Nationwide Trends in Body Mass Index, Underweight, Overweight and Obesity Among Korean with Disabilities from 2008 to 2017

Background: The maintenance of optimal body weight is a crucial component in health and quality of life. However, little is known about weight distribution and trends among people with disabilities. This study in South Korea examined the 10-year trends of weight and prevalence of underweight, overweight and obesity according to disability grade and types compared with those without disabilities. Methods: We linked national disability registration data with national cancer screening program data. Age-standardized prevalence of underweight and obesity were analyzed for each year during the period 2008 to 2017, according to the presence, type, and severity of disabilities. Risk of underweight, overweight, obesity, and severe obesity were examined by multinomial logistic regression after adjusting for socio-demographic and clinical variables as of 2017. Findings: People with disabilities (both male and female) had a higher risk of underweight compared to those without disability (OR 1·41, 95% CI 1·38-1·44, and OR 1·31, 95% CI 1·28-1·34, respectively), especially in those with severe disabilities (OR 2·00, 95% CI 1·94-2·06 in male, and OR 1·83, 95% CI 1·77-1·89 in female, respectively). The age-standardized prevalence of severe obesity (BMI ≥30·0 kg/m2 ) was also higher in people with disability, and the disparity relative to people without disability widened from 1·8% in 2008 to 3·7% in 2017. Women with disabilities are more likely to be obese than those without disabilities regardless of disability severity (OR 1·40, 95% CI 1·38-1·41). The risk of severe obesity was also more prominent in women with disabilities (OR 2·08, 95% CI 2·05-2·11). Interpretation: Physical, mental and developmental disabilities were significantly associated with higher prevalence of obesity as well as underweight. The intersection of female gender, severe disability, and mental/developmental disabilities was associated with risk of severe obesity. Simultaneous efforts are needed to enhance food security as well as weight control and exercise for people with disabilities. Funding Statement: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Ministry of Science and ICT (MSIT) (No. 2019R1A2C1087507 and 2021R1C1C2008683) and the Korean Ministry of Education (No. 2019R1D1A3A03103862). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The study protocol was approved by the Institutional Review Board of Chungbuk National University (CBNU-201910- BMETC-946-01)