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Treatment for sarcopenic obesity should both work to reduce adipose tissue and preserve or increase muscle mass (Prado et al., 2024). Interventions should include both dietary interventions and consistent aerobic and resistance-based physical activity. Resistance training in particular can reduce adipose tissue and improve or maintain muscle mass as well as functional capacity in older adults with sarcopenic obesity (Prado et al., 2024; Chen et al., 2017). Digital tools have been shown to be helpful for supporting these strategies in older adults (Prado et al., 2024).
Although hypocaloric diets produce weight loss, they can contribute to muscle loss, and this muscle loss may be more pronounced in older adults with preexisting sarcopenia (Prado et al., 2024). Calorie restriction should be moderate, and it is important to ensure that adequate protein intake is maintained at 1.0 to 1.2 g/kg body weight or higher in individuals with multiple chronic conditions (Prado et al., 2024).
Bariatric surgery may be an option but can result in substantial loss of muscle mass and has not been well studied in individuals with sarcopenic obesity. Similarly, obesity medications have not been well studied in this population and may have a negative impact on muscle mass (Prado et al., 2024).
A GSA Momentum Discussion Podcast episode, Nutritional Needs of Older Adults with Obesity, explores complex issues around dietary needs of older adults, including the importance of assessing for and addressing sarcopenia, and highlights how comprehensive nutritional care can support function, independence, and quality of life while enabling the older adult to reach and maintain their desired body weight.
Overview | Goal Setting | Evaluate Treatment Guidelines | Physical Activity Interventions | Nutritional Interventions | Counseling and Behavioral Interventions | Evaluate Digital Health Options | Pharmacotherapy | Prepare People to Manage Common Medication Adverse Events| Recommend Dietary Supplementation When Appropriate | Evaluate Interventions for Sarcopenic Obesity | Evaluate for Metabolic Surgery Referral | Resources