It is important to record obesity on the medical certificate of cause of death (MCCD)

Abstract

Recent data shows that 37% of the Irish adult population are overweight (body mass index, BMI 25–29.9) and a further 24% are obese (BMI>30). From 2007-2012 an average of 28,339 people died per annum in Ireland, yet obesity featured in the MCCD an average of only 84 times per annum. We examined figures from our autopsy service: in 200 cases where the BMI was recorded 22.5% were >30, but this was recorded in the MCCD in a minority of cases as a contributing factor to the death. All postmortem rooms in Ireland were surveyed on the ability to assess BMI at autopsy. The MCCD is an important source of information for national health statistics. We conclude that the omission of obesity on the MCCD is due to a combination of factors including fear of offending the family of the deceased, lack of knowledge on conditions associated with an elevated BMI and lack of education on the importance of recording BMI across all levels of the healthcare system. We suggest modifications to the MCCD to allow appropriate recording of risk factors for disease.