Last year the world didn’t see enough of North Korean Supreme Leader Kim Jong-un. He disappeared from public view and almost immediately stories appeared speculating that he was ill or dead. Of course, he eventually reappeared, embarrassing those who participated in a global death watch.

Now the talk has started again, though this time because he remained in public view. First, he obviously lost weight, as much as 44 pounds in the estimation of South Korean analysts. If intended, that is good news for him. He was estimated to weigh as much as 308 pounds which, given his relatively short stature, made him morbidly obese. (He also drinks and smokes, two other risk factors.) He is vulnerable to heart disease, diabetes, and several other maladies. Dropping a couple of pounds would improve his longevity.

However, substantial weight loss isn’t always intended. If not, it can be a sign of a serious illness, such as cancer. If there was no other indication of infirmity, the drop in weight would more likely be chalked up to a diet fit for a king, or at least a different sort of hereditary leader like himself. But he also recently sported a mark and later a bandage on his head.

Of these nothing was said publicly, of course, and they could reflect minor issues. Seven years ago he disappeared after limping and returned to view walking with a cane. He reportedly had ankle surgery, from which he apparently recovered completely and without difficulty. (In 2008 his father disappeared for far longer with a stroke, and nothing was said to the public then, though after Kim pere reappeared his enfeebled state could not be hidden from viewers.) The latest incident also could be unimportant.

Yet there are indications that Kim Jong-un or his colleagues might be preparing for a succession. Earlier this year the Supreme Leader acquired a promotion, to the general secretary of the Workers’ Party of Korea. No longer is that position reserved for his father, who died almost a decade ago. Kim fils vacated the position of first secretary, which could become a second-in-command. This move could be unimportant, but venerable North Korea-watcher Andrei Lankov suggested that it related to possible succession: “No other ruling communist party has had a formally defined position of second-in-command—a ruler in-waiting.”

In fact, the Kims have on occasion informally shared power. Kim’s father, Kim Jong-il, acted as quasi-prime minister, running domestic policy during DPRK founder Kim Il-sung’s final years. As Kim Jong-il recovered from a stroke in August 2008 his brother-in-law, Jang Song-thaek, acted in the former’s stead. (After Kim Jong-il’s death, Jang was tasked to help mentor Kim Jong-un, only to be executed by his pupil, perhaps for attempting to take over.)

All that we know about Kim Jong-un’s present health are hints, rumors, and other wisps of information gained while peering through the glass darkly into the DPRK. The fixation on Kim’s health seems creepy. However, in a regime widely (though not universally) believed to reflect one-man rule, what happens when that person crosses the River Styx is hugely important. The deaths of Vladimir Ilyich Lenin, Joseph Stalin, and Mao Zedong all set off lengthy and consequential power struggles.

In contrast, Kim Il-sung spent a couple decades planning the transition—eliminating rivals, promoting Kim Jong-il, and turning day-to-day management over to the latter. The younger Kim had less time with his son, since the process did not start until Kim Jong-il recovered from his stroke. That left less than three years. Although the succession seemed to go smoothly, it is unclear how much authority Kim Jong-un inherited immediately and how much was added as he surmounted any ensuing challenges.

In any case, today’s Supreme Leader has no obvious heir. His kids are too young. His wife has no political role. His older brother was judged lacking by their father and is a political non-entity. His half-uncle was exiled as ambassador to several European nations by Kim Jong-il. The only plausible candidate would be his sister, Kim Yo-jong. Although she plays an important role, her power appears to be almost entirely derivative, dependent on her brother. Indeed, she appears to have been promoted and demoted, presumably by him, with some regularity, suggesting the lack of an independent power base.

She does possess royal blood, but that means little if her status has not been presented to the public. Nor is it obvious that the Kim pedigree matters much these days: given the floodtide of information from South Korea which has raised Kim Jong-un’s ire, North Koreans appear to be less credulous than in years past. Equally important: DPRK politics is unremittingly sexist. The only women who have enjoyed substantial authority have been the Kims’ wives, consorts, and sisters, and their influence dissipated immediately when a succession occurred.

If not among Kim’s relations, then who would become the next Great Successor? Kim Jong-un’s tendency to transfer, replace, and purge aides leaves no obvious number two, which might well be his intention. In late June he demoted a couple of top officials for “creating a grave incident in ensuring the security of the state and safety of the people.” However, rather than follow Uncle Jang into oblivion, they moved to lesser positions.

Given the lack of an obvious heir apparent, a succession fight would likely be brutal and unpredictable. Heads of security agencies might make a grab for the brass ring. In the Soviet Union long-time secret police chief Lavrentiy Beria failed when he sought the top role in 1953; KGB head Yuri Andropov won the leadership of the communist party in 1982 but died shortly thereafter. The military could bid for power or play kingmaker while extracting promises to protect the institution’s role and privileges.

A collective leadership could emerge, at least at the start. However, North Korean politics always has featured a dominant leader. So has the South, though since 1987 it has relied on elections to select the men and women who rule. The very nature of the North Korean system—totalitarian with no safety net for those who fail—puts a premium on ending up atop the pack. As Donald Trump might say, second place is for losers.

There’s very little that the U.S. could do to influence the outcome. However, the Biden administration should watch carefully if instability seems to threaten. Washington also has cause to maintain open communication with China about potential political challenges in the North. The best case would be a new reform-minded government, something which all should hope for but no one should expect.

The worst case would be a bitter faction fight that turns violent, with military clashes and let loose nuclear, chemical, and biological weapons. When Bruce Bennett analyzed the possibility of a DPRK collapse nearly a decade ago, he warned: “There is a reasonable probability that North Korean totalitarianism will end in the foreseeable future, with the very strong likelihood that this end will be accompanied by considerable violence and upheaval.” This possibility, though small, is terrifying enough to warrant conversations with the ROK and China over how to protect peace and stability on the peninsula in the event of a DPRK implosion.

Of course, none of that might happen, at least now. Indeed, most likely Kim Jong-un is healthy, or at least healthy enough to survive the next few years. Which would make the latest round of speculation come to naught. Indeed, so grave are the possible consequences of his death, many people in the West might be praying for his well-being.

Some day the Kim dynasty will pass from the scene. Until then absences and bandages involving Kim Jong-un will matter to not only people living on the Korean peninsula, but around the world. Hopefully, peace will survive his passing.

Doug Bandow is a Senior Fellow at the Cato Institute. A former Special Assistant to President Ronald Reagan, he is author of several books, including Tripwire: Korea and U.S. Foreign Policy in a Changed World and co-author of The Korean Conundrum: America’s Troubled Relations with North and South Korea.