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.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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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:

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.

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:

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

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.

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.

Lifestyle and dietary changes are essential for treating sarcopenia. Doctors may recommend one or more of the following:

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.

Learn more about treatments for 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.

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.