Thick Thighs Save Lives
...whose lives?
I wanted to post something on here about fat studies because…well, I want to provide a perspective without stakes in this one.
I don’t have a diet to sell you, I don’t have a product. I just have an opinion, backed by some research, that I think is middle of the road and reasonable.
Here we go.
Do They?
The origin of the saying “Thick Thighs Save Lives” seems to be an article often cited from blackdoctor.com. That’s the earliest version I could find of the exact statement.
It does rhyme, and it does validate the idea that being heavier isn’t necessarily bad, which is something a lot of folks are inclined to be happy about hearing, so I can see why it caught on.
Let’s check the legitimacy of blackdoctor.com, overall.
For starters, the About Us section lists a CEO, CMO, and Editor. None of them are doctors or medical professionals of any sort. Strike one.
The site did win a web award. On their site, it lists the award as “2006 Web Award for Health Care Standard of Excellence.” However, when I checked to confirm, the award is for 2006 WEBAWARD FOR OUTSTANDING ACHIEVEMENT in Web Development.
That’s web development, not health information. So you could have a great-looking website that’s peddling total garbage and still win that award.
That’s a misleading strike two.
When it comes to the actual article, the article is linked to a Harvard study. The link from blackdoctor.com just goes to the general health.harvard.edu as opposed to the actual study, which indicates to me that they either don’t have access to the study or didn’t know how to link it. Excellence in web development indeed! Strike three.
But I did manage to dig up the original article: https://www.health.harvard.edu/staying-healthy/big-thighs-may-be-wise
Do thick thighs save lives?
Possibly
The study found a decreased rate of certain health problems was associated with thicker thighs. A few important caveats should be noted:
The study did not distinguish between muscle and fat composition when measuring thigh circumference, so we have an intermingling of people with thick, muscular thighs and people with thick, less muscular thighs, going up against people with thin thighs.
There was a similar study that found thicker, muscular upper arms also indicated health, suggesting that muscularity may be of high importance as opposed to general thickness.
The study did find a range. Below a certain thickness was bad. Above a certain thickness was not necessarily found to be bad, but didn’t provide any improved stats. So there’s a ceiling to “the thicker, the better.” That “ideal” circumference, where the thigh meets the butt, was about 24”, which is not super big.
While thigh fat was found to be less connected to bad health outcomes than midsection fat, this doesn’t mean it was good, it means it was less bad. In this sort of thing, the difference between “good” and “less bad” is significant. Imagine driving cross-country and you have the choice between “bad” music and “less bad” music. You’ll pick the “less bad” music, of course, but it’s a far cry from “good” music.
C&C Fitness Factory
The big problem with this study, and many others, is the difference between correlation and causation, and that’s why I wanted to highlight this particular study. The study mentions the problem in this form:
In America and around the world, women tend to be pear-shaped, while men tend to be apple-shaped. It may be one reason that women live longer than men, both in America and around the world.
While it seems possible that this body shape is a longevity factor, it’s far from demonstrated in this study that the fat distribution is the primary factor, or that it’s not itself a side effect of some other mechanism that contributes to longevity.
We’ve had a recent version of this with COVID studies and the death rates among men and women.
Men have died at a higher rate from COVID, but it seems very unlikely that this higher rate is due to biology (the presence of certain hormones or other biological differences), and instead is more likely due to a collection of factors, including the fact that men are less likely to be able to telecommute.
It’s like this, people: you can’t notice a difference between two groups of people, then notice another difference, and then be like, “Well, it must be because of Difference A that Difference B exists.” It might not be the first thing you hit on.
Doing This Simply
Let’s say we did a study that showed people who drink expensive coffee live longer. I bet we could arrange that. Then we say, “Hey everyone, people who drink expensive coffee live longer!”
When the study is reported that way, it sends the consumer a message: “Spend more on coffee, buy yourself a few years.”
But the truth is probably that people with higher household income have more money to blow on fancy coffee machines that grind beans and do all that shit, meanwhile broke-ass fools are drinking them Folgers crystals for free from the tire shop next door to their work.
I don’t think it’d be groundbreaking to say having a higher income gives you a better shot at a long life.
But we can isolate one factor, one signifier of wealth, and attribute longevity to that, and then we’ve got a story on our hands.
