In Korea, the prevalence of obesity as defined by body mass index(BMI) ≥25 kg/m² has been steady in the recent years; however, the prevalence of severe (BMI ≥30 kg/m²) and extreme obesity (BMI ≥35 kg/m²) has rapidly increased during the past decade. The change in the prevalence of abdominal obesity showed a similar trend to the prevalence of obesity. Based on the Korean data, the list of obesity-related diseases in Korea resembles those for the Western countries. The association between BMI and all-cause mortality in Koreans displayed a ‘U’ or inverted ‘J’ curve pattern. However, these curves have changed, and the BMI nadir of these curves exhibits a change to a higher BMI point during the past decades. Recent change in the obesity epidemic in Korea seems to resemble the previous changes in the obesity epidemics seen in the Western populations.
Comorbidity ; Korea ; Mortality ; Obesity* ; Obesity, Abdominal ; Prevalence

Metabolically healthy obesity (MHO) is a new concept in which an individual may exhibit an obese phenotype in the absence of any metabolic abnormalities. There are a number of definitions of MHO that utilize a variety of components. The findings of clinical and basic studies indicate that subjects with MHO do not exhibit an increased mortality, an increased risk of cardiovascular disease, or an increased risk of type 2 diabetes mellitus, as compared to normal-weight controls. Although these findings imply that metabolic health is a more important factor than obesity, several studies have shown that subjects with MHO have a similar risk of metabolic or cardiovascular diseases as those with metabolically unhealthy obesity. Thus, there is still debate regarding not only the implications of the MHO phenotype but its very existence. Accordingly, future studies should focus on developing a unified definition of MHO and distinguishing subjects who will be at a high risk for metabolic and cardiovascular diseases.
Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Mortality ; Obesity* ; Phenotype*

The prevalence of obesity and overweight is increasing in mood disorder, and it is connected to an increased cardiovascular mortality. Because of them, treatment for obesity may be an essential part of mood disorder treatment. Similar to the general population, non-pharmacological treatment such as correction of life habits should be considered first of all. If this approaches are fail, pharmacological treatment for obesity would be required as next step. Any drug for obesity is not approved officially in mood disorder. So approved drugs in general population, and drugs supported by several studies are prescribed in clinical settings. Several treatment guidelines for mood disorder and studies support that orlistat, metformin, topiramate and bupropion is effective and safe.
Bupropion ; Drug Therapy* ; Metformin ; Mood Disorders* ; Mortality ; Obesity* ; Overweight ; Prevalence

BACKGROUND/AIMS: Dyslipidemia and obesity are risk factors for the development of acute myocardial infarction (AMI) that affect the clinical outcomes in patients. METHODS: We analyzed 2,751 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) (mean age, 63.7 +/- 12.1 years). The patients were divided into four groups based on serum triglyceride levels and central obesity [Group Ia: triglycerides < 200 mg/dL and (-) central obesity; Group Ib: triglyceride < 200 mg/dL and (+) central obesity; Group IIa: triglyceride > or = 200 mg/dL and (-) central obesity; Group IIb: triglyceride > or = 200 mg/dL and (+) central obesity]. In-hospital outcome was defined as in-hospital mortality and complications. One-year clinical outcome was compared and defined as the composite of 1-year major adverse cardiac events (MACE), including death, recurrent MI, and target vessel revascularization. RESULTS: Total MACE developed in 502 patients (18.2%), while 303 patients (11.0%) died prior to the 1-year follow-up visit. In-hospital complications and in-hospital mortality were not different among the four groups. One-year clinical outcomes based on triglyceride levels (Group I vs. Group II) were not different. In addition, there were no differences in clinical outcomes in patients with a triglyceride level < 200 mg/dL, regardless of central obesity. One-year MACE rates were not significantly different among the four groups. CONCLUSIONS: There was no significant difference in the 1-year MACE rate based on the triglyceride level and presence of central obesity in patients with AMI who underwent PCI.
Dyslipidemias ; Follow-Up Studies ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Obesity ; Obesity, Abdominal* ; Percutaneous Coronary Intervention* ; Risk Factors ; Triglycerides*

