Association Between Obesity and Post-COVID-19 Condition in Military Conscripts

Objectives: Obesity has been suggested as a possible risk factor for the post-COVID-19 condition, but most studies rely only on body mass index (BMI), which does not reflect body fat distribution. Waist-to-height ratio (WHtR) is a simple anthropometric indicator of central obesity and a practical proxy for body fat distribution, yet it has not been studied in relation to the post-COVID-19 condition. This study aimed to examine whether obesity, measured by BMI and WHtR, is associated with the post-COVID-19 condition. Methods: A total of 500 male military conscripts (aged 18 years) underwent anthropometric measurements (height, weight, and waist circumference). Participants with prior COVID-19 were asked whether they had persistent or new symptoms after infection. BMI categories followed WHO definitions, and WHtR ≥ 0.50 was used to define central obesity. Results: Of the 376 participants who had previously experienced COVID-19, 82 (21%) experienced the post-COVID-19 condition. Obesity (BMI ≥ 30) was more common among those with the post-COVID-19 condition than those without (15% vs. 5%). BMI-defined obesity was associated with higher odds of the post-COVID-19 condition (OR 2.80, 95%CI 1.25-6.24). Central obesity was also more frequent in the post-COVID-19 condition (26% vs. 14%) and was linked to increased odds as well (OR 2.18, 95% CI 1.20-3.97). Conclusions: Both BMI-defined obesity and central obesity were associated with the post-COVID-19 condition. While WHtR does not directly quantify body fat distribution, it represents a simple and feasible anthropometric indicator. Therefore, it may be an additional useful tool for identifying individuals at higher risk of prolonged symptoms after COVID-19 infection.