OBJECTIVES: The risk of developing cardiovascular and other life threatening diseases is strongly linked to increased body weight. This is particularly relevant to people with type 2 diabetes (T2D) in whom over 80% are overweight. Limited data exist on the impact on Health Related Quality of Life (HRQOL) of Body Mass Index (BMI) for people with type 2 diabetes. The aim of this study was to characterize the impact of BMI on HRQOL for people with and without T2D in England. METHODS: Data from the Health Survey for England 2003 (HSE03) was evaluated. HSE03 consisted of a stratified random sample designed to provide data about the general population living in private households in England. Observations for 13,233 non-diabetic patients and 461 patients with T2D were included. HRQOL was measured using the EQ-5D. Overall HRQOL differences were investigated using t-tests. Analyses of variance (ANOVA) were used to investigate relations between EQ-5D scores and categories of BMI (underweight (<18.5), normal (18.5-<25), overweight (25-<30), obese (30-<40) and extremely obese (>40). RESULTS: The overall HRQOL was significantly lower for people with T2D compared to non-diabetic patients, with EQ-5D scores of 0.795 versus 0.867, respectively (p<0.01). An ANOVA showed that the non-diabetic obese subgroup (BMI>-30) had a significant reduced HRQOL compared to others (p<0.05). The HRQOL for people with T2D was significantly (p<0.05) lower for the morbidly obese (BMI>40) compared to people in the normal weight band (BMI of 18.5-<25). The HRQOL was lower for people with T2D across all BMI categories compared to non-diabetics. CONCLUSION: These findings suggest that obesity in the general adult population in England has a significant impact on HRQOL. The impact of obesity on HRQOL is particularly evident in people with T2D who are further burdened by the impact of their disease.