The Other Thick Thigh Problem
A lot of studies about thigh circumference and mortality also are about older people.
Older people, like 75+, have a different set of issues than younger people, and having thicker thighs in your 70’s has a different meaning because older folks tend to shed muscle mass as they march towards the grave.
When you get into studies about older folks, you also have to deal with the issue that these are people who made it to old age. So, anyone who was killed by their weight fairly young is off the board. The folks who are heavier and older have the genetics that make it a reasonable proposition to be heavier and healthy.
Getting a Grip
There’s another important aspect here, which is probably that the thick thighs saying is an anti-anti-fat thing. What’s the right way to say that...An anti-fat-shaming thing?
In the “Thick Thighs” movement, I’ve also seen an oft-repeated tale that grip strength is really the best measure of health.
Let me explain something, first using the study that is most often cited:
tl;dr: grip strength can be a good measure of health, and that’s because it’s strongly correlated with limb muscle strength, physical activity, low sedentary time, ethnicity, age, sex, height, and socioeconomic status.
With all of these factors also affecting grip strength, it basically says that it’s not possible to determine which things affect handgrip most and why exactly handgrip can be a measure of health.
This study expands the definition of “unfit” by including people who aren’t fat but are also not fit, and that’s useful in the mix here.
So, yes, you can be fat and be stronger than someone who is thin, but this doesn’t mean you’re healthy. It simply means that there is someone LESS healthy than you walking around. I guess this is good news for anyone that feels that their health is a relative proposition. As long as you’re healthier than THAT GUY, we’re good.
In this study, it was found that being obese affected handgrip fatigability, meaning that perhaps an obese person had a forceful grip, but could not maintain that grip as long as a non-obese person.
This one found, “...after controlling for age, sex, education, smoking, alcohol use, physical activity, several chronic diseases, and current body weight,” that obesity had a negative effect on handgrip.
So here’s what you get when you put all this together: grip strength may be a good measure of health. And fit people tend to have better grip strength.
BMI Rears its Stupid Head
Both the thick thighs and grip strength might be something that people have spread around because everyone is looking for something other than BMI to measure and predict health.
BMI is not necessarily the best predictor of health. There’s a lot of other anthropometric data that matters beyond height and weight. A guy who’s 5’5” with really broad shoulders, or, as we put it delicately, built like a brick shithouse, will probably never have a “good” BMI. I knew a guy whose arms were thickest at the elbow joint, he was just naturally that skinny. His BMI was never going to tip into “obese” if he started doing olive oil shots for a daily power hour.
BMI is also obviously not suited to people who have an athletic build, and less obviously, it may underestimate the body fat in someone who has aged and converted muscle into fat.
It’s far from perfect.
That said, I’m of the opinion that BMI is a useful, quick tool for doing some measurements when there’s no big need to be precise. It’s a ballpark that’s measurable with the info most people know and have tools to measure at home (as opposed to their grip strength or water displacement).
Because, in reality, your grip strength would need to be put into the context of your overall size anyway. Someone who weighs 225 lbs is absolutely going to have a stronger grip than someone who weighs 98 lbs, even if that 98-pounder is a lean mean deadlift device. Bet you thought I was going to say “Machine.” But I’ve learned from this very newsletter that rhyming isn’t always the way.
While BMI probably isn’t a great tool for comparing two different people, it’s probably useful for you, as an individual, to see sharp variations. If you were a pretty steady BMI for 5 years in your mid-30s, then shot up in one year without a significant other change (having a baby or something), then it’s a good indicator that perhaps something’s up.
Go ahead and use multiple options. If your grip strength gets worse, your BMI goes up, and your thigh circumference changes drastically one way or the other, maybe see if there’s something going on.
The Issue At Gripping Hand
I really dislike when people try to prove, scientifically, something that just isn’t true.
Being super overweight is not healthy. Being super underweight is also not healthy.
The mistake, to me, comes in trying to prove scientifically that there is no such thing as a healthy range for individuals.
And this is where I deviate from a lot of social causes.
The Other Truths
Fat people have value. Their value isn’t based on their weight. They, in the same numbers as people who aren’t fat, are great people. There are plenty of useless skinny people, plenty of athletic dickheads out there.
