Poorer Health-Related Quality of Life Is Associated with Psychological Distress in Women with Overweight and Obesity

Background/Objectives: Obesity is a multifactorial disease that affects both physical and mental health, deteriorating health-related quality of life (HRQoL). This is an exploratory cross-sectional study aimed to evaluate the association between HRQoL and psychological distress in women with overweight and obesity. Methods: This study included 128 women aged 18–44 years with a BMI ≥ 25 kg/m2. Participants completed the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Depression, Anxiety, and Stress Scales-21 (DASS-21) questionnaires; anthropometric and biochemical measures were also assessed, and insulin resistance indices were calculated. Associations were evaluated using Spearman’s correlation coefficients and linear regression. Results: Women with obesity exhibited significantly higher insulin resistance and lower HRQoL than those with overweight. This difference was particularly evident in domains such as physical function, sexual life, and public distress (p < 0.05). Additionally, higher levels of depression, anxiety, and stress symptoms were consistently associated with a poorer quality of life in both groups (ρ = −0.434 to −0.625). Self-esteem, public distress, and work were the domains most strongly correlated with psychological distress, and these associations largely remained significant after Bonferroni correction. Waist circumference (WC) and hip circumference (HC) were associated with public distress among women with obesity independently of age (p < 0.001), but not after further adjustment for BMI. No significant associations were found between central adiposity and DASS-21 subscales. Conclusions: HRQoL was associated with psychological distress in women with overweight and obesity, whereas central adiposity and surrogate measures of insulin resistance were not associated with DASS-21 scores. These exploratory findings serve to generate hypotheses and should be confirmed in longitudinal studies.