Obesity rates are reaching an epidemic worldwide. In the US, nearly 40 million people are obese. The automotive safety community is starting to question the impact of obesity on occupant protection. This study investigates fatality and serious injury risks for front-seat occupants by Body Mass Index (BMI). NASS-CDS data was analyzed for calendar years 1993-2004. Occupant exposure and injury was divided in seven BMI categories with obese defined as those with BMI ≥ 30 kg/m
2
. Injuries were studied for drivers and right-front passengers and included analysis of lap-shoulder belted and unbelted occupants. The results show that obese occupants have a higher fatality risk compared to normal BMI occupants; morbidly obese occupants (BMI ≥ 40 kg/m
2
) have 2.25 times higher fatality risk (1.15% v 0.51%). The fatality risk for belted obese drivers was 0.29%, which was 6.7 times lower than the 1.94% for those unbelted. These rates are similar to other BMI occupants. In conclusion, obesity influences the risk of serious and fatal injury in motor vehicle crashes. The greatest difference in risk is for fatalities, which are highest in the morbidly obese, in part, because of lower seatbelt wearing rates.
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