Nationwide trends in prevalence of underweight, overweight, and obesity among people with disabilities in South Korea from 2008 to 2017

Objectives: To investigate 10-year trends in weight and the prevalence of underweight, overweight, obesity, and severe obesity by disability status, type, and severity compared with those without disabilities. Methods: Serial cross-sectional analyses linking South Korea’s national disability registration data with National Health Information Database (NHID) general health checkup data (2008–2017). Age-standardized prevalences were estimated annually by disability presence, type, and severity. In 2017 data, multinomial logistic regression examined odds of underweight, overweight, obesity, and severe obesity adjusting for socio-demographic, behavioral, and clinical covariates. Results: Each year included over 10 million adults; in 2017, 14,246,785 adults (53.1% men). From 2008–2017, age-standardized obesity and severe obesity increased across sexes and disability status. Underweight declined among those without disabilities but rose in 2012 and then plateaued among those with disabilities. In 2017, disability was associated with higher odds of underweight (men OR 1.41, 95% CI 1.38–1.44; women OR 1.31, 95% CI 1.28–1.34), especially severe disabilities (men OR 2.00, 1.94–2.06; women OR 1.83, 1.77–1.89). Women with disabilities had higher odds of obesity than women without disabilities (OR 1.40, 1.38–1.41) and markedly higher odds of severe obesity (OR 2.08, 2.05–2.11). Mental disorder showed the highest obesity prevalence, followed by epilepsy and developmental disabilities. Conclusions: Disability is associated with increased odds of both underweight and obesity. Severe obesity is most pronounced among women with severe, mental, or developmental disabilities. Policies should target both underweight and obesity among people with disabilities.