A still from an official North Korean video of Kim Jong-un shows the leader giving a speech while firmly grasping the lectern with the facial expression of an unwell person.

A just-released official photo of Kim Jong-un is stirring speculation on whether the North Korean leader is ill and if his previously reported health problems have returned.

The photo, distributed by the DPRK on Wednesday, shows Kim with a noticeably puffy face, with his sister, Kim Yo-jong on his left and Kim Yong-nam, the president of the Presidium of the Supreme People’s Assembly, on his right. Yo-jong and Yong-nam were with the North Korean delegation that attended South Korea’s Winter Olympics.

Kim Jong-un seen with his sister and another member of North Korea’s delegation to the Pyeongchang Olympics, Kim Yong-nam.

“Possibly they are hugging him, but it really looks like they are holding him upright to prevent him from falling over. His face also seems rather bloated. Both of these features suggest a return of the health problems that have bedeviled him since coming to power,” John Pike, a Washington, DC-based military intelligence expert told Asia Times.

Pike called attention to the photo and detailed what are believed to be Kim’s past health problems in a Wednesday post on his website globalsecurity.org. He noted that North Korea’s media acknowledged Kim’s ill-health in late September 2014 following a near-month-long absence from the public eye.

He says another image — a still of an official video of Kim from Wednesday — shows the leader giving a speech while firmly grasping the lectern with the facial expression of an unwell person.

Kim is rumored to be suffering from various diseases, such as obesity, hyperlipidemia, high blood pressure and diabetes. Others say he may have gout or a thyroid condition.

“There is a history of heart disease in his family. His grandfather, Kim Il-sung, and father, Kim Jong-il, both had heart problems. The rumors going around that his heart condition isn’t very good were based on these facts,” Pike said in his post.

“In July 2014, a portly Kim was seen awkwardly limping across a stage at a ceremony marking the 20th anniversary of the death of his grandfather, the country’s founding president. Shortly thereafter, a state media documentary mentioned in passing that the leader, regarded by many North Koreans as an almost divine figure, was experiencing unspecified ‘discomfort.’ Kim had gained a large amount of weight since he took over as the country’s top leader following the death of his father in 2011,” Pike added.

If Kim does have health problems, it raises questions about his fitness to lead North Korea in the face of a tense nuclear standoff with the US and its allies. Health issues could also affect his ability to preside at a possible summit with South Korean President Moon Jae-in in Pyongyang. Kim extended a formal invitation to Moon for a meeting on February 10 as the Winter Olympics got underway in Pyeongchang.

Moon is yet to accept the invitation.

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