Review

Endocrine

, Volume 47, Issue 3, pp 699-716

First online:

Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity

  • Eleonora PoggiogalleAffiliated withDepartment of Experimental Medicine, Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, “CASCO” High Specialization Center for Obesity Care, Sapienza University of Rome Email author 
  • , Silvia MigliaccioAffiliated withDepartment of Experimental Medicine, Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, “CASCO” High Specialization Center for Obesity Care, Sapienza University of RomeDepartment of Movement Human and Health Sciences, “Foro Italico” University of Rome
  • , Andrea LenziAffiliated withDepartment of Experimental Medicine, Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, “CASCO” High Specialization Center for Obesity Care, Sapienza University of Rome
  • , Lorenzo Maria DoniniAffiliated withDepartment of Experimental Medicine, Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, “CASCO” High Specialization Center for Obesity Care, Sapienza University of Rome

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Abstract

In recent years, mounting interest has been directed to sarcopenic obesity (SO), given the parallel increase of life expectancy and prevalence of obesity in Western countries. The phenotype of SO is characterized by the coexistence of excess fat mass and decreased muscle mass, leading to the impairment of physical performance. The aim of the present review was to summarize the impact of different treatment strategies contrasting body composition changes in older obese and overweight subjects, providing insight into the SO phenotype. Revision questions were formulated; relevant articles were identified from Pubmed through a systematic search strategy: definition of the search terms (sarcopenic obesity, diet, nutritional supplements, physical activity, exercise, pharmacological treatment); limits: papers published in the last 10 years; humans; age ≥ 60 years old; body mass index >25 kg/m2; language: English. Studies dealing with sarcopenia associated to cancer cachexia or neurological diseases, any malignant disease, inflammatory or autoimmune diseases, corticosteroids for systemic use, bedridden subjects, and syndromic obesity were excluded. 14 articles were identified for inclusion in the present systematic review, and were grouped basing on the type of the main intervention: data assessing body composition changes after combined lifestyle interventions, exercise/physical activity, dietary interventions, and pharmacological treatment. Most of the studies were randomized, controlled. Sample size ranged from 12 to 439 subjects, and study duration varied from 6 weeks to 12 months. Weight loss based on diet combined with exercise seems to be the best strategy to adopt for treatment of phenotypic aspects of SO, improving metabolic consequences related to excess fat, preserving lean mass, and allowing functional recovery.

Keywords

Body composition Sarcopenic obesity Nutrition Exercise Physical activity Pharmacological treatment