Quality of Life in Thyroid Cancer Survivors: The Influence of Obesity

Although thyroid cancer has an excellent prognosis, many survivors report persistent quality of life (QoL) impairments. Obesity is highly prevalent among thyroid cancer survivors (TCS) and may exacerbate these impairments, yet data on this association remain limited. This study aimed to evaluate the relationship between body mass index (BMI) and health-related QoL in TCS. A cross-sectional study was conducted between January 2021 and July 2022 among 342 TCS. QoL was assessed using the EORTC THY34 module. Clinical, metabolic, and demographic data were collected. Patients were stratified by BMI: normal weight (18.5–24.9 kg/m 2 ), overweight (25–29.9), and obese (≥30). Associations between BMI and QoL domains were analyzed using multivariate linear regression. Among the 307 respondents to the THY34, 52.9% were obese. Obesity was significantly associated with older age, female sex, and higher prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome ( P < 0.001). Obese patients reported significantly poorer body image ( P = 0.020) and more muscle cramps ( P = 0.039) after adjusting for confounders. No significant differences were found in global QoL, emotional well-being, or social support across BMI groups. While overall health-related QoL did not differ significantly by BMI category, specific physical and body image-related symptoms, particularly body image dissatisfaction and muscle cramps, were more pronounced among obese TCS. These findings underscore the need for comprehensive survivorship care, including metabolic assessment, rehabilitation, and tailored psychosocial support, to address obesity-related challenges.