JMIR Publications

ABSTRACT

Background:

Over 39% of individuals globally are obese. In addition to obesity, metabolic syndrome is regarded as a major contributor to non-communicable diseases, and the two are closely related. Given this relationship, the concepts of metabolically healthy and unhealthy obesity, considering the metabolic status, have been evolving. Attention is being directed to metabolically healthy obese individuals, who have relatively low transition rates to other chronic diseases. Particularly, as obesity rates continue to rise and unhealthy behaviors prevail among young adults, there is a growing need for obesity management that takes these metabolic statuses into account.

Objective:

To identify demographic factors, health behaviors, and 5 metabolic statuses related to the transition from metabolically healthy obesity to unhealthy obesity among people aged 20 to 44 and to develop a screening tool to predict this transition.

Methods:

This was a secondary analysis study using national health information data from the National Health Insurance System in South Korea. We analyzed the customized data using SAS and conducted logistic regression to identify factors related to the transition from metabolically healthy to unhealthy obesity. A nomogram was developed to predict the transition using the identified factors.

Results:

There was a significant association between the transition from metabolically healthy to unhealthy obesity and male participants, those with the lowest socioeconomic status, smokers or current smokers, those consuming more than 30g/day of alcohol, those not exercising regularly, and those having abnormal metabolic factors. Each relevant variable was assigned a point value, and when the nomogram's total points reached 295, it was determined that the shift from metabolically healthy to unhealthy obesity had a prediction rate of greater than 50%.

Conclusions:

The study identified risk factors for the transition of young adults from metabolically healthy to unhealthy obesity. A screening tool was developed using these risk factors to predict metabolically unhealthy obesity. The established nomogram enables prediction of the risk rate at which young adults with obesity may transition to metabolically unhealthy states, making it a valuable tool for interventions tailored to the needs of the target group.