Sarcopenic obesity: time to meet the challenge

Barazzoni, Rocco; Bischoff, Stephan C.; Boirie, Yves; Busetto, Luca; Cederholm, Tommy; Dicker, Dror; Toplak, Hermann; Van Gossum, Andre; Yumuk, Volkan; Vettor, Roberto

doi:10.1016/j.clnu.2018.04.018

Cited by 260Nutrition and Health in AgingMuscle Physiology and DisordersBody Composition Measurement Techniques

Sarcopenic obesity: time to meet the challenge

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Barazzoni, Rocco, Bischoff, Stephan C., Boirie, Yves, Busetto, Luca, Cederholm, Tommy, Dicker, Dror, Toplak, Hermann, Van Gossum, Andre +2 more·2018·Clinical Nutrition

DOI 10.1016/j.clnu.2018.04.018

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Abstract

The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social and multi-disciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures and cancer, as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenetic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight-reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term "sarcopenic obesity" has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.

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Experts and guidelines recommend a combination of moderate calorie restriction, increased protein intake, and exercise for the treatment of sarcopenic obesity.
“Experts and guidelines recommend a combination of moderate calorie restriction, increased protein intake, and exercise for the treatment of sarcopenic obesity.16,44,49,53,55”
From Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis (2023) · cites this paper as [49]
In individuals with sarcopenic obesity, inflammatory processes, other myocellular mechanisms, or hormonal changes, as well as the presence of chronic diseases and pathological processes, likely lead to higher protein needs to maintain or even improve muscle mass, strength, and function.
“In individuals with sarcopenic obesity, it is likely that inflammatory processes, other myocellular mechanisms, or hormonal changes, as well as the presence of chronic diseases and pathological processes, lead to higher protein needs to maintain or even improve muscle mass, strength, and function.3,49”
From Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis (2023) · cites this paper as [49]
Nutritional interventions such as increasing dietary protein intake are essential for reaching the treatment aims in individuals with sarcopenic obesity, namely, maintaining muscle mass and function and reducing fat mass.
“However, nutritional interventions such as increasing dietary protein intake are clearly essential for reaching the treatment aims in individuals with sarcopenic obesity, namely, maintaining muscle mass and function and reducing fat mass.7,49”
From Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis (2023) · cites this paper as [49]

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Tardif N, Salles J, Guillet C, Tordjman J, Reggio S, Landrier JF, Giraudet C, Patrac V, Bertrand-Michel J, Migne C, Collin ML, Chardigny JM, Boirie Y, Walrand S: Muscle ectopic fat deposition contributes to anabolic resistance in obese sarcopenic old rats through eIF2α activation. Aging Cell 2014; 13: 1001-1111.
Batsis JA, Barre LK, Mackenzie TA, Pratt SI, Lopez-Jimenez F, Bartels SJ: Variation in the prevalence of sarco- penia and sarcopenic obesity in older adults associated with different research definitions: dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999-2004. J Am Geriatr Soc 2013; 61: 974-980.

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Self-citation
Diagnosis and Management of Sarcopenic Obesity
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Authors: Barazzoni, R., Bischoff, S. C., Boirie, Y., Busetto, L., Cederholm, T., Dicker, D., Toplak, H., Van Gossum, A., Yumuk, V., & Vettor, R.
Affiliations: University of Trieste (IT)
University of Hohenheim (DE)
University of Padua (IT)
Uppsala University (SE)
Tel Aviv University (IL)
Medical University of Graz (AT)
Istanbul University-Cerrahpaşa (TR)
Corresponding author: Barazzoni, Rocco
ORCID: Barazzoni, Rocco
Bischoff, Stephan C.
Boirie, Yves
Busetto, Luca
Cederholm, Tommy
Dicker, Dror
Toplak, Hermann
Yumuk, Volkan
Vettor, Roberto
Venue: Clinical Nutrition
Publisher: Elsevier BV
Published: 2018-12
Volume: 37
Issue: 6
Pages: 1787-1793
ISSN: 0261-5614 (ISSN-L)
DOI: 10.1016/j.clnu.2018.04.018
OpenAlex: W2801249437
Cited by: 260
References: 88
Citations by year: 2026: 20 · 2025: 19 · 2024: 36 · 2023: 57 · 2022: 40 · 2021: 34 · 2020: 27 · 2019: 21 · 2018: 4 · 2016: 1 · 2012: 1
FWCI: 14.74
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
HAL (submittedVersion, other-oa)
ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by-nc-nd)
Padua Research Archive (University of Padova) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords: sarcopenic obesity, obesity, skeletal muscle mass, muscle function, frailty, body composition, diagnostic criteria, nutritional therapy, weight loss treatment, chronic comorbidities
MeSH terms: Frailty, Body Composition, Chronic Disease, Diabetes Mellitus, Type 2, Humans, Life Style, Obesity, Prognosis, Risk Factors, Muscle, Skeletal, Metabolic Syndrome, Nutrition Therapy, Adiposity, Sarcopenia

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