Suicide is much more common in underweight Koreans who think they are too heavy, a study showed on Sunday.

Among 1,122 underweight Koreans surveyed by the Samsung Medical Center, 101 of them said they had tried to lose weight as they thought they were not thin enough.

Those respondents were 2.5 times more likely to die by suicide than those without, the study found. The group with the disorder also had a 2.2 times higher risk of depression.

The average body mass index of the group with the disorder was 17.6, which was much lower than what the World Health Organization considers as a healthy weight range for East Asians, from 18.5 to 22.9.

“Underweight individuals who try to lose weight while they think they are obese are at risk ― both physically and psychologically,” said Dr. Lee Jung-kwon, one of the researchers.

“Society needs to pay more attention so these individuals don’t end up making tragic choices.”

Overseas studies have shown that extreme weight perceptions ― seeing oneself as overweight or obese ― may be a suicide warning sign, especially among teenage girls.

Widespread media images of skinny bodies also affect people’s perception of “normal bodies,” studies have shown.

In Korea, more than 90 percent of patients with bulimia nervosa, one of the most common eating disorders, are women, and about 70 percent of them are in their 20s and 30s.

The condition is characterized by binge eating followed by an attempt to purge the intake, such as by vomiting, or excessive exercise ― mostly because of an extensive concern with body image and weight. Those with the disorder usually have an additional psychiatric disorder, such as anxiety or mood disorders.

Korea’s suicide rate has been the highest among OECD nations since 2003.

By Claire Lee (dyc@heraldcorp.com)