My Mother said, “I Like a Man With Love Handles.” Science Suggests She’s Half-Right

I took my cardiologist's advice—move more and worry less about your weight—in two ways. 

First, I began regularly exercising. This didn't come naturally to a nerdy reporter, and it dramatically improved my life. 

The second way I took it was less than smart. I treated his words as a green light to celebrate, splurging on peanut butter (Skippys Super Crunch) on Ritz Crackers, a few glasses of wine, and a bowl of Wheaties.

Weight has always been a struggle of mine. I missed the slim gene that lets some people eat whatever they want and stay lean. Over the years, I've heard every version of the overweight person’s plight— that my weight is killing me, that it's causing hidden damage, or simply that I should relax about it.

I love you, Mom, but at 73, I want to know what modern science says.

In 1989, researcher Steven Blair at the Cooper Institute published a study of about 13,000 men and women whose fitness they had measured on a treadmill. Over the next eight years, the least fit died at more than 3x the rate of the most fit. 

But a follow-up study of nearly 22,000 men found that skinny men who were unfit had a higher risk of death than fit obese men. The researchers concluded that the benefits of being lean were limited to men who were also fit. When Blair's team then looked at people over 60, they found the same thing. Fitness, not fatness, predicted who lived longer.

My mother may have been onto something. According to newer research, being overweight is not linked to a higher risk of death as we age. 

In a 2014 analysis, which pooled 32 studies of nearly 200,000 people over 65, the risk of death rose instead for older people at the low end of what the charts call a healthy weight, and only began climbing once people were well into the obese range. 

Doctors still argue about why, and part of it may be that sick people lose more weight. 

Once we enter our 70s, the bigger threat is not extra pounds, but the loss of muscle and bone. When we age, most of us lose muscle every year unless we work to keep it, and this loss can increase the risk of falls, broken hips, and frailty that takes away independence.

Where the fat sits seems to matter more than how much the scale reads.  Fat that settles around the belly and wraps the internal organs–called visceral fat–is more dangerous than the superficial kind. It drives up blood sugar, blood pressure and cholesterol, and it is linked to diabetes, heart disease and fatty liver. 

Fat on the hips and thighs does less damage. Britain's health watchdog, NICE, now recommends a simple test: keep your waist measurement under half your height. For a man who is six feet tall, that means a waist under 36 inches.

A review of 88 twin studies with more than 140,000 twins estimates that genes account for between half and three-quarters of the differences in body weight between people. Some people really are built to stay lean on the same food that makes me heavier. 

Genetics is not an excuse to eat a big bowl of sugar pops in an afternoon, but it does mean the guilt I have carried for most of my life does not match biology.

New weight-loss drugs add another wrinkle. They work, but in clinical trials, anywhere from a quarter to 40% of the weight lost was lean tissue, including muscle. For an older person, losing muscle comes at a cost, which is why doctors increasingly insist on strength training and plenty of protein alongside them.

The scale is the least useful number I have. I pay more attention to:

If those are in good shape, my weight probably won’t kill me.

If they start to slip, that is when the weight deserves my attention.  And when it does, I want to lose fat without losing the muscle I have worked to keep.

Weight loss also has vanity benefits. I like myself more in the mirror; my clothes fit better, and I move freely with more confidence. It brings joy to living. But scientifically, my cardiologist had it right years ago: keep moving, stay strong, watch your waistline, and stop treating the scale as a moral verdict. 

As for the sandwich, pasta, and cereal… I probably shouldn't have celebrated quite that hard.

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