BACKGROUND/AIMS: Dyslipidemia and obesity are risk factors for the development of acute myocardial infarction (AMI) that affect the clinical outcomes in patients. METHODS: We analyzed 2,751 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) (mean age, 63.7 +/- 12.1 years). The patients were divided into four groups based on serum triglyceride levels and central obesity [Group Ia: triglycerides < 200 mg/dL and (-) central obesity; Group Ib: triglyceride < 200 mg/dL and (+) central obesity; Group IIa: triglyceride > or = 200 mg/dL and (-) central obesity; Group IIb: triglyceride > or = 200 mg/dL and (+) central obesity]. In-hospital outcome was defined as in-hospital mortality and complications. One-year clinical outcome was compared and defined as the composite of 1-year major adverse cardiac events (MACE), including death, recurrent MI, and target vessel revascularization. RESULTS: Total MACE developed in 502 patients (18.2%), while 303 patients (11.0%) died prior to the 1-year follow-up visit. In-hospital complications and in-hospital mortality were not different among the four groups. One-year clinical outcomes based on triglyceride levels (Group I vs. Group II) were not different. In addition, there were no differences in clinical outcomes in patients with a triglyceride level < 200 mg/dL, regardless of central obesity. One-year MACE rates were not significantly different among the four groups. CONCLUSIONS: There was no significant difference in the 1-year MACE rate based on the triglyceride level and presence of central obesity in patients with AMI who underwent PCI.
Dyslipidemias ; Follow-Up Studies ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Obesity ; Obesity, Abdominal* ; Percutaneous Coronary Intervention* ; Risk Factors ; Triglycerides*

BACKGROUND: The aim of this study was to investigate the association between body mass index (BMI) and survival in patients with severe sepsis or septic shock. METHODS: We analyzed the sepsis registry of patients presenting to the emergency department (ED) of a tertiary urban hospital and meeting the criteria for severe sepsis or septic shock from August 2008 to March 2012. We categorized patients into the underweight group (BMI < 18.5 kg/m2), the normal weight group (18.5 < or = BMI < 25 kg/m2) and the obese group (BMI > or = 25 kg/m2). Then, we analyzed the registry to evaluate the relation between obesity and in-hospital mortality. RESULTS: A total of 770 adult patients with severe sepsis and septic shock were analyzed. In-hospital mortality rate of the underweight group (n = 86), the normal weight group (n = 489) and the obese group (n = 195) was 22.1%, 15.3% and 16.4%, respectively. In a multivariate regression analysis, the underweight group had a significant association with in-hospital mortality compared with the normal weight group (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.68-1.87; p = 0.028). The obese group showed no significant difference in mortality (OR, 2.04; 95% CI, 1.08-3.86; p = 0.65). CONCLUSIONS: The underweight patients showed significantly higher mortality than the normal weight patients with severe sepsis and septic shock.
Adult ; Body Mass Index* ; Emergencies ; Hospital Mortality ; Hospitals, Urban ; Humans ; Mortality ; Obesity ; Sepsis* ; Shock, Septic* ; Thinness

Obesity has become a global public health problem. The importance of obesity is highlighted by the fact that obesity-related comorbidities, such as type 2 diabetes, cardiovascular disease, and cancer, are a leading cause of death in Westernized countries. As endorsement of lifestyle modifications has proven to be inadequate to combat obesity, pharmacological treatment has become more critical for weight reduction as well as for the treatment of obesity-related morbidity and mortality. However, safety issues dampened the success of the development of anti-obesity drugs, leaving orlistat as the single approved drug for long-term weight management until 2012, when two new anti-obesity drugs were approved by the FDA: lorcaserin and phentermine/topiramate. In 2014, another two drugs were approved by the US FDA for the treatment of obesity: naltrexone/bupropion and liraglutide. In this review, we describe the new FDA-approved anti-obesity drugs and briefly introduce other anti-obesity drugs still under development.
Anti-Obesity Agents ; Cardiovascular Diseases ; Cause of Death ; Comorbidity ; Life Style ; Liraglutide ; Mortality ; Obesity* ; Public Health ; Weight Loss

