Sarcopenic obesity: how do we treat it?
Open accessAbstract
PURPOSE OF REVIEW: The increasing prevalence of sarcopenic obesity in older adults has heightened interest in identifying the most effective treatment. This review highlights recent progress in the management, with an emphasis on lifestyle interventions and pharmacologic therapy aimed at reversing sarcopenic obesity. RECENT FINDINGS: Whereas weight loss and exercise independently reverse sarcopenic obesity, they act synergistically in combination to improve body composition and physical function, beyond which is observed with either intervention alone. Optimizing protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition is associated with favorable changes in body composition in animal studies, although experience in humans is relatively limited. Testosterone and growth hormone offer improvements in body composition, but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy shows promise, but further studies are needed in older adults. SUMMARY: At present, lifestyle interventions incorporating both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. Maintenance of adequate protein intake is also advisable. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH analogs have a role in the treatment of sarcopenic obesity.
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Adults 65 years and older are at increased risk of sarcopenia, characterized by an age-related decrease in skeletal muscle mass with accompanying losses of strength and physical function.
“Adults 65 years and older are at increased risk of sarcopenia, characterized by an age-related decrease in skeletal muscle mass, with accompanying losses of strength and physical function [74, 75].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [75]
Sarcopenic obesity is managed with lifestyle interventions, exercise, nutrition, and medical therapies.
“Sarcopenic obesity is treated with a range of management approaches, such as lifestyle interventions, exercise, nutrition and medical therapies.”
From Sarcopenic obesity in older adults: a clinical overview (2024) · cites this paper as [128]
The main goals when treating sarcopenic obesity are to decrease body fat and to support the build-up or preservation of muscle mass and muscle function.
“As well as reducing the accompanied complications such as cardiovascular disease, the main goals when treating sarcopenic obesity are to decrease body fat and to support the build-up or preservation of muscle mass and muscle function [5, 11••, 12].”
From Effects of nutrition and exercise interventions on persons with sarcopenic obesity: an umbrella review of meta-analyses of randomised controlled trials (2023) · cites this paper as [12]
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“The correct identification of people with this condition using an accurate diagnostic criterion would greatly facilitate targeting people who have SO with appropriate public health measures and interventions [27].”
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- Authors
- Bouchonville, M. F., & Villareal, D. T.
- Affiliations
- University of New Mexico (US)
- Corresponding author
- Villareal, Dennis T.
- Venue
- Current Opinion in Endocrinology, Diabetes & Obesity
- Published
- 2013-10
- Volume
- 20
- Issue
- 5
- Pages
- 412-419
- ISSN
- 1752-296X (ISSN-L)
- PMC
- PMC4046899
- OpenAlex
- W2122546156
- Cited by
- 141
- References
- 88
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 9 · 2023: 19 · 2022: 13 · 2021: 13 · 2020: 16 · 2019: 8 · 2018: 16 · 2017: 9 · 2016: 6 · 2015: 11 · 2014: 5
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000041, UL1TR001449, 7r01ag025501-06)
- National Institute on Aging (R01-AG025501, R01AG031176)
- National Center for Advancing Translational Sciences
- 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 › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- sarcopenic obesity, older adults, weight loss, physical activity, lifestyle intervention, protein intake, muscle protein accretion, myostatin inhibition, testosterone replacement therapy, growth hormone therapy, body composition, physical function
- MeSH terms
- Adult, Aged, Animals, Combined Modality Therapy, Humans, Life Style, Obesity, Testosterone, Risk Reduction Behavior, Myostatin, Sarcopenia
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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