Metabolic Phenotypes—The Game Changer in Quality of Life of Obese Patients?

Abstract

Background: The present study aimed to investigate the association of obesity phenotypes and quality of life (QoL) scales and their relationship with fat mass (FM) parameters. Methods: This study categorized 104 subjects into 4 obesity phenotypes based on BMI and metabolic syndrome status: metabolically healthy obese (MHO), metabolically unhealthy obese (MUO), metabolically healthy non-obese (MHNO), and metabolically unhealthy non-obese (MUNO). Body composition was measured by dual-energy X-ray absorptiometry (DEXA) and metabolic profile was characterized by blood samples. All subjects completed the SF-36 item Short Form Health Survey Questionnaire. Results: Comparing the four obesity phenotypes, significant results were reported for Bodily Pain between MHNO/MUNO (p = 0.034), for Vitality between MHO/MUO (p = 0.024), and for Mental Component Score between MHO/MUO (p = 0.026) and MUO/MUNO (p = 0.003). A more thorough inside-groups analysis yielded a positive and moderate to high correlation between FM parameters and QoL scales in MHO and MHNO, while a negative and weak to moderate correlation was observed in MUO and MUNO. Conclusion: This study reported an inverse U-shaped relationship between FM and QoL in obesity phenotypes, suggesting that metabolic status is a key factor involved in modulating QoL and therefore challenging the idea of obesity as a main driver of low QoL. We recommend the inclusion of FM percentage in the definition of obesity phenotypes in future research, to better evaluate QoL of obesity phenotypes.