pharmacological advancements have substantially transformed obesity management. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (2.4 mg) and the dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist tirzepatide (15 mg) have demonstrated significant weight loss effects (15–21%) and have shown benefits across various obesity-related comorbidities, including type 2 diabetes, cardiovascular disease, and heart failure with preserved ejection fraction. Additionally, investigational agents such as CagriSema, retatrutide, and oral GLP-1 receptor agonists hold promise for enhanced efficacy and improved patient convenience. These developments underscore a shift toward personalized, mechanism-based pharmacotherapy.Discussion and Conclusion: Despite encouraging outcomes, significant challenges remain. Issues such as weight regain after discontinuation, limited long-term safety data, and access barriers due to high treatment costs continue to present obstacles. In Korea, the absence of insurance reimbursement for most anti-obesity medications severely restricts patient access, even among high-risk populations. Given the recognition of obesity as a chronic, relapsing disease, treatment strategies should incorporate the individual patient's comorbidity profile and personal needs. Alongside pharmacologic advancements, healthcare policies must evolve to ensure equitable medication access and optimize clinical outcomes.

Background: This study aimed to analyze the medical expenses covered by the Korean National Health Insurance Service (KNHIS) according to body mass index (BMI) in Korean adults. Methods: We included 1,170,464 adults (623,498 men and 546,966 women) aged ≥19 years from the KNHISNational Sample Cohort database (2016 to 2019) after excluding individuals with cancer. Average annual medical expenses per person and average annual medical expenses (Korean won [KRW], 1 United States dollar=1,292 KRW) by BMI classification were assessed according to age and sex. Medical expenses comprised those for medication and combined outpatient department (OPD) and hospitalization services. Means and 95% confidence intervals were analyzed using a two-part model. Results: Average annual medical expenses increased in higher BMI quintile groups (P for trend <0.001). Average annual medical expenses per person increased significantly as BMI increased in women but not in men. Average annual medical expenses were highest in the highest quintile of BMI among women and in all age groups.While BMI showed a U-shape association with medical expenses for OPD and hospitalization in young individuals, medical expenses for medication in all age groups and those for OPD and hospitalization in middle-aged individuals increased sharply in the highest BMI quintile. Conclusion All types of average annual medical expenses increased in higher BMI groups in Korean adults, particularly in women. Individuals with the highest BMI quintile incurred the greatest medical expenses among women and across all age groups. Strategies for preventing and managing obesity are warranted to reduce the burden of obesity-related medical expenses.

The traditional definition of obesity, relying solely on body mass index, inadequately captures individual health status and is insufficient for guiding therapeutic interventions. In January 2025, The Lancet Diabetes & Endocrinology Commission proposed a paradigm-shifting redefinition that introduces the concepts of “clinical obesity” and “preclinical obesity.” Clinical obesity is defined as a chronic, systemic illness characterized by excess adiposity resulting in functional impairments in tissues, organs, or overall individual health. In contrast, preclinical obesity involves excess adiposity without current functional impairment. This review examines the significance of this new diagnostic paradigm for cardiovascular disease prevention and risk assessment. From a cardiovascular perspective, the new framework offers several advantages: it facilitates personalized intervention strategies based on individual risk profiles, refines cardiovascular risk assessments by incorporating body fat distribution and functional parameters, promotes more efficient resource allocation, and shifts treatment goals toward functional improvements beyond mere weight loss. Although further research is required to evaluate practical implementation and long-term outcomes, this novel approach represents a substantial advancement in obesity management and cardiovascular disease prevention.

Obesity is a chronic disease associated with substantial health consequences, including cardiovascular disease, type 2 diabetes, and certain cancers. Although lifestyle modifications remain foundational to treatment, pharmacotherapy has become a crucial strategy, particularly for patients unable to achieve sustained weight loss. This review aims to provide an updated overview of long-term anti-obesity medications, discussing their mechanisms of action, efficacy, safety profiles, clinical applicability, and future perspectives on emerging therapeutic agents.Current Concepts: Recent pharmacological advancements have substantially transformed obesity management. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (2.4 mg) and the dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist tirzepatide (15 mg) have demonstrated significant weight loss effects (15–21%) and have shown benefits across various obesity-related comorbidities, including type 2 diabetes, cardiovascular disease, and heart failure with preserved ejection fraction. Additionally, investigational agents such as CagriSema, retatrutide, and oral GLP-1 receptor agonists hold promise for enhanced efficacy and improved patient convenience. These developments underscore a shift toward personalized, mechanism-based pharmacotherapy.Discussion and Conclusion: Despite encouraging outcomes, significant challenges remain. Issues such as weight regain after discontinuation, limited long-term safety data, and access barriers due to high treatment costs continue to present obstacles. In Korea, the absence of insurance reimbursement for most anti-obesity medications severely restricts patient access, even among high-risk populations. Given the recognition of obesity as a chronic, relapsing disease, treatment strategies should incorporate the individual patient's comorbidity profile and personal needs. Alongside pharmacologic advancements, healthcare policies must evolve to ensure equitable medication access and optimize clinical outcomes.

