One size doesn’t fit all
Eleven years ago I was invited to address 1000 GP’s at a conference on obesity. In Seoul, South Korea. I had to admit I wasn’t too familiar with things Korean so after accepting the invitation I set about my homework. Koreans are not Chinese, or Japanese, they are, very proudly, Korean. But my initial findings were confusing. Why, in a country that had published obesity levels of only 3% were doctors anxious to learn from me how to treat it? To put it into context, the UK had obesity levels of 21% at that time and concern was rapidly growing about our own obesity crisis. My educational journey has never stopped. I am always learning new things about the subject. But what I learned then was very significant. And it’s all about the futility of trying to measure everything in the same way……
We calculate obesity, and overweight, using the “body mass index (BMI)”. You can find out what your BMI is from lots of places, including on the home page of www.jennycraig.co.uk We traditionally consider a BMI of 25+ as being overweight, and a BMI 30+ as obese. Now, when you use this definition, there are indeed only 3% of South Koreans who are obese. But what I quickly learned from speaking with the Korean doctors, and which has since been recognised internationally, was that Koreans, and many other Asian peoples, develop health problems associated with overweight at a much lower level of body fat. They are in effect genetically programmed to be much lighter than Caucasian (European) people. Instead of health risk starting at a BMI of 25, as we use here in the UK, in Asian countries, the same level of disease risk cuts in at a BMI of around 23. Instead of the risks of obesity starting at a BMI of 30, in Asia it starts at a BMI of 27.5. Calculate the number of South Koreans with a BMI of 27.5+ and suddenly we were looking at a population where some 15% were, from a health perspective, to be considered obese. And that’s why the Korean doctors were so worried.
My first trip to Korea was followed sometime later by a second, to run training courses for Korean doctors on weight management. I enjoyed my time there immensely. Such a friendly, dignified, cultured, and fascinating nation. In some ways we are so different, and in others so alike. But since that time, as a general rule I encourage people to consider the following. If you’re Caucasian, and your BMI is 25 or over, you might want to think about losing weight. Your health risk is already unacceptably raised. If you’re of Asian, Chinese, or Indian descent, the same increased risk of disease starts with a BMI of 23, and although some tables might tell you your weight is normal, take it from me, my Korean doctor colleagues, and the WHO, it probably isn’t. Once you’ve decided that weight loss is important to you however, at this point the same rules apply to everyone.
On my first visit to Seoul, one of my new colleagues took me straight out for lunch. I was amazed at what was laid out in front of me. The table was set in traditional Korean style with 17 different, delicious dishes. Fortunately each was just a tiny portion. Sometimes quality is far more important than quantity.
Dr Ian Campbell
One size doesn’t fit all
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By Dr Ian Campbell December 2011
Eleven years ago I was invited to address 1000 GP’s at a conference on obesity. In Seoul, South Korea. I had to admit I wasn’t too familiar with things Korean so after accepting the invitation I set about my homework. Koreans are not Chinese, or Japanese, they are, very proudly, Korean. But my initial findings were confusing. Why, in a country that had published obesity levels of only 3% were doctors anxious to learn from me how to treat it? To put it into context, the UK had obesity levels of 21% at that time and concern was rapidly growing about our own obesity crisis. My educational journey has never stopped. I am always learning new things about the subject. But what I learned then was very significant. And it’s all about the futility of trying to measure everything in the same way……
We calculate obesity, and overweight, using the “body mass index (BMI)”. You can find out what your BMI is from lots of places, including on the home page of www.jennycraig.co.uk We traditionally consider a BMI of 25+ as being overweight, and a BMI 30+ as obese. Now, when you use this definition, there are indeed only 3% of South Koreans who are obese. But what I quickly learned from speaking with the Korean doctors, and which has since been recognised internationally, was that Koreans, and many other Asian peoples, develop health problems associated with overweight at a much lower level of body fat. They are in effect genetically programmed to be much lighter than Caucasian (European) people. Instead of health risk starting at a BMI of 25, as we use here in the UK, in Asian countries, the same level of disease risk cuts in at a BMI of around 23. Instead of the risks of obesity starting at a BMI of 30, in Asia it starts at a BMI of 27.5. Calculate the number of South Koreans with a BMI of 27.5+ and suddenly we were looking at a population where some 15% were, from a health perspective, to be considered obese. And that’s why the Korean doctors were so worried.
My first trip to Korea was followed sometime later by a second, to run training courses for Korean doctors on weight management. I enjoyed my time there immensely. Such a friendly, dignified, cultured, and fascinating nation. In some ways we are so different, and in others so alike. But since that time, as a general rule I encourage people to consider the following. If you’re Caucasian, and your BMI is 25 or over, you might want to think about losing weight. Your health risk is already unacceptably raised. If you’re of Asian, Chinese, or Indian descent, the same increased risk of disease starts with a BMI of 23, and although some tables might tell you your weight is normal, take it from me, my Korean doctor colleagues, and the WHO, it probably isn’t. Once you’ve decided that weight loss is important to you however, at this point the same rules apply to everyone.
On my first visit to Seoul, one of my new colleagues took me straight out for lunch. I was amazed at what was laid out in front of me. The table was set in traditional Korean style with 17 different, delicious dishes. Fortunately each was just a tiny portion. Sometimes quality is far more important than quantity.
Tags: Health