What’s in a Label: Obesity in One of the World's Thinnest Countries
I am 174 centimeters (5 feet 8 inches) tall and weigh 76 kilograms (167 lbs). That means my body mass index (BMI) is 25.1. The international standard for obesity is 30. To be labeled obese, I need to gain 15 more kilograms — roughly the weight of a large Welsh corgi.
But in South Korea, I am already obese, because BMI 25 is the obesity standard here.
By some estimates, South Korea has one of the lowest obesity rates in the world. Clothing stores exhibit sizes that would fit figures described as ‘skinny’ in most parts of the world. The media often fixate on golden standards of weight, especially for women — most beautiful female celebrities all seem to weigh less than 50 kg (roughly 110 lbs).
It’s not easy for someone like Park Ji-won to feel at home with her body. “People here often stare at me, ask about my weight, or sneer behind my back,” she said. “I am regularly shunned by clothing store employees saying they just don’t carry my size, 3XL.”
Meet the women breaking the “48 kg myth.” Video by Jieun Choi
Descriptions of the body feel much more ‘objective’ when quantified with numbers about weight and obesity. Numbers are more difficult to brush off than someone looking into the mirror and saying, “I’m looking a little bloated.” If a metric labels my body obese, then how do I reject that label?
The numbers that determine obesity, it turns out, are not as infallible as we think.
Body mass index is a global metric used to determine a person’s weight-to-height ratio. Its equation was created in the mid-19th century by Belgian mathematician Adolphe Quetelet, who defined the concept of l’homme moyen, or the average man. This equation was widely utilized to gauge a person’s thinness, via the equation mass (kg) / height (m2).
The limitations of relying on BMI as a diagnostic basis for individual patients are well-documented. It is not reliable for gauging children’s health; it overlooks the mass differences in individuals’ fat, muscle, and bone; and the standards for each weight class are deemed arbitrary. On an individual level, BMI 29 and 30 differ little, despite being classified as “overweight” and “obese,” respectively.
Institutions like the World Health Organization (WHO) and the Center for Disease Control in the U.S. acknowledge that BMI is not “diagnostic of the body fatness or the health of an individual.” But it is still a surprisingly effective predictor of other public health metrics, such as blood pressure, risk of diabetes, and risk of heart disease. Until there’s another unit of measurement with a better indicator of a population’s overall health, BMI is here to stay.
“Some people tell me that my weight is a burden to society,” said Park, who is classified as obese under the BMI metrics. “But really, I take care of my own health.”
South Korea is hypervigilant about weight, much in line with its general obsession with beauty. A national survey of 7,400 adults in 2016 revealed that 60.9 percent of female respondents and 41.8 percent of male respondents were either already on a diet or considering going on one. The results were more damning for minors: 72.7 percent for girls and 36 percent for boys. A 2015 survey by Nielson Korea found that three out of five Koreans consider themselves overweight.
This weight anxiety is partly rooted in the South Korean definition of obesity, which easily labels someone that looks healthy, if perhaps a tad rotund, as obese. South Korea isn’t alone: This lower BMI standard for obesity is commonly used in many Asian regions like Japan or Hong Kong.
In 2000, the Western Pacific Region of the WHO (WPRO) published a report titled, “The Asia-Pacific Perspective: Redefining Obesity and Its Treatment,” which proposed a lower obesity cut-off line for Asian countries because Asians tended to have a higher ratio of body fat — and thus a higher risk of contracting various illnesses — than other ethnicities at equal BMI measurements.
But the report was inconclusive, stating, “Sparse data exist at present to make definitive recommendations.” A follow-up expert consultation recommended that region-specific standards be used as “points for public health action.”
Nonetheless, South Korea has adopted the WPRO proposal as its official standard for determining obesity. The 2017 Obesity Factsheet, published by the Korean Society for the Study of Obesity, reads, “Obesity was defined as a body mass index ≥ 25.0 in adults, in accordance with the Asia-Pacific criteria of the WHO guidelines.”
Adding to the confusion, South Korea uses different BMI standards domestically and internationally. “When collecting obesity-related data, the government follows BMI 25 for internal use and BMI 30 for submission to international organizations that conduct comparative studies,” said Kwon Seon-hee, researcher at Korea Center for Disease Control.
“BMI is a very simplified metric,” Kwon said. “It is not a particularly meaningful indicator of an individual’s health, and is used for monitoring and maintaining public health.” Despite years of debate within the medical community, BMI 30 has not demonstrated sufficient merit over BMI 25 in being the more accurate indicator of public health in South Korea, Kwon said.
If BMI 25 is the obesity standard, 34.8 percent of people in South Korea were obese in 2016: 42.3 percent of men and 26.4 percent of women.
If BMI 30 is the standard, 5.7 percent of men and 4.5 percent of women were obese. Compared to international obesity rates — 36.2 percent in the U.S., 35.4 percent in Saudi Arabia, 23.8 percent in Spain — South Koreans have one of the lowest obesity rates in the world.
Park Ji-won wants to dissociate value judgements from our bodies and body types. She wants to create a world in which everyone can be comfortable in their own bodies, regardless of size, color, or ability.
“I don’t claim that being fat is healthy,” she said. “But it does come down to being free from stigma.”
Yeom Yun-hye is a plus-sized model for Korean online shopping mall J-Style, renowned for making clothes in sizes up to 99, equivalent to 3XL. “People often assume we are lazy, simple, or nice just because of our weight,” said Yeom. “We take care of our health, don’t worry.”
“Beauty and self-worth are connected,” she said. “As I began to tell myself I was valuable, I could see that I deserve to feel beautiful, too.”
“We [at J-Style] want to show more people that they deserve to love and feel loved.”
Park says her ‘body positive activism’ is different from looking pretty despite the fat. “Body positive activists show themselves the way they really are — cellulite and all.”
In Park’s world, it’s okay not to be beautiful.
Cover image: How infallible are the numbers? (Source: mohammed via PublicDomainPictures, CC0 Public Domain)