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Sarcopenic obesity is a combination of high body fat and low muscle mass. The low muscle mass is usually due to age-related muscle loss. Treatment includes lifestyle and dietary changes.
Sarcopenia, which is the loss of muscles and increasing frailty, usually affects older people, as well as those with medical conditions that affect strength.
People with sarcopenic obesity commonly have co-occurring medical conditions. There is also some evidence that sarcopenic obesity may increase the risk of earlier death. Diet and exercise interventions can help treat the condition.
Learn more about sarcopenic obesity, including the causes, treatments, and outlook.
What is sarcopenic obesity?
Sarcopenic obesity is the combination of high body fat and significant muscle loss.
A 2020 study on sarcopenic obesity defines obesity as the presence of any of the following:
- • a body mass index (BMI) greater than or equal to 30
- • a body fat percentage of greater than 30%
- • a waist circumference of more than 88 centimeters (cm) or 34.6 inches (in) for females and 102 cm or 40.1 in for males
However, it is worth noting that measures of obesity can sometimes have limitations. For example, BMI cannot tell a doctor what a person’s overall strength or level of health is.
There is also no clear consensus on the definition of sarcopenic obesity among researchers. In studies, the definitions can vary.
Obesity combined with a significantly lower-than-average score on a strength test may indicate a person has sarcopenic obesity.
What causes sarcopenic obesity?
No single cause explains all cases of sarcopenic obesity. However, sarcopenia is usually age-related.
In a 2020 study of 521 men and women at age 75 and 288 men at age 85, 4% of women and 11% of men in the younger cohort had sarcopenic obesity. In the older cohort, 10% of men had sarcopenic obesity, suggesting a significant role for advancing age.
Additionally, many of the same risk factors for obesity are also risk factors for sarcopenia, which may explain why it often co-occurs with obesity. These risk factors include:
- • inflammation
- • insulin resistance
- • oxidative stress
- • being sedentary
Effects on health
The effect sarcopenic obesity has on a person will depend on their circumstances and the severity of the condition.
Doctors use a two-stage system for diagnosing the severity of sarcopenic obesity. In stage 1, a person has an altered body composition but no complications as a result. In stage 2, a person has one or more related complications, which may include:
- • metabolic diseases, such as diabetes
- • cardiovascular diseases, such as high cholesterol
- • respiratory diseases
Even if a person has none of these complications, sarcopenia alone can negatively affect quality of life. Sarcopenia has links to:
- • higher incidence of falls
- • higher likelihood of bone fractures
- • muscle pain and weakness
- • joint pain
- • loss of independence
- • a higher risk of complications after surgeries
Is sarcopenic obesity reversible?
Treatment for sarcopenic obesity can slow muscle loss and reduce the risk of health complications. In some cases, it can also reverse sarcopenic obesity, according to an older 2013 paper.
Diagnosing sarcopenic obesity
Doctors consider two factors when diagnosing sarcopenic obesity: body fat and muscle strength.
In most cases, doctors diagnose obesity based on BMI. However, BMI is not a perfect tool, so doctors may also assess body fat percentage or measure waist circumference.
Doctors may use several different tests to measure muscle strength. These include:
- • tests of hand strength
- • tests of how many times a person can get up and down from their chair unassisted
- • measures of balance
- • tests of walking speed
When using the staging system to determine the severity of a person’s condition, a doctor may also test for co-existing conditions to determine whether a person is in stage 1 or 2.
Treatment and management
Lifestyle and dietary changes are essential for treating sarcopenia. Doctors may recommend one or more of the following:
- • eating a calorie-controlled diet
- • aerobic exercise
- • strength training
- • eating more protein, or using protein supplements
- • taking calcium and vitamin D supplements
Diets for obesity typically involve eating fewer calories for gradual, sustainable weight loss. This could mean eating fewer carbohydrates or less fat.
As weight loss also causes muscle loss, it is important for people to work with a dietitian and a doctor to develop a fitness plan that will counteract this. They can recommend the best approach for a person’s individual situation.
Management for other underlying conditions, such as diabetes, may also be part of treatment. Managing such conditions may reduce the risk of other illnesses and complications.
If a person’s BMI is over 30, doctors may consider obesity medications. If it is over 40, or over 35 and a person has another severe condition, they may recommend surgery.
Outlook for sarcopenic obesity
Sarcopenic obesity is a risk factor for several health conditions. Additionally, there is some evidence it may affect mortality risk.
In a 2020 cohort study, researchers found that older women with sarcopenic obesity had a higher risk of dying within 10 years. There was a similar association among older men, but it was not statistically significant.
However, sarcopenic obesity is treatable with diet and exercise. Diet and exercise may also reduce the effect of other conditions that tend to co-occur with sarcopenic obesity, which may further increase health and quality of life.
People who are concerned they might have sarcopenic obesity should contact a doctor for professional support.
Summary
Sarcopenic obesity is a combination of a high BMI or body fat percentage with low muscle mass. It often affects older adults and frequently occurs alongside other conditions.
Sarcopenic obesity can cause disability and may be a factor in the development of several chronic conditions. However, it is also treatable through diet, exercise, and management of any underlying conditions.
People who experience weakness or are concerned they might have obesity should consult a doctor. Obesity is a medical condition, and the right interventions can improve health and well-being.