Background: The 2023 Obesity Fact Sheet aims to present an updated overview of obesity prevalence across all age groups, including children and adolescents. Methods: This study included individuals aged ≥20 years (n=16,941,423 in 2021) who underwent health checkups provided by the Korean National Health Insurance Service between 2012 and 2021. The prevalence of obesity and abdominal obesity was standardized by age and sex using data from the 2010 population and housing census. For children and adolescents (6 to 18 years) (n= 884 in 2021), we used the Korea National Health and Nutrition Examination Survey (2012 to 2021), and obesity was defined by the corresponding sex- and agespecific body mass index percentile of 95th or greater based on the 2017 Korean National Growth Chart for Children and Adolescents. Results: The overall prevalence of obesity in 2021 is 38.4% (49.2% in men and 27.8% in women), which is a 1.27-fold increase from 30.2% in 2012. The prevalence of obesity has increased across all age groups, particularly among those aged 20, 30, and 80 years. The prevalence of class III obesity substantially increased from 0.35% (men) and 0.42% (women) in 2012 to 1.21% and 0.97% in 2021, with 3.46- and 2.31-fold increases, respectively.This increase was particularly pronounced in young adults. The prevalence of obesity in children and adolescents has surged from 9.7% in 2012 to 19.3% in 2021, with a greater increase among boys. Conclusion Our study provides information on the current status of obesity prevalence based on the 2023 Obesity Fact Sheet, emphasizing the urgency of implementing timely strategies to reverse this increasing trend.

Background: The 2023 Obesity Fact Sheet aims to present an updated overview of obesity prevalence across all age groups, including children and adolescents. Methods: This study included individuals aged ≥20 years (n=16,941,423 in 2021) who underwent health checkups provided by the Korean National Health Insurance Service between 2012 and 2021. The prevalence of obesity and abdominal obesity was standardized by age and sex using data from the 2010 population and housing census. For children and adolescents (6 to 18 years) (n= 884 in 2021), we used the Korea National Health and Nutrition Examination Survey (2012 to 2021), and obesity was defined by the corresponding sex- and agespecific body mass index percentile of 95th or greater based on the 2017 Korean National Growth Chart for Children and Adolescents. Results: The overall prevalence of obesity in 2021 is 38.4% (49.2% in men and 27.8% in women), which is a 1.27-fold increase from 30.2% in 2012. The prevalence of obesity has increased across all age groups, particularly among those aged 20, 30, and 80 years. The prevalence of class III obesity substantially increased from 0.35% (men) and 0.42% (women) in 2012 to 1.21% and 0.97% in 2021, with 3.46- and 2.31-fold increases, respectively.This increase was particularly pronounced in young adults. The prevalence of obesity in children and adolescents has surged from 9.7% in 2012 to 19.3% in 2021, with a greater increase among boys. Conclusion Our study provides information on the current status of obesity prevalence based on the 2023 Obesity Fact Sheet, emphasizing the urgency of implementing timely strategies to reverse this increasing trend.

In the 2023 series, we summarized the major clinical research advances in gynecologic oncology based on communications at the conference of Asian Society of Gynecologic Oncology Review Course. The review consisted of 1) Endometrial cancer: immune checkpoint inhibitor, antibody drug conjugates (ADCs), selective inhibitor of nuclear export, CDK4/6 inhibitors WEE1 inhibitor, poly (ADP-ribose) polymerase (PARP) inhibitors. 2) Cervical cancer: surgery in low-risk early-stage cervical cancer, therapy for locally advanced stage and advanced, metastatic, or recurrent setting; and 3) Ovarian cancer: immunotherapy, triplet therapies using immune checkpoint inhibitors along with antiangiogenic agents and PARP inhibitors, and ADCs. In 2023, the field of endometrial cancer treatment witnessed a landmark year, marked by several practice-changing outcomes with immune checkpoint inhibitors and the reliable efficacy of PARP inhibitors and ADCs.