Obesity has been shown to increase the risk of some types of injury in crashes. One hypothesis is that obesity adversely effects belt fit by changing the routing of the belt relative to the underlying skeletal structures. To evaluate this hypothesis, belt fit was measured in a laboratory study of 54 men and women, 48 percent of whom were obese, with a body mass index (BMI) of 30 kg/m2 or greater.
The results suggest that obesity effectively introduces slack in the seat belt system by routing the belt further away from the skeleton. Particularly in frontal crashes, but also in rollovers and other scenarios, this slack will result in increased excursions and an increased likelihood and severity of contacts with the interior.
The higher routing of the lap belt with respect to the pelvis also increases the likelihood of submarining in frontal crashes. (Quoted from the document's abstract.)
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