I’m not a fan of that line of thinking that out-of-shape people are costing us insurance money and so on. It’s not like a heavy dude is like, “Fuck it, joint replacement surgery is a blast!” Besides, very few of us can throw stones on that one, it’s not like any of us can honestly say that we’ve never done anything that’s a health risk. So give it a rest.
I think the message I want to send is that you should question the wisdom here. Ask yourself what you know about health, everything you’ve learned about it, and in which scenarios being fatter is better.
There are some answers, I think.
I think when we say “fatter,” there’s a big matter of degree. Someone who has been shredded most of their life and puts on 25 pounds in their 40’s, while continuing to take care of themselves, is probably okay.
If someone has been underweight most of their life, being fatter probably IS healthier.
A bodybuilder who stops bodybuilding and puts on a few pounds is probably a healthier person than they were when they were bodybuilding and competing severely dehydrated.
Someone who gains weight while carrying a baby is healthy, that’s very normal.
Someone who perceives themselves as at a good weight when they’re really underweight is probably healthier as a fatter person.
Social Messages and Medical Messages
Socially, there’s no reason to make fun of a fat person, no reason to see a fat person as lesser. If someone’s general level of fitness is not preventing them from doing anything they want to do, then there’s no issue, socially. If you go to work and your coworker is very fat, but your job is mostly sitting at a desk all day, this person being fat doesn’t really have anything to do with you, and it’s not your place to have a little chat with them about it.
Basically, if you’re not a medical professional or someone who is helping someone with their fitness level, and if you’re not doing a super physical job together like loading a truck, someone else’s weight or relative fitness isn’t any of your business.
Your Body And What You Want To Do With It
If your body is doing what you’d like, without too much complaint, and you feel like your life activities are not restricted because of your fitness, then you might be good to go.
When I go on vacation, I usually go to a city, and I usually do a lot of walking. For me, it’s important to be able to walk 5 miles in a day every day for 5 days in a row without being destroyed. I’d like to be able to do that in an enjoyable way, know what I mean? It’s a vacation, not an athletic feat.
So, for me, a level of fitness that makes this possible is important. It facilitates what I want to do with my life.
Maybe that’s not you. And if that’s not you, that’s cool.
And I would encourage you to start thinking about weight in that way: Is my fitness level holding me back from doing things I’d like to do?
Now, this DOES NOT include something like, “I would like to model swimsuits on Instagram.” It doesn’t include things you’d “like” to do in an aesthetic sense.
And this is hard for people, because “I’d like to feel confident in a swimsuit” is high up on a lot of lists.
This, to me, is where social causes and science can meet:
You can feel confident in a swimsuit at whatever weight. I think it’s a good thing to try and decouple your confidence level from your appearance.
If your confidence and your appearance are linked, that means when you feel fat, you’ll also have no confidence. Not a fun combo.
If you feel confident because of things other than your appearance, you’ll be able to still have confidence even when you’re not feeling totally awesome about your appearance, and that’s good, that will help carry you through times when your body isn’t what you’d like.
Here’s the one extra caveat I want to put on it, though: If you’re able to live the life you want and don’t feel held back by your fitness, that’s awesome. But if you’re in your 20’s or 30’s and feel that way, you should know that most of us will find further problems coming home to roost in our 40’s and beyond.
Feeling good, being mobile, and even having good bloodwork in your 20’s often has less to do with what you’re doing and more to do with the fact that you’re in your 20’s.
Do Thick Thighs Save Lives?
Seems like probably not.
But maybe, in a way, the attitude behind the saying can.
Be confident in who you are and your value.
If your fitness is a problem or headed towards being a problem, don’t toss it off with a cute rhyme. At the same time, don’t feel shitty about it.
We can all learn to acknowledge the scientific truth about fitness while also recognizing a sometimes-paradoxical emotional truth about how important it is to feel good about yourself.
It doesn’t have to be one or the other. You can change your fitness without hating yourself. Or you can be satisfied with yourself while still acknowledging that your state isn’t ideal, but, eh, good enough, you know?
Truth be told, I think that route is a fuck of a lot easier than the self-loathing, mirror-gazing path.
Because I just don’t think feeling shitty about yourself is anything approaching a good motivator, and even if it does motivate you to make a change, you’ll still be pretty miserable.