Background The US Preventive Services Task Force recently recommended screening all adult patients for obesity due in part to the strong association between obesity and numerous chronic diseases. However, how obesity affects health-related quality-of-life (HRQL), particularly for persons without any chronic diseases, is less clear.

Methods The relationship between obesity and HRQL was examined using data from the 2000 Medical Expenditure Panel Survey. Respondents ≥18 years were classified as underweight, normal weight, overweight, class I obesity, and class II obesity based on their BMI. HRQL was measured by the 12-item Short Form physical and mental summary scores (PCS-12 and MCS-12, respectively) and EuroQol EQ-5D index and visual analogue scale (EQ VAS). The impact of obesity on HRQL was examined through multivariate regression, adjusting for sociodemographics and disease status.

Results After adjustment, HRQL decreased with increasing level of obesity. Compared to normal weight respondents, persons with severe obesity had significantly lower scores with scores on the PCS-12, MCS-12, EQ-5D index, and EQ VAS being 4.0, 1.1, 0.073, and 4.8 points lower, respectively. Such decrements of HRQL for severe obesity were similar to the decrements seen for diabetes or hypertension. Persons with moderate obesity or who were overweight also had significantly lower HRQL scores, particularly on the PCS-12 and EQ-5D index. Underweight persons also had lower MCS-12 and EQ VAS scores.

Conclusions Persons with obesity had significantly lower HRQL than those who were normal weight and such lower scores were seen even for persons without chronic diseases known to be linked to obesity.