Obesity was determined by body mass index (BMI), a measurement that takes both height and weight into account.
As the level of obesity increased, so did the odds of dying in the crash. Compared to normal-weight drivers, those at the lowest level of obesity were 21 percent more likely to die, those at the next level were 51 percent more likely to die and those who were most obese were 80 percent more likely to die, Rice and Zhu found.
Obese women had a greater risk of dying than obese men, the researchers noted.
In addition, underweight men were slightly more likely to die in a crash than normal-weight drivers, the study found.
These risks remained even for drivers wearing seat belts and even when the airbag deployed, the authors noted.
Car design may have to be adapted to reduce the risk to these drivers, Rice and Zhu add, especially in light of the U.S. obesity epidemic.
"It may be the case that passenger vehicles are well designed to protect normal-weight vehicle occupants but are deficient in protecting overweight or obese occupants," they wrote in their study.
Commenting on the findings, Dr. David Katz, director of the Yale University Prevention Research Center, said: "We have a serious and pernicious problem of anti-obesity bias in the United States. Efforts to address that may at times invite us to pretend that size doesn't matter, but, in fact, it does."
The world around us has been built to accommodate prevailing norms of height, weight, he noted. "It just stands to reason that safety systems such as those in cars, designed for people of a certain average size, may serve a population of a larger average size less well," Katz said.
That may be what's behind the new findings, he said, but it also could be that obesity-related illne
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