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Stimson Center: Kim Jong Un’s Recent Weight Loss: A Medical Assessment


July 2, 2021 

by: Kenneth Dekleva

Recent media reports in the West, South Korea and even in North Korea have highlighted Chairman Kim Jong Un’s recent weight loss, leading to a flurry of speculation as to whether his weight loss is intentional or due to illness. A careful review of comments in the North Korean media, plus Kim’s recent political behavior and likely intentions, suggest that Kim’s weight loss is intentional and related to health concerns. Both a desire on his part to improve his health—as contrasted with his potential worsening health—and his actual health have huge political implications for the Korean Peninsula.

Since taking power in December 2011, following the sudden cardiac death of his father, Kim Jong Il, Kim has gained a large amount of weight. He is approximately five foot seven, thought to weigh over 300 pounds, and suffers from morbid obesity (e.g., body mass index [BMI] > 40; the above numbers suggest a BMI of 47). Kim’s weight alone raises legitimate health concerns regarding possible cardiac disease, secondary diabetes, obstructive sleep apnea, hypertension and elevated cholesterol. These risk factors, along with his family history of cardiac disease (in both his father Kim Jong Il and his grandfather Kim Il Sung) and his heavy smoking habit, put him at a high risk of suffering a cardiac event or stroke within the next decade.

The domestic political context of Kim’s recent weight loss, following an absence from public view for several weeks, has important implications for North Korea. In recent months, Kim has publicly highlighted the need to struggle against external conditions and adversaries, even referring to the language of the tragic “Arduous March” of the late 90s, in which over one million North Koreans perished due to famine, and noting recent food shortages.[1] Recent North Korean media accounts have lamented that its citizens were “heartbroken” at seeing their leader so “emaciated” at a recent televised art performance. The most striking aspect of such commentary in the Democratic People’s Republic of Korea (DPRK)’s media is that it happened at all. Kim’s health has previously been—like that of most autocratic leaders—a closely guarded state secret. The state media’s recent openness in this regard suggests that Kim wants to play up his weight loss for political reasons. But doing so also serves to humanize Kim and make him more appealing—and not only to the North Korean public; in this sense, he is acting like a very modern, even millennial type of leader.

What might account for Kim’s recent weight loss, if not due to underlying disease? One possibility is that he has been on weight loss medications for the past few months, which would typically allow for weight loss of one to two pounds per week if accompanied by a properly managed diet.[2] Alternatively, Kim may have had a bariatric surgery procedure such as a gastric sleeve or a gastric bypass. In most cases, these can be done laparoscopically and would lead to a weight loss of five pounds per week, with long-term targeted weight loss of 50 percent of his excess weight (e.g., > BMI 25).

At this point, time and further apparent weight loss might answer the question of whether Kim has had bariatric surgery or medically treated weight loss. That said, even if Kim is finally (!) paying more attention to his health, we’ll get a better sense of his intentions if he also quits smoking and heavy drinking. As first noticed during his initial 2018 summits with South Korean President Moon, his wife (Ri Sol Ju) has nagged him—even in public—about quitting smoking. More recently, she may have played an important role in Kim’s health choices and health promotion.

It’s also possible that COVID—and its ongoing mutations and variants (some of which are more infectious)—may have further alarmed Kim, as his morbid obesity and likely cardiovascular disease and Type 2 diabetes are risk factors. And he may thereby be even more motivated to remain healthy so as to complete his long-term aspirational goals for the DPRK.

As Kim asks the North Korean people to tighten their belts more, it is politically wise for him to lose weight. Surely, he cannot help but notice the good health and vigor of other (older) leaders whom he has met, such as Presidents Xi Jinping, Vladimir Putin and Moon Jae-in. And most importantly, if he wishes to pass on the Mt. Paektu lineage to one of his children, he’ll have to remain healthy enough to do so over time (as was the case with his father), versus his rapid period of preparation following Kim Jong Il’s stroke in 2008. Kim may have begun to appreciate that HIS longevity and health—not merely possessing nuclear weapons—is what ensures the survival of the DPRK and his legacy. In this sense, Kim’s weight loss may not be a bad thing. It also sends signals to the US and others that ­a healthier Kim will have more time to wait for the optimal conditions to negotiate. Presidents Joseph Biden, Xi, Moon and Putin should take note.

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Kenneth Dekleva is a senior fellow with the George H. W. Bush Foundation for U.S.-China Relations. The views expressed in this publication are solely those of the author and do not necessarily reflect the views of the George H.W. Bush Foundation for U.S. China Relations.