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Review
. 2013 Oct;20(5):412-9.
doi: 10.1097/01.med.0000433071.11466.7f.

Sarcopenic obesity: how do we treat it?

Matthew F Bouchonville  1 , Dennis T Villareal
Affiliations
Review

Sarcopenic obesity: how do we treat it?

Matthew F Bouchonville et al. Curr Opin Endocrinol Diabetes Obes. 2013 Oct.

Abstract

Purpose of review: The increasing prevalence of sarcopenic obesity in older adults has heightened interest in identifying the most effective treatment. This review highlights recent progress in the management, with an emphasis on lifestyle interventions and pharmacologic therapy aimed at reversing sarcopenic obesity.

Recent findings: Whereas weight loss and exercise independently reverse sarcopenic obesity, they act synergistically in combination to improve body composition and physical function, beyond which is observed with either intervention alone. Optimizing protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition is associated with favorable changes in body composition in animal studies, although experience in humans is relatively limited. Testosterone and growth hormone offer improvements in body composition, but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy shows promise, but further studies are needed in older adults.

Summary: At present, lifestyle interventions incorporating both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. Maintenance of adequate protein intake is also advisable. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH analogs have a role in the treatment of sarcopenic obesity.

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Conflict of interest statement

Conflicts of interest

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Changes in body composition after weight loss therapy in a frail obese older adult
Physical performance test (PPT) score 0–36 with higher scores indicating better performance (<32 indicates frailty)
Figure 2
Figure 2. Changes in body composition after combined (exercise plus weight loss) intervention in a frail obese older adult
Physical performance test (PPT) score 0–36 with higher scores indicating better performance (<32 indicates frailty)
See this image and copyright information in PMC

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