Introduction: The current longitudinal study aimed to investigate the association of three stable obesity phenotypes (persistent metabolically healthy normal weight (P MHNW), persistent metabolically healthy obese (P MHO), persistent metabolically unhealthy obese (P MUO)), and one transient (MHO to MUO) obesity phenotype with health-related quality of life (HRQoL) throughout an 18-year period. Methods: 1932 participants (649 men and 1283 women) who completed the HRQoL questionnaire during 2016-2019 were recruited in the current investigation. Based on the body mass index (BMI) and metabolic status, participants were classified into four obesity phenotypes, including 1) P MHNW, 2) P MHO, 3) P MUO, and 4) Transient from MHO to MUO. The HRQoL was compared between groups using analysis of covariance. Participants' age, marital status, occupation status, education level, physical activity, and smoking were adjusted. Results: After adjustment for confounder variables, a significant difference among obesity phenotypes was indicated in PCS scores of both sexes and MCS scores just in women (P value=

The Author(s). Published by S. Karger AG, Basel