Sarcopenic obesity is a condition that occurs when you have both obesity (excess body weight) and sarcopenia (low muscle mass). Up to 23% of people may have sarcopenic obesity.
Sarcopenic obesity has features of both obesity and sarcopenia. These include a lower-than-average muscle mass and a higher percentage of body weight from fat versus muscle or bone.
It can cause symptoms such as fatigue during physical activity that occurs earlier than usual, and difficulty doing activities like climbing stairs, lifting weights, carrying groceries, or getting up from a chair. Many people with sarcopenic obesity are sedentary or inactive and may not notice any symptoms.
It’s also possible to have sarcopenic obesity without having a body mass index (BMI) of 30 or greater. People can have a higher percentage of fat mass, with relatively low muscle mass. In this case, you would have sarcopenic obesity despite having a BMI below the obesity threshold.
Sarcopenic obesity occurs when you have a low amount of muscle mass compared to a higher amount of body fat. Researchers are still learning the exact cause of sarcopenic obesity, but certain risk factors may be key contributors, like:
- Older age: People of all ages can develop sarcopenic obesity, but it’s more common among older adults, who tend to gain body fat and lose muscle mass as they age. Age-related changes in hormones, specifically testosterone, may contribute to age-related muscle loss.
- Insulin resistance: This condition, where your body doesn’t respond well to insulin, can reduce your muscle mass and lead to weight gain. This can make it harder to be physically active, which in turn makes it easier to gain weight, lose muscle, and further increase the risk of sarcopenic obesity.
- Diet: You need to eat enough protein to maintain muscle health. Without enough protein, your muscle mass may decline. Diets high in sugars and simple carbohydrates also contribute to insulin resistance and obesity.
- Physical inactivity: Physical activity is important for weight management and muscle health. If you sit a lot or don’t get much daily movement, you’re more likely to have a higher risk of obesity, insulin resistance, and muscle loss due to inactivity.
A healthcare provider may recommend a test that measures both your muscle mass and fat mass to diagnose sarcopenic obesity. A magnetic resonance imaging (MRI) test may offer the best results, but this kind of test can also be time-consuming and expensive.
Instead, healthcare providers may choose to use other scans and tests. These include:
- Bioelectrical impedance analysis (BIA) scan: This test only takes a few minutes. They work by using harmless electrical currents to estimate your body composition. You can’t feel it, and because there’s no radiation, you can use these scans to monitor your fitness progress frequently.
- Dual-energy X-ray absorptiometry (DEXA) scan: This scan uses X-rays to determine what percentage of your body weight is from fat and muscle. They give more accurate information than BIA scans, but they’re usually more expensive and may involve radiation exposure.
- Muscle function tests: Your healthcare provider may recommend muscle function tests to determine how well you can complete certain tasks. They may want to see how many times you can stand from a chair in a certain time frame or how fast you can walk a short distance.
There are no medications available specifically for sarcopenic obesity. The goal of treatment for sarcopenic obesity is to change your body composition, increasing muscle mass and decreasing fat mass.
Changing your body composition may take time. Lifestyle modifications can help you make progress, including:
Supporting your overall health can also be beneficial. If you have underlying conditions like insulin resistance or hormonal imbalances, working with your healthcare provider to better manage them may help improve your symptoms.
The best ways to prevent sarcopenic obesity are to reach and maintain a weight that your healthcare provider recommends for you and to exercise regularly to support your muscle mass.
Experts recommend a high-protein diet paired with 150 minutes of weekly aerobic activity and two strength training sessions per week. Consider meeting with a personal trainer who can show you how to use resistance exercise equipment or perform bodyweight exercises with proper form.
Some health conditions are associated with sarcopenic obesity. If you have any of the following conditions, it’s best to speak with your healthcare provider about sarcopenic obesity and steps to prevent it. These conditions include:
- Cardiovascular disease: Sarcopenic obesity may increase your risk of heart disease more than obesity alone would. Cardiovascular disease can also increase the risk of sarcopenic obesity.
- Type 2 diabetes: Having extra body fat increases the risk of type 2 diabetes, a chronic (long-lasting) condition in which your body can’t use insulin properly, increasing the risk of dangerous blood sugar changes.
- Fractures: Sarcopenic obesity increases your risk of falls and frailty, which can lead to bone fractures (broken bones).
- Dementia: Obesity may also be associated with a higher risk of dementia, which causes issues with memory and other cognitive functions.
- Cancer: This condition is also linked to a higher risk of cancer.
Sarcopenic obesity can also make it more challenging to recover from surgeries.
Among older adults, sarcopenic obesity is a significant contributor to hospitalizations and overall mortality.
If you have sarcopenic obesity, maintaining an active lifestyle and eating a balanced diet can help improve your muscle mass and fat composition, while also improving other health conditions that can impact your quality of life.
