Illustration depicting the contrast between healthy muscle and excessive fat in sarcopenic obesity.

Sarcopenic Obesity: Unmasking the Silent Threat to Your Health

Author's portrait.
Kai Mendoza in Health & Wellness April 2025 • 4 min read.

"Discover how the dangerous combination of muscle loss and excess fat impacts your long-term well-being and what you can do about it."


The prevalence of obesity has increased alarmingly in older adults in recent years, with studies indicating that nearly 30% of men and women aged 60 and over in the United States are affected. This increase is mirrored in Europe, highlighting a global trend that demands attention.

As we age, our bodies naturally undergo changes, including a progressive increase in fat mass, which typically peaks around age 65 for men and later for women. This is often coupled with shifts in body fat distribution, characterized by an increase in visceral abdominal fat and a decrease in subcutaneous abdominal fat. What's more concerning is the development of ectopic fat deposition, where fat accumulates within non-adipose tissues such as skeletal muscle, cardiac muscle, liver, and pancreas. This phenomenon can occur even without significant changes in overall body mass index (BMI) or body weight.

Concurrently, age-associated muscle mass and strength loss occur even in individuals who maintain a stable weight. This juxtaposition of increased fat and decreased muscle leads to a condition known as sarcopenic obesity (SO), which presents unique health challenges.

What is Sarcopenic Obesity?

Illustration depicting the contrast between healthy muscle and excessive fat in sarcopenic obesity.

Sarcopenic obesity (SO) was first defined in 2000 by Baumgartner and colleagues as the coexistence of low muscle mass and high body fat mass. Since then, numerous definitions have been proposed, each attempting to capture the nuances of this complex condition. The initial definition may underestimate sarcopenia in overweight and obese individuals, potentially leading to underdiagnosis.

Several limitations exist across the proposed definitions. Many definitions fail to account for the quality of muscle, particularly fat infiltration and fibrosis. Studies have documented that increased triglycerides within muscle tissue can negatively impact muscle function. Body composition methods like Dual Energy X-ray Absorptiometry (DXA) and Bioelectrical Impedance Analysis (BIA), commonly used to assess sarcopenia, often can't detect myosteatosis (MS) or myofibrosis (MF), critical indicators of muscle health.
  • Muscle quality overlooked by most definitions
  • Assessment tools fail to recognize key indicators
  • Muscle function is not adequately considered
  • BMI-based fat quantification is limiting
Another significant concern is that SO definitions often do not adequately consider muscle function in terms of strength and performance. Muscle strength and performance decline more rapidly with age than muscle mass. Current definitions don't align with the European and International Working Group on Sarcopenia in Older People, which recommends evaluating both low muscle mass and low muscle function to diagnose sarcopenia. Using BMI to quantify fat is also problematic, as it may not accurately reflect fat distribution, especially in older adults. Visceral abdominal fat, which increases with age, even without BMI changes, is a more relevant indicator. Measuring abdominal circumference can better assess fat distribution and identify at-risk individuals.

Taking Action Against Sarcopenic Obesity

The age-related reduction in muscle mass and increase in fat mass are interconnected, emphasizing the need for a holistic approach. Identifying elderly individuals at risk can help mitigate adverse health outcomes. While improving sarcopenia definitions is crucial, proposed definitions like dynapenic abdominal obesity (DAO) offer promising alternatives, utilizing simple measurements to identify those at high risk. A combined approach of proper exercise, diet and regular checkups with doctors will help prevent Sarcopenic Obesity.

Related Articles

Newsletter Subscribe

Subscribe to get the latest articles and insights directly in your inbox.