Obesity carries yet another surprising risk, according to a new study: obese drivers are more likely than normal weight drivers to die in a car crash.
Researchers reviewed data on accidents recorded in the Fatality Analysis Reporting System, managed by the National Highway Traffic Safety Administration. Beginning with 41,283 collisions, the scientists selected accidents in which the cars, trucks or minivans were the same size.
Then the investigators gathered statistics on height and weight from driver's licenses and categorized the drivers of wrecked cars into four groups based on body mass index. The study, published online Monday in the Emergency Medicine Journal, also recorded information on seat-belt use, time of day of the accident, driver sex, driver alcohol use, air bag deployment and collision type.
In the analysis, there were 6,806 drivers involved in 3,403 accidents, all of which involved at least one fatality. Among the 5,225 drivers for whom the researchers had complete information, 3 percent were underweight (a B.M.I of less than 18.5), 46 percent were of normal weight (18.5 to 24.9), 33 percent were overweight (25 to 29.9) and 18 percent were obese (a B.M.I. above 30).
Drivers with a B.M.I. under 18 and those between 25 and 29.9 had death rates about the same as people of normal weight, the researchers found. But among the obese, the higher the B.M.I., the more likely a driver was to die in an accident.
A B.M.I. of 30 to 34.9 was linked to a 21 percent increase in risk of death, and a number between 35 and 39.9 to a 51 percent increase. Drivers with a B.M.I. above 40 were 81 percent more likely to die than those of normal weight in similar accidents.
The reasons for the association are unclear, but they probably involve both vehicle design and the poorer health of obese people. The authors cite one study using obese and normal cadavers, in which obese people had significantly more forward movement away from the vehicle seat before the seat belt engaged because the additional soft tissue prevented the belt from fitting tightly.
"This adds one more item to the long list of negative consequences of obesity," said the lead author, Thomas M. Rice, an epidemiologist with the Transportation Research and Education Center of the University of California, Berkeley. "It's one more reason to lose weight."
Other factors that might have affected fatality rates — the age and sex of the driver, the vehicle type, seat-belt use, alcohol use, air bag deployment and whether the collision was head-on or not — did not explain the differences between obese and normal weight drivers.
"Vehicle designers are teaching to the test — designing so that crash-test dummies do well," Dr. Rice said. "But crash-test dummies are typically normal size adults and children. They're not designed to account for our nation's changing body types."
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