Objective  To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) among adult residents in Hubei province.

  Methods  We conducted a survey among 27 814 ≥ 18 years old residents recruited using stratified multistage cluster sampling across Hubei province in 2013. The Euro-Quality of Life-5 Dimension (EQ-5D) was adopted to assess the HRQOL of the participants. The relationship between categorized BMI and the scores of HRQOL and each dimension of EQ-5D were analyzed.

  Results  The scores of EQ-5D and EuroQol Visual Analogue Scale (EQ-VAS) were lower in both underweight male and female participants than in the participants with normal weight but there was no statistical difference in the scores between the overweight or obese participants and the normal weight participants. Both the male and female underweight participants had higher risks of health problems than the normal weight participants in the five dimensions of EQ-5D. Overweight male participants had a lower risk of anxiety/depression than the normal weight participants (odds ratio OR = 0.776, 95% confidence interval 95% CI: 0.626 – 0.961); overweight female participants had a higher risk of pain/discomfort than the normal weight female participants (OR = 1.150, 95% CI: 1.105 – 1.303); obese male and female participants had greater risks of mobility and self-care than normal weight participants and obese female participants were more likely to suffer from anxiety/depression than the normal weight female participants (OR = 1.381, 95% CI: 1.028 – 1.856).

  Conclusion  The HRQOL of underweight residents is relatively poor and the HRQOL is influenced by some physical or psychological problems among overweight or obese residents in Hubei province.