SARCOPENIC OBESITY – A CLINICAL REVIEW

Shaista Sumayya, Siddiqua Parveen, Meraj Fatima, Ameena Begum, Syed Jaffer, *S. P. Srinivas Nayak and Anupama Koneru

ABSTRACT

Purpose of review: Sarcopenic obesity is a chronic condition, which is due to progressively aging populations, the increasing incidence of obesity, and lifestyle changes. The increasing prevalence of sarcopenic obesity in elderly has augmented interest in identifying the most effective treatment. This article aims at highlighting potential pathways to muscle impairment in obese individuals, the consequences that joint obesity and muscle impairment may have on health and disability, recent progress in management with attention on lifestyle management and pharmacologic therapy involved in reversing sarcopenic obesity. Recent findings: It has been suggested that a number of disorders affecting metabolism, physical capacity, and quality of life may be attributed to sarcopenic obesity. Excess dietary intake, physical inactivity, low-grade inflammation, insulin resistance and hormonal changes may lead to the development of sarcopenic obesity. Weight loss and exercise independently reverse sarcopenic obesity. Optimum protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition causes favourable changes in body composition. Testosterone and growth hormone offer improvements in body composition but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy is effective but further studies are needed in older adults. Summary: Lifestyle changes involving both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. It is also advisable to maintain adequate protein intake. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH-analogs have a role in the treatment of sarcopenic obesity.

Keywords: sarcopenic obesity, myostatin inhibitors, exercise, weight loss, elderly, testosterone.