Sarcopenic Obesity: understanding assessment and developing diagnostic criteria

Sarcopenic Obesity: understanding assessment and developing diagnostic criteria

Sarcopenic Obesity has:

  • strong negative clinical impacts,
  • may lead to disabilities,
  • drives complications, and
  • negatively affects health and survival.

The lack of universally-recognized diagnostic criteria for sarcopenic obesity (SO) clearly hampers patient identification, reliable assessment of SO prevalence, as well as the assessment of SO-related outcomes. Most importantly, the lack of diagnostic criteria has a strong negative impact on development of SO prevention and treatment strategies. Building a consensus on the definition and the diagnostic criteria of SO was considered an urgent, unmet clinical priority. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) thus promoted and developed a SO initiative involving an international expert panel. The panel started its activity by performing a systematic review aimed at analysing the available scientific literature on definitions and diagnostic criteria for SO which have been applied in human studies. Its results confirmed a marked heterogeneity in definitions and diagnostic approaches, due to different definitions of obesity and sarcopenia, differences in methodologies to assess body composition and function, as well as in the applied reference values for the variables that have been used (different cut-offs, interquartile analysis, diverse statistical stratification methods).

Based on these results, a procedure was promoted to reach consensus on: 1) definition of SO; 2) diagnostic procedures – including approach to screening, diagnostic and staging criteria, at the level of both potential gold-standards and acceptable surrogates with wide clinical applicability; 3) methodologies to be employed and related cut-off values.

We congratulate the teams at ESPEN and EASO who worked to develop consensus on this important challenge. Stay tuned for additional factsheets to promote key aspects around nutrition and metabolism.