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Background Obesity has become a major health issue not only in the West but also in Asia. Morbid obesity can lead to much comorbidity and can markedly interfere with quality of life. The aim of this study was to compare the health-related quality of life (HRQL) between patients with morbid obesity coming for bariatric surgery and the healthy population in Taiwan. Methods Patients were between age 18 and 65 years. Patients had a BMI between 32 and 40 kg/m2 with obesity-related comorbidities or a BMI > 40 kg/m2. Patients were enrolled for bariatric surgery by a modified recommendation of the Asia-Pacific consensus. Physical and psychiatric evaluations were accomplished simultaneously. The World Health Organization Quality of Life (WHOQOL-BREF), Taiwan version, was administered 1 month before the operation. The quality of life of the obese patients was compared with age-, sex-, education-, marriage-, and municipality-matched healthy control patients taken from a national survey in Taiwan. Multiple regression analyses were conducted to study risk factors for impairment of HRQL. Results A total of 114 consecutive patients with obesity coming for bariatric surgery at our hospital were enrolled in 2007. Obese subjects had poorer WHOQOL-BREF scores than those of the healthy referents in physical, psychological, and social domains but not in environmental domain (P