Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity
Open accessAbstract
This paper reviews the health implications of obesity, sarcopenia and sarcopenic obesity on CVD and mortality in older adults and discusses the obesity paradox seen in patients with CVD. Obesity is a major public health problem with increasing prevalence worldwide. It is an established risk factor for cardiovascular morbidity and mortality in adult populations. However, there is controversy surrounding the effects of obesity as measured by BMI in older people, and overweight and obesity (BMI ⩾ 25 kg/m 2 ) are apparently associated with increased survival in those with CVD (obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass which have opposing effects on mortality. Thus BMI is not a good indicator of obesity in older adults. Sarcopenia, the age-associated loss of skeletal muscle mass, is a major concern in ageing populations and has been associated with metabolic impairment, CVD risk factors, physical disability and mortality. Sarcopenia often coexists with obesity. Sarcopenic obesity is a new category of obesity in older adults who have high adiposity coupled with low muscle mass. To fully understand the effect of obesity on mortality in the elderly it is important to take muscle mass into account. The evidence suggests that sarcopenia with obesity may be associated with higher levels of metabolic disorders and an increased risk of mortality than obesity or sarcopenia alone. Efforts to promote healthy ageing should focus on both preventing obesity and maintaining or increasing muscle mass.
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Sarcopenic obesity has been associated with mobility limitation, cardiometabolic complications, disability, lower quality of life and mortality risk, and these associations appear stronger when obesity-related metabolic burden and sarcopenia-related functional impairment coexist.
“SO has been associated with mobility limitation, cardiometabolic complications, disability, lower quality of life and mortality risk, and these associations appear stronger when obesity-related metabolic burden and sarcopenia-related functional impairment coexist (4, 5).”
From Exercise-based interventions for sarcopenic obesity in middle-aged and older adults: an umbrella review of systematic reviews with pairwise meta-analyses and network meta-analyses (2026) · cites this paper as [5]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredSarcopenic obesity may have a greater impact on metabolic diseases and CVD-associated mortality than either sarcopenia or obesity alone.
“Thus, sarcopenic obesity may have a greater impact on metabolic diseases and CVD-associated mortality than either sarcopenia or obesity alone (82–85).”
From Health Consequences of Sarcopenic Obesity: A Narrative Review (2020) · cites this paper as [82]
Lipid overload in skeletal muscle lowers muscle mass and induces sarcopenia.
“Lipid overload in the skeletal muscle lowers muscle mass and induces sarcopenia [19,20].”
From A High-Fat Diet Induces Muscle Mitochondrial Dysfunction and Impairs Swimming Capacity in Zebrafish: A New Model of Sarcopenic Obesity (2022) · cites this paper as [20]
Either low-grade inflammation or ectopic fat distribution generates myokine imbalance and mitochondrial dysfunction.
“Moreover, either low-grade inflammation or ectopic fat distribution generates myokine imbalance and mitochondrial dysfunction (32, 33).”
From Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments (2020) · cites this paper as [32]
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- Authors
- Wannamethee, S. G., & Atkins, J. L.
- Affiliations
- University College London (GB)
- Corresponding author
- Wannamethee, S. Goya
- Venue
- Proceedings of the Nutrition Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-04-27
- Volume
- 74
- Issue
- 4
- Pages
- 405-412
- ISSN
- 0029-6651 (ISSN-L)
- 1475-2719
- OpenAlex
- W2104069717
- Cited by
- 404
- References
- 71
- Citations by year
- 2026: 22 · 2025: 48 · 2024: 54 · 2023: 42 · 2022: 49 · 2021: 54 · 2020: 34 · 2019: 26 · 2018: 33 · 2017: 24 · 2016: 10 · 2015: 8
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Proceedings of The Nutrition Society (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (SPCR-031)
- British Heart Foundation (RG/08/013/25942, RG/13/16/30528)
- National Institutes of Health
- NIHR School for Primary Care Research
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- sarcopenia, sarcopenic obesity, obesity, older adults, cardiovascular disease, mortality, obesity paradox, body mass index, visceral fat, muscle mass, aging, healthy aging, metabolic disorders
- MeSH terms
- Aging, Body Composition, Humans, Obesity, Body Mass Index, Muscle, Skeletal, Abdominal Fat, Sarcopenia
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