Sarcopenic Obesity: Epidemiologic Evidence, Pathophysiology, and Therapeutic Perspectives

This review provides a comprehensive update on the definition, assessment, epidemiology, pathophysiology, clinical implications, and therapeutic approach of sarcopenic obesity (SO) and highlights the challenges, limitations, and knowledge gaps in SO research.

The confluence of a rapidly aging population with rising obesity rates has led to the phenotype of SO, defined as the concurrent presence of sarcopenia and obesity. Despite efforts, a standardized definition of SO is still lacking. Its prevalence varies widely between studies, depending on population characteristics and different definitions. The major pathogenetic mechanisms include age-related changes in body composition and hormonal milieu, positive energy balance, pro-inflammatory pathways, and insulin resistance. Lifestyle interventions, including caloric restriction and physical activity, are the cornerstones of SO treatment. SO is a multifaceted syndrome with serious clinical implications. The development and implementation of effective prevention and treatment strategies is a top priority based on its dramatically increasing health impact.