Obesity Prevalence and Annual Weight Control Attempts across Municipalities in Chungcheongbuk-do and the Necessity of Korean Medicine Interventions

Objectives: This study analyzed the distribution of obesity prevalence and annual weight control attempt rates in Chungcheongbuk-do and examined the potential role of Korean medicine in community-based management.Methods: A cross-sectional descriptive study was conducted using 2024 Community Health Survey data from 14 municipalities in Chungcheongbuk-do.A four-category classification system was developed based on national median values, and indirect age-adjusted obesity rates were calculated using the national aging rate (19.2%).Stratified analyses by urbanization and aging status were performed, with 95% confidence intervals derived by the Wilson score method.Results: The mean obesity prevalence was 34.7% (range: 31.4-40.8%),slightly higher than the national median (34.4%).After age adjustment, urban areas showed higher obesity prevalence (adjusted mean 38.4% vs. 24.6% in rural areas), reversing the pattern observed in the unadjusted analysis.Nine municipalities were classified as high-obesity/low-attempts type.Conclusions: Obesity in Chungcheongbuk-do is influenced not only by individual behaviors but also by demographic and healthcare resource factors.The predominance of "high obesity⋅low attempt" regions, identified through a novel four-category classification system based on national medians, highlights structural barriers to weight management in rural, aging communities.Notably, the obesity paradox in elderly populations suggests the need for age-stratified approaches.Given the high density of Korean medicine institutions in the province (21.7%), evidence-based interventions-including acupuncture (grade A), herbal medicine (grade B), and constitution-based counseling-can provide accessible, integrated obesity management.These approaches may be particularly effective in underserved rural areas, where conventional lifestyle programs show limited success.