The NIS estimates the authoritarian leader, who is around 40 years old, weighs 140kg and is at high risk for heart disease, which runs in the family. The agency believes he first started showing symptoms of high blood pressure and diabetes in his early 30s, said Mr Lee.

“A trend has been detected in which Kim Jong-un is seeking medications other than the existing ones,” he said.

Some of Kim’s stress may be related to the weather. North Korea has been hit again this year by record-breaking rain and major floods that have left thousands of people stranded and damaged farmland crucial for providing food for the malnourished population.

The heavy rains submerged homes and swamped Sinujiu city and Uiju county, bordering China. Kim was spotted in rare pictures apparently intended to show him leading the relief effort as he traversed flooded roads in his black Lexus, water lapping at the bottom of the vehicle’s doors.

Kim was angered by a “grave crisis” caused by local officials, according to state media, reported NK News.

He was reported to have “personally directed the battle” and declared parts of three provinces as “special disaster emergency zones” while ordering officials to deliver aid to victims and take rapid action to prevent further disasters from future rainfall.

More than 4200 residents were said to have been evacuated by air but the flooding will compound fears about increased food insecurity in the coming months.

South Korea’s unification ministry said the coverage of the floods appeared intended to strengthen propaganda about Kim’s image as a leader who loves his people and to emphasise his crisis management capabilities.

The Telegraph, London