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Sarcopenia is the medical term for muscle loss. Although it’s commonly linked to aging, it can also affect people living with obesity. When both conditions are present, it’s known as sarcopenic obesity.
Sarcopenic obesity describes a body composition that includes a high percentage of body fat and low muscle mass. This imbalance between fat and lean tissue can lead to reduced strength, slower metabolism, and increased health risks.
Researchers are still learning about this complex condition, which is becoming more common as life expectancy increases and obesity rates rise. A meta-analysis of 50 studies estimated that globally, around 11 percent of adults over 60 live with sarcopenic obesity. Still, this condition remains relatively underrecognized, and healthcare providers are working to find the best ways to detect and treat it.
Here’s why sarcopenic obesity matters — and what you can do to address it.
Obesity raises the risk of sarcopenia, and sarcopenia raises the risk of obesity. Research suggests the two conditions may be connected in several ways.
One reason for this connection is that obesity increases chronic (long-term), low-grade inflammation throughout the body. It also promotes insulin resistance (a key feature of type 2 diabetes), which interferes with the body’s ability to maintain and build muscle mass and strength.
People living with obesity are more likely to have chronic conditions such as cancer, chronic kidney disease, and heart disease. These conditions can increase muscle breakdown and make it harder to rebuild muscle. Fatigue, inactivity, and hospital stays caused by these illnesses can also contribute to muscle loss.
Obesity and sarcopenia share risk factors, such as low physical activity. Each condition can make it harder to stay active, and being sedentary can worsen both conditions over time.
People with obesity often have a history of weight loss followed by weight regain, a pattern called weight cycling or yo-yo dieting. Each round of dieting often results in losing both fat and muscle, especially when the diet is very low in calories or protein and isn’t paired with strength-building exercise. When weight returns, fat is usually regained more easily than muscle, which can result in a higher fat-to-muscle ratio over time.
With newer weight-loss medications like semaglutide, people can lose weight more quickly — but without enough dietary protein and resistance training, they may lose more muscle than intended.
Members of MyObesityTeam have described how weight loss impacts their strength. “I had weight loss surgery, and along with the help of semaglutide, I am starting to get back to my old self. Now, I just need to work on building strength within my body, which was so weak for so long,” said one member.
It’s not always easy for someone with severe obesity or other medical conditions to exercise. In some cases, healthcare providers may recommend starting with dietary changes first. But working with a registered dietitian nutritionist can help ensure you’re getting enough protein. A healthcare team can also help you start a safe, strength-building exercise plan as soon as you’re able.
Hormonal changes also contribute to sarcopenia. Testosterone levels decline with age in men, making it harder to preserve muscle, according to research in Frontiers in Endocrinology. In women, lower levels of growth hormone and estradiol (a form of estrogen) promote fat gain and muscle loss as they age.
Sarcopenia tends to worsen with age, even for people who don’t live with obesity. Most people start to experience age-related muscle loss around age 40. After 50, muscle mass typically decreases by 1 percent to 2 percent each year.
Sarcopenic obesity increases the risk for several serious health conditions, including:
It also raises the chance of fractures and physical disabilities. These complications can make it harder to stay independent and may reduce quality of life, especially as people age.
In people under age 50, having less muscle mass has been linked to a higher risk of type 2 diabetes, even when body fat levels are similar.
Members of MyObesityTeam have shared firsthand experiences with falls. “Getting out of the car and walking up to the curb, my knee gave way, and I fell. I haven’t done that in a few months,” one member shared. “The doctor gave me some exercises to strengthen my legs and knees. I haven’t been doing them. Now, I will be doing them on a regular basis. Fortunately, I didn’t get hurt.”
Falls like this can be frightening and shake your confidence about leaving the house. They can also lead to injuries that require a long recovery.
Studies show people living with sarcopenic obesity are nearly twice as likely to experience symptoms of depression compared with those without sarcopenia or obesity. Having only sarcopenia or only obesity did not appear to raise the risk of depression in the same way. This stronger link may be due to the compounded physical, hormonal, and lifestyle challenges that come from managing both conditions together.
Aging and obesity can both make it harder to build or maintain muscle, but there are steps you can take to protect yourself and improve your body composition.
Health experts are still refining how best to screen for and manage sarcopenia in people living with obesity. Some tests assess handgrip strength and walking speed, while others look at muscle and fat levels using imaging or body measurements.
There’s no one-size-fits-all treatment for sarcopenic obesity. But if your doctor says it’s safe, resistance training (muscle-strengthening exercise) can make a big difference. These exercises don’t have to involve lifting heavy weights or going to the gym. Chair-based workouts, water aerobics, or using resistance bands at home are all effective ways to begin. A physical therapist or exercise specialist familiar with obesity care can help design a program that fits your needs and goals.
Members of MyObesityTeam have explained why it’s never too late to be more active. “I am just now starting exercise,” said one member. “I am going to focus on chair exercise, physical therapy, and a foot pedal. I am relearning my body and what I am capable of. I was over 445 pounds. Today, I’m down to 355 pounds.”
Another suggested, “If you have a laptop or iPad, you can go to YouTube to find exercise videos that range from ten to 62 minutes. There’s chair yoga, tai chi, kickboxing, belly dancing, and even Billy Blanks Tae Bo. If you make the time to exercise, then you look forward to doing it every day. Always look for something new so you don’t get bored,” they said.
A low-calorie diet may support weight loss, if that’s one of your treatment goals. However, it’s important to also get enough protein, vitamins, and minerals to preserve your muscle mass. A registered dietitian nutritionist can help you build a meal plan that supports both fat loss and muscle strength.
Hormone replacement therapy may be considered for some older adults, especially those with low levels of key hormones like testosterone or estrogen. However, these treatments carry risks, especially for heart health, and must be carefully evaluated and prescribed by your healthcare provider.
There’s also some evidence that electromyostimulation — gentle electrical currents that trigger muscle contractions — may b a way to improve muscle strength. While promising, more research is needed to confirm its safety and effectiveness in sarcopenic obesity.
Focusing on what you can do today — whether it’s a short walk, a balanced meal, or a gentle stretch — helps you move toward better health. Small, consistent actions add up. Working with your healthcare provider, you can develop a care plan that meets you where you are and supports you in building strength, confidence, and momentum.
MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.
Have you noticed changes in your muscle strength or energy? Have you tried resistance training, aerobic activity, or other strategies to help? Share your experience in the comments below or on your Activities page or connect with like-minded members in Groups.
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