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Impact of EASO/ESPEN-Defined Sarcopenic Obesity Following a Technology-Based Weight Loss Intervention

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Abstract

Background

Sarcopenic Obesity is the co-existence of increased adipose tissue (obesity) and decreased muscle mass or strength (sarcopenia) and is associated with worse outcomes than obesity alone. The new EASO/ESPEN consensus provides a framework to standardize its definition. This study sought to evaluate whether there are preliminary differences observed in weight loss or physical function in older adults with and without sarcopenic obesity taking part in a multicomponent weight loss intervention using these new definitions.

Methods

A 6-month, non-randomized, non-blinded, single-arm pilot study was conducted from 2018 to 2020 in adults ≥ 65 years with a body mass index (BMI) ≥ 30 kg/m2. Weekly dietitian visits and twice-weekly physical therapist-led exercise classes were delivered using telemedicine. We conducted a secondary retrospective analysis of the parent study (n = 53 enrolled, n = 44 completers) that investigated the feasibility of a technology-based weight management intervention in rural older adults with obesity. Herein, we applied five definitions of sarcopenic obesity (outlined in the consensus) to ascertain whether the response to the intervention differed among those with and without sarcopenic obesity. Primary outcomes evaluated included weight loss and physical function (30-s sit-to-stand).

Results

In the parent study, mean weight loss was − 4.6 kg (95% CI − 3.6, − 5.6; p < 0.001). Physical function measures of 30-s sit-to-stand showed a mean increase of 3.1 in sit-to-stand repetitions (+ 1.9, + 4.3; p < 0.001). In this current analysis, there was a significant decrease in weight and an increase in repetitions between baseline and follow-up within each group of individuals with and without sarcopenia for each of the proposed definitions. However, we did not observe any significant differences in the changes between groups from baseline to follow-up.

Conclusions

The potential lack of significant differences in weight loss or physical function between older adults with and without sarcopenic obesity participating in a weight loss intervention may suggest that well-designed, multicomponent interventions can lead to similar outcomes irrespective of sarcopenia status in persons with obesity. Fully powered randomized clinical trials are critically needed to confirm these preliminary results.

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Abbreviations

6MWT:

6-Minute walk test

BIA:

Bioelectrical impedance analysis

BMI:

Body mass index

DEXA:

Dual x-ray absorptiometry (DEXA)

EASO:

European association for the study of obesity

ESPEN:

European society for clinical nutrition and metabolism

LLFDI:

Late-life function and disability instrument

REAP-S:

Rapid eating and activity assessment for patients short version

SD:

Standard deviation

STS:

Sit to stand

VAT:

Visceral adipose tissue

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Funding

Dr. Batsis’ research reported in this publication was supported in part by the National Institute on Aging under Award Number K23AG051681. Support was also provided by the Dartmouth Health Promotion and Disease Prevention Research Center supported by Cooperative Agreement Number U48DP005018 from the Centers for Disease Control and Prevention, the Dartmouth Clinical and Translational Science Institute, under award number UL1TR001086, and the NC Translational and Clinical Sciences (NC TraCS) Institute, which is supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR002489. Dr. Batsis also owns equity in SynchroHealth LLC.

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Authors and Affiliations

  1. Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA

    Brian S. Wood, David H. Lynch, Hillary B. Spangler, Curtis L. Petersen & John A. Batsis

  2. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 5017 Old Clinic Building, Chapel Hill, NC, 27599, USA

    Dakota J. Batchek, Danae C. Gross & John A. Batsis

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Wood, B.S., Batchek, D.J., Lynch, D.H. et al. Impact of EASO/ESPEN-Defined Sarcopenic Obesity Following a Technology-Based Weight Loss Intervention. Calcif Tissue Int 114, 60–73 (2024). https://doi.org/10.1007/s00223-023-01138-4

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