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Sarcopenic obesity is a condition that often goes unnoticed but early screening can make all the difference. Sarcopenia is a loss of muscle mass and strength that often occurs in sedentary individuals as they age.
Overweight and obesity present numerous challenges throughout the lifespan. The risk of developing sarcopenic obesity is particularly high as adults age (Batsis and Villareal, 2018). Sarcopenia is a loss of muscle mass and strength that often occurs in sedentary individuals as they age and may compromise the ability to perform IADL. Sarcopenia is associated with a reduced quality of life, a higher risk of falls and fractures, and a higher risk of mortality (Beaudart et al., 2025). Sarcopenic obesity presents as a decline in muscle mass and function concurrent with increased adiposity (Prado et al., 2024). The prevalence of sarcopenic obesity in the United States among adults 60 years and older is 28.3%, with higher prevalence in certain populations, including institutionalized adults and Mexican Americans (Prado et al., 2024).
Sarcopenic obesity is defined as the coexistence of obesity and sarcopenia (Donini et al., 2022). It can occur during weight gain if muscle mass and strength do not increase to support the added weight. It may emerge during situations that limit mobility, such as injuries and illnesses. It can also arise during weight loss, particularly if substantial muscle mass is lost. Finally, risk increases with cycles of weight loss and weight regain (Prado et al., 2025; Mozaffarian et al., 2025).
The SARC-F is a screening instrument for sarcopenia that measures Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (see the following table). The SARC-F has good reliability and validity in hospital settings (Ishida et al., 2020). In the community, the instrument is very good at correctly classifying a person who does not have sarcopenic obesity but has a high number of false positives, or instances in which a person is incorrectly classified as having sarcopenic obesity (Voelker et al., 2021). Nevertheless, it is an easy-to-administer and useful option for screening for sarcopenic obesity.
People whose SARC-F scores suggest the presence of sarcopenia can be assessed further with tests of mobility and strength, such as the chair–stand assessment for lower extremity strength (time to complete 5 chair stands of ≥15 seconds indicates low muscle strength); hand-grip strength using dynamometers (readings of <27 kg for men or <16 kg for women indicate low grip strength); and asking about the person’s ability to climb 10 stairs (Ibrahim et al., 2018).
The Sarcopenic Obesity Global Leadership Initiative (SOGLI) has published an algorithm for the screening and diagnosis of sarcopenic obesity (Prado et al., 2024). This algorithm calls for screening for high BMI or waist circumference (based on appropriate ethnic cut-off points) and a high risk of sarcopenia (based on clinical symptoms, clinical suspicion, or questionnaires such as the SARC-F). Individuals who are identified as potentially having sarcopenic obesity should undergo a diagnostic evaluation that considers skeletal muscle function, body composition, and the presence of complications resulting from high fat mass and reduced muscle mass (Prado et al., 2024).
Overview | Assess BMI | Body Composition Assessments | Assess Function | Screen for Sarcopenic Obesity | Assess for Obesity-Related Complications | Take a Thorough Weight History | Assess Medications | Assess References