South Korea has become a super-aged society, and sarcopenic obesity (SO) has been considered as a significant health concern among older adults. SO, characterized by the coexistence of sarcopenia and obesity, is associated with impaired physical function, metabolic disorders, cardiovascular diseases, and increased mortality. However, the variability in the definition, diagnostic criteria, and assessment tools for SO have led to discrepancies in its prevalence estimates, often resulting in the underestimation of its clinical significance. In response, the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity have proposed standardized SO definitions and diagnostic criteria in 2022. Screening for SO involves the assessment of high body mass index or waist circumference alongside indicators of sarcopenia. If muscle function is impaired, further evaluations of increased fat mass and muscle mass loss are performed, followed by staging into two severity levels. The major pathophysiological factors of SO include chronic inflammation, age-related physiological changes, insulin and anabolic resistance, hormonal imbalances, decreased physical activity, and poor nutrition. Its management strategies include combined resistance and aerobic exercise, high-protein balanced nutrition, and pharmacological or surgical interventions. Emerging approaches, such as blood flow restriction training, whole-body electromyostimulation, and novel drug therapies, have shown potential therapeutic benefits. To enhance SO prevention and treatment, standardized diagnostic criteria, optimized exercise and nutrition strategies, and validated therapeutic approaches should be implemented. Furthermore, these advancements will contribute to maintaining physical function and improving metabolic health in individuals with SO.
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