"Childhood obesity is the starting point for adult diseases"

"Early intervention is key"

Professor Kyoung-gon Kim of the Department of Family Medicine at Gachon University Gil Medical Center

Lifestyle modification alone has limitations in treating obesity…"If required, drug therapy may be combined"

Treatment options in Korea are limited compared to overseas countries…expanded access to new drugs is needed

Professor Kyoung-gon Kim of the Department of Family Medicine at Gachon University Gil Medical Center

"Obesity is no longer just a matter of appearance.

 

Especially in growing children and adolescents, obesity is the starting point for adult diseases like diabetes and hypertension, and a factor that determines lifelong health.

 

It must be approached as a disease, not just simple weight management." Professor Kyoung-gon Kim of Department of Family Medicine at Gachon University Gil Medical Center, during a recent meeting with DailyPharm, emphasized that obesity is clearly a disease that requires proactive, early intervention.

 

If neglected, it leads to risks of future cardiovascular disease, diabetes, and liver disease.

 

The importance of treating obesity in children and adolescents, not just adults, is gaining attention.

 

The Korean Society for the Study of Obesity (KSSO) recently released its 'Obesity Fact Sheet 2025,' which reported that while the obesity rate in children and adolescents has slightly decreased in the last five years, nearly three out of 10 are still classified as obese.

 

According to the fact sheet, an analysis of the prevalence of overweight and obesity from 2014 to 2023 showed an increasing trend until 2020, which reversed to a decrease after 2021.

 

The prevalence of obesity in boys increases from age 8, peaking at 28.3% at age 14.

 

For girls, the rate increases after age 16, reaching 26.7%.

 

The higher the parents' Body Mass Index (BMI), the higher the probability of obesity in their children; children whose parents are in obesity class 2 or higher are more than five times more likely to be obese.

 

The problem lies with the comorbidities of obesity.

 

There is an increasing incidence of Type 2 diabetes and adult chronic diseases among overweight and obese children and adolescents.

 

Professor Kim stated, "Ten years ago, Type 2 diabetes in children and adolescents was rare, but recently, we see it frequently in the hospital.

 

Most cases are caused by obesity.

 

Since obesity starts earlier and lasts longer in childhood, it shortens healthy life expectancy and increases the risk of complications." The long-term impact of obesity is closely related to the 'timing of exposure.' If chronic diseases or other comorbidities occur during the growth period due to being overweight, there are concerns about a lifelong financial burden of medical care, reduced quality of life, and the onset of complications.

 

Professor Kim said, "Adult obesity often occurs after other diseases are already present, but when obesity begins at a young age, the impact lasts a lifetime." He stressed, "Child and adolescent obesity is not just an aesthetic issue but a problem that leads to future risks of cardiovascular disease, diabetes, and liver disease." Professor Kim further stated, "Just as uncontrolled hypertension leads to cerebral hemorrhage, heart disease, or kidney damage, obesity itself is a disease that causes organ damage," and added, "It must be understood as a physiological abnormality, not just an appearance problem." "Obesity is not a lack of willpower…requires therapeutic approach" Professor Kim particularly emphasized that lifestyle modification alone has limitations in treating obesity.

 

He argued that if weight loss is difficult for adults with obesity in terms of willpower, it is much harder for adolescents, who are still growing, to suppress their own appetite.

 

Professor Kim stated, "Appetite is not a matter of willpower; it is a biological response involving the action of various neurological and hormonal substances secreted by the pituitary gland and adipose tissue," and added, "For this reason, weight loss is difficult with the 'eat less' approach." Recently, the treatment paradigm has been changing with the emergence of additional new obesity drugs, such as the Glucagon-like Peptide-1 (GLP-1) class of drugs.

 

Consequently, the concept of treatment is gradually taking root among overweight and obese adult patients.

 

Professor Kim assessed, "In the past, obesity treatments were centered on appetite suppression, but with the emergence of GLP-1 class drugs, we can now regulate the physiological mechanism itself.

 

The perception of treatment among patients has also changed significantly due to recently launched treatments, and cases of actively considering drug therapy are increasing." However, the use of these drugs in the child and adolescent population is limited.

 

Currently, only orlistat drugs, 'Saxenda (liraglutide)' and 'Wegovy (semaglutide)' are approved for use in patients aged 12 and older in Korea.

 

On the other hand, obesity drugs approved relatively recently for adult patients, such as 'Qsymia (phentermine·topiramate)' and 'Mounjaro (tirzepatide),' are still not available for use in obese children and adolescents in Korea.

 

Professor Kim assessed, "Government regulations are too strict.

 

There are no approved drugs for children under 12, and the options for those over 12 are limited." He argued, "If efficacy and safety are proven through studies in Korean patients, the government must actively consider approving additional medications." In the case of some new obesity drugs like Qsymia, they are already being used for adolescent patients in the U.S.

 

While concerns about misuse and abuse may arise, the expert view is that it is premature to make a rash judgment, given the current lack of treatment options.

 

Professor Kim said, "Qsymia is already approved as an adolescent obesity treatment in the U.S." He said, "Considering the circumstance in Korea, the potential for adolescent misuse and abuse is low.

 

Overly stringent regulations due to concerns about misuse are undesirable." Beyond the case of children and adolescents, the societal perception that obesity is a disease remains low.

 

While prevention is most important in child and adolescent obesity, experts believe that proactive treatment is necessary once the disease stage has been reached.

 

Professor Kim stated, "Drug therapy is maximized only when based on a healthy lifestyle." However, he added, "Adolescents with severe obesity or those with complications such as hypertension, elevated liver enzymes, or Type 2 diabetes need to consider drug treatment actively." Professor Kim emphasized, "For adolescents, for whom lifestyle modification is more challenging than for adults, drug therapy should be combined with education to maintain healthy eating habits and physical activity in the long term."