Body-Mass-Index Associated Differences in Ortho- and Retronasal Olfactory Function and the Individual Significance of Olfaction in Health and Disease

Odor (including flavor) perception plays a major role in dietary behavior. Orthonasal olfactory function (OOF) has been shown to decrease in obese subjects. Changes in retronasal olfactory function (ROF) after weight loss and in the individual significance of olfaction (ISO) in obesity are yet to be investigated. Firstly, 15 obese subjects were recruited in a pilot study and supported to conventionally lose weight. OOF (Sniffin' Sticks) was measured at the beginning and after 5.6 +/- 1.3 months. Eleven subjects re-visited but barely lost weight and no major changes in OOF were observed. Secondly, the body-mass-index (BMI), OOF, and ROF (Candy Smell Test, CST) were recorded in subjectively olfactory-healthy subjects (SOHSs) and additionally the ISO questionnaire was collected in patients with olfactory dysfunction (OD). BMI correlated significantly negatively with odor discrimination (p = 0.00004) in 74 SOHSs and negatively with CST (p < 0.0001) in 66 SOHSs. In 48 SOHSs, there was a gender difference in ISO scores (p = 0.034), but no significant correlation with BMI was found (p > 0.05). ISO scores were significantly higher in 52 OD patients in comparison to SOHSs (p = 0.0382). Not only OOF but also ROF may decline with higher BMI. ISO does not seem to alter with BMI, but olfaction becomes more important once it is consciously impaired.