In international death statistics based on medical certificates of death, obesity is still a rare cause of death despite a large number of publications about the obesity’s significant impact on population mortality. There are no international recommendations describing the criteria of obesity as a underlying cause of death or a contributing cause of death. This discussion article has addressed issues of the E66 code (obesity) specifying in medical certificates of death, substantiated the need to prepare methodological recommendations based on the consensus of professional communities of physicians, pathologists, cardiologists, endocrinologists and psychiatrists. The publication and application of the recommendations will contribute to a better understanding of the role which obesity can play in mortality and will allow to clearly reflect the obesity’s impact on population.