Unseen and untreated: implementing sarcopenic obesity care in Nordic general practice

Sarcopenic obesity (SO) is defined as the coexistence of low muscle mass and excess adiposity. Despite growing international attention, SO remains under-researched and under-recognized in Nordic countries, particularly in primary care, where body mass index (BMI)-driven approaches dominate and muscle health is rarely assessed.

The objective of this study is to discuss opportunities for integrating SO screening and treatment into everyday clinical care in primary care settings.

Limited prevalence data and inconsistent diagnostic criteria make SO difficult to detect in Nordic primary care settings. The increasing use of pharmacological weight-loss therapies further highlights the need for age- and muscle-informed approaches. Most studies are cross-sectional and conducted in hospitals/community samples, limiting insights into disease trajectories and intervention effects and widening the gap between research and clinical practice.

Although muscle loss and obesity jointly worsen health outcomes, current obesity strategies rarely assess muscular health, creating a critical blind spot in clinical practice for older adults. Moreover, few clinical guidelines offer age-specific recommendations, limiting recognition and management of SO and contributing to suboptimal care for a growing older population.

Nordic primary care represents a key setting for integrating SO case finding into existing preventive frameworks. We propose that primary care adopts pragmatic diagnostic pathways for SO based on a simple case-finding approach combining basic functional tests, nutritional risk assessment, and anthropometric measures alongside BMI, without additional resources. This should be supported by clinician education and cross-sector collaboration to ensure that both adiposity and muscle decline are addressed. Ultimately, bridging the gap between research and practice remains crucial to improving outcomes for older adults with SO.