The precision of results obtained from the ¹⁰⁹Cd K XRF in vivo measurement system of bone lead for obese subjects with high BMI (body mass index) was poor. The main factor affecting the precision was the distance between tibia and detector. Compared with the standard phantom, a large phantom was used to simulate the obese subject in the measurements at different distances to the detector. The counts of Compton scattering increased highly because of the tissue overlying and surrounding tibia of the obese subject. When the distance between leg and detector was too small, the instrument would produce the distorted x-ray spectra, so that the obtained data were inaccurate. In order to ensure good measurement precision and accuracy, the distance between leg and detector should be maintained at 25 mm during the counting period. Meanwhile, the dead time displayed instantly on the instrument should be controlled to around 30%.