**Riccardo Dalle Grave \*, Fabio Soave, Antonella Ruocco, Laura Dametti and Simona Calugi**

Department of Eating and Weight Disorders, Villa Garda Hospital, 37138 Garda (VR), Italy; info@attiviperstarbene.it (F.S.); anto82ruocco@gmail.com (A.R.); lauradametti96@gmail.com (L.D.); si.calugi@gmail.com (S.C.)

**\*** Correspondence: rdalleg@tin.it

Received: 6 February 2020; Accepted: 24 February 2020; Published: 26 February 2020

**Abstract:** Background: The aim of this study was to investigate the interconnections between specific quality-of-life domains in patients with obesity and high or low physical performance using a network approach. Methods: 716 consecutive female and male patients (aged 18–65 years) with obesity seeking weight-loss treatment were included. The 36-item Short Form Health Survey (SF-36) and the six-minute walking test (6MWT) were used to assess quality of life and physical performance, respectively. The sample was split into two groups according to the distance walked in the 6MWT. Network structures of the SF-36 domains in the two groups were assessed and compared, and the relative importance of individual items in the network structures was determined using centrality analyses. Results: 35.3% (*n* = 253) of participants covered more distance than expected, and 64.7% (*n* = 463) did not. Although low-performing patients showed lower quality of life domain scores, the network structures were similar in the two groups, with the SF-36 Vitality representing the central domain in both networks. Mental Health was a node with strong connections in patients who walked less distance. Conclusions: These findings indicate that psychosocial variables represent the most influential and interconnected features as regards quality of life in both groups.

**Keywords:** obesity; physical performance; network analysis; vitality; mental health
