REVIEW   

Panminerva Medica 2022 December;64(4):537-47

DOI: 10.23736/S0031-0808.22.04784-X

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Understanding sarcopenic obesity in young adults in clinical practice: a review of three unsolved questions

Marwan EL GHOCH ^{1, 2}, Andrea P. ROSSI ^{3, 4}, Ludovica VERDE ⁵, Luigi BARREA ^{5, 6}, Giovanna MUSCOGIURI ^{5, 7, 8} ✉, Silvia SAVASTANO ^{5, 7}, Annamaria COLAO ^{5, 7, 8} on behalf of the Obesity Programs of Nutrition, Education, Research and Assessment (OPERA) group

¹ Department of Nutrition and Dietetics, Faculty of Health Sciences, Arab University of Beirut, Beirut, Lebanon; ² Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; ³ Division of Geriatrics, Department of Medicine, Healthy Aging Center, University of Verona, Verona, Italy; ⁴ Division of Geriatrics, Department of Medicine, Ospedale Ca’ Foncello ULSS2 Treviso, Treviso, Italy; ⁵ Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; ⁶ Department of Human Sciences, Pegaso Telematic University, Naples, Italy; ⁷ Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy; ⁸ UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy

INTRODUCTION: Our aim was to summarize the available literature on three yet unsolved questions, namely: 1) the dilemma surrounding definition of sarcopenic obesity (SO), especially in young adults; 2) the potential impact of this phenotype on weight-loss programme outcomes; and 3) the strategies for optimum management (prevention/treatment) of SO in clinical practice.
EVIDENCE ACQUISITION: A literature review using the PubMed/Medline database was conducted, and data were summarized based on a narrative approach.
EVIDENCE SYNTHESIS: Firstly, SO can be screened by the 30-sec sit-to-stand test; ≤25 and ≤21; and confirmed by the ratio of (appendicular lean mass/Body Mass Index) ≤0.789 and 0.512 in males and females, respectively. Secondly, SO is associated with impaired physical fitness, reduced resting energy expenditure and an inactive lifestyle, that seems to negatively impact on weight-management outcomes, namely increasing early dropout and difficulty in maintaining weight loss in the long term. Finally, prevention/treatment of SO in young adults must be realized through tailored lifestyle intervention (diet+exercise) to preserve and improve strength and muscle mass, even where weight loss is necessary.
CONCLUSIONS: Our findings have clinical implications since they may help in screening, managing and improving the weight-loss outcomes of patients with SO in clinical settings.

KEY WORDS: Obesity; Weight loss; Treatment outcome