General Health

Sarcopenic Obesity: Clinical Definition and Treatment Options

Obesity and Sarcopenia

In the last few decades, obesity and ageing have become intertwined epidemics, resulting in an increased global public health concern, sarcopenic obesity (SO). A sarcopenic condition is characterized by a loss of skeletal muscle mass and strength, commonly associated with physical impairment, poor health, and death. Age, gender, and level of physical activity are all risk factors for sarcopenia. Initially, sarcopenia was only associated with physiological ageing and the loss of muscle mass.

According to current evidence, both older and younger adults can suffer from sarcopenia. The main factors to be considered when diagnosing sarcopenia are mass, strength, and muscle function. Both sarcopenia and obesity have similar pathophysiological factors, such as lifestyle behaviours, hormones, and immunological factors, which may synergistically influence the risk of developing health complications. In addition to accelerated functional decline, SO has also been associated with increased risks of cardiometabolic diseases. The identification of this disease condition is therefore critical for clinicians in ageing as well as in young societies.

Among women and men over 60 years old, the prevalence rate of SO was 18.1% and 42.9%, respectively, in a 14-year prospective study done by the National Health and Nutrition Examination Survey III. Obesity causes sarcopenia in older people by affecting skeletal muscle, lipid metabolism, insulin resistance, and inflammatory pathways. Obesity causes ectopic fat deposition in skeletal muscle, which can exacerbate sarcopenia. Furthermore, it is a topic of critical concern for women’s health, as obesity-related disorders affect women more than males.

Another process that leads to sarcopenia is obesity-related adipose tissue inflammation. Through adipocyte hypertrophy and hyperplasia, as well as the accumulation of immune cells such as macrophages, mast cells, and T lymphocytes that release pro-inflammatory cytokines, obesity promotes inflammatory pathways in visceral fat.

Health consequences of Sarcopenic Obesity

  • Institutionalization
  • Disability
  • Increased mortality rate
  • Metabolic disorders
  • Cardiovascular diseases
  • CVD

Over an 8-years follow up, obese sarcopenic adults had a 23% increased risk of CVD and a 42% increased risk of congestive heart failure compared to non-obesity non-sarcopenic controls. Sarcopenia was linked to lower cardiovascular fitness, high fasting glucose levels, a higher risk of hypertension, hyperlipidaemia, and insulin resistance, and an 8-fold increased risk of metabolic syndrome when compared to non-sarcopenic, non-obese people.

In both men and women, the associations between sarcopenia defined solely in terms of muscle mass, SO and metabolic syndrome were found to be statistically significant. Obesity and muscle weakness, either characterized by low muscle mass or insufficient muscle strength, is linked to serious medical conditions mainly in elderly people.

Treatment

Management for sarcopenic obesity should be considered as it is associated with poor outcomes. The cornerstone of its treatment is lifestyle adjustment, which includes food intervention and physical activity. Treatment for this condition aims to minimize fat mass while preserving fat-free mass and improving physical function. Among the non-pharmacological therapies that can minimize SO, dietary interventions and exercise are the most important. The effects of exercise on individuals with SO are multiple. Moderate energy restriction diets combined with exercise are the most effective treatment for both obesity and SO.

To conclude, Sarcopenic obesity is a new type of obesity in elderly people that combines a lack of skeletal muscle mass with a high level of adiposity. According to the studies, elderly people with this disease had a higher level of cardiovascular risk factors and a higher risk of death.

Author

Navya Koshi

Navya Mariam Koshi is a diligent, self-motivated Pharm D graduate using this platform to leverage her skills in this field to provide excellent and exceptional health care services to the public.

 

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