Both obesity and diabetes impose not only individual health problems, but also large socioeconomic burdens worldwide. Obesity is a major cause of insulin resistance and diabetes and is closely linked to a series of microvascular and macrovascular complications that ultimately lead to increased morbidity and mortality. According to recent national survey data in Korea, obesity affects about 50% of adults with type 2 diabetes mellitus. Given the evidence that anti-obesity management has been beneficial in the treatment for patients with type 2 diabetes mellitus and obesity, providers should establish a strategy for weight loss for optimal, comprehensive patient management. Lifestyle intervention including diet and exercise is the cornerstone of prevention and management for obesity and type 2 diabetes mellitus. Anti-obesity drugs should be provided to those who do not respond appropriately to lifestyle intervention. Emerging data support the superiority of metabolic surgery over lifestyle or medical management for the management of type 2 diabetes associated with severe obesity. This article concisely reviews the current recommendation for lifestyle intervention including diet and exercise and pharmacological and surgical methods for obesity management in type 2 diabetic patients.
Adult ; Anti-Obesity Agents ; Bariatric Surgery ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Diet ; Diet Therapy ; Humans ; Insulin Resistance ; Korea ; Life Style ; Mortality ; Obesity* ; Obesity, Morbid ; Weight Loss

BACKGROUND: Renal function in patients, who undergo medical examination, is usually evaluated by the serum creatinine level. However this numerical value does not always represent the entire renal function because the values increases only when the renal function has decreased more than 50%. The purpose of this study was to find the prevalence of renal diseases through the GFR (Glomerular filtration rate) using MDRD (Modification of Diet in Renal Disease) equation and to analyze the risk factors related to renal diseases. METHODS: We reviewed all the clinical records of 440 patients who had visited for medical examination between January 1, 2004 and December 31, 2004. We have calculated the GFR for each group using the MDRD equation and then figured out the correlation between the GFR and its risk factors. RESULTS: Patients haing GFR of less than 60 mL/min/1.73 m2 were 19 (7.2%), 60~90 mL/min/1.73 m2 were 123 (46.4%) and more than 90 mL/min/1.73 m2 were 123 (46.2%). The correlation between the GFR and age, obesity, hypertension and diabetes melitus were observed as negative results in univariate analysis of variance (P<0.05). Age and diabetes melitus were independent factors affecting the GFR (OR=3.1, 2.2 respectively, P<0.05) in multiple logistic regression analysis. CONCLUSION: It is a well known fact that the declined renal function is related to the aging process and diabetes melitus. Therefore, the mortality rate caused by renal failure and its complications should be decreased through the control of diabetes melitus, aging process and other risk factors.
Aging ; Creatinine ; Diet ; Filtration ; Humans ; Hypertension ; Logistic Models ; Mortality ; Obesity ; Prevalence* ; Renal Insufficiency ; Risk Factors*

Inflammation is one mechanism through which cancer is initiated and progresses, and is implicated in the etiology of other conditions that affect cancer risk and prognosis, such as type 2 diabetes, cardiovascular disease, and visceral obesity. Emerging human evidence, primarily epidemiological, suggests that walnuts impact risk of these chronic diseases via inflammation. The published literature documents associations between walnut consumption and reduced risk of cancer, and mortality from cancer, diabetes, and cardiovascular disease, particularly within the context of the Mediterranean Diet. While encouraging, follow-up in human intervention trials is needed to better elucidate any potential cancer prevention effect of walnuts, per se. In humans, the far-reaching positive effects of a plant-based diet that includes walnuts may be the most critical message for the public. Indeed, appropriate translation of nutrition research is essential for facilitating healthful consumer dietary behavior. This paper will explore the translation and application of human evidence regarding connections with cancer and biomarkers of inflammation to the development of dietary guidance for the public and individualized dietary advice. Strategies for encouraging dietary patterns that may reduce cancer risk will be explored.
Biomarkers ; Cardiovascular Diseases ; Chronic Disease ; Diet* ; Diet, Mediterranean ; Humans ; Inflammation ; Juglans* ; Mortality ; Obesity, Abdominal ; Prognosis