Sarcopenic Obesity

Sarcopenic obesity is a geriatric syndrome characterized by the simultaneous presence of excess body fat and reduced skeletal muscle mass and strength. This dual condition creates a unique metabolic burden that is more harmful than obesity or sarcopenia alone.

The prevalence is increasing steadily in adults aged 65 years and older, with a major subset of this population now classified as having sarcopenic obesity. Key causes include excess energy intake, physical inactivity, low-grade inflammation, insulin resistance, and hormonal changes associated with aging and a sedentary lifestyle. Adipose tissue derangements and chronic diseases further contribute to muscle catabolism in obese patients.

Currently, there are no commonly accepted diagnostic criteria beyond those for sarcopenia and obesity separately. Treatment emphasizes lifestyle interventions: resistance exercise training to build muscle, adequate protein intake, and controlled caloric reduction to reduce fat while preserving muscle mass. Pharmacologic approaches are still under investigation. Recognition of obese patients with associated muscle problems is essential for clinicians to prevent this important geriatric syndrome.