Sarcopenic obesity: Time to meet the challenge

Abstract

The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social and multi-disciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures and cancer, as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenetic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight-reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term "sarcopenic obesity" has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.

Sarcopenic Obesity: Definition, Health Consequences and Clinical Management

“…and to use powerful randomized controlled trials to test their efficacy in limiting sarcopenia deterioration in patients with obesity. This is in line with the recommendation endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO), entitled "Sarcopenic obesity: Time to meet the challenge", This recommendation suggests that this condition should be considered a scientific and clinical priority for both researchers and clinicians [17].…”

Obesity and ageing: Two sides of the same coin

“…Although sarcopenia is often thought of as a disease of ageing and is more common among older adults, sarcopenia can occur earlier in life. With obesity, deleterious alterations in skeletal muscle structure and metabolism may result in declines in muscle mass and function …”

Sarcopenic Obesity Predicts Early Attrition in Treatment-Seeking Patients with Obesity: A Longitudinal Pilot Study

“…In 2018, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) declared that sarcopenic obesity (SO) [1][2][3][4][5][6]-which is represented by the coexistence of obesity (i.e., increase in body fat mass deposition) [7,8] and sarcopenia (i.e., decrease in muscle mass and strength) [9]-should be considered a priority by both researchers and clinicians [10]. The reason behind this recommendation stems from the fact that patients with SO appear to have a higher risk of cardiometabolic diseases as well as psychosocial comorbidities when compared to their counterparts without SO [1][2][3]11,12].…”