Secretly Obese: The High Costs of Sarcopenic Obesity

Secretly Obese: The High Costs of Sarcopenic ObesitySarcopenic obesity is a combination of two dangerous conditions: low muscle mass and strength (sarcopenia) and high body fat (obesity.) Most often, these people have slender arms and legs, but too much fat in the abdominal area. While the precise criteria used to determine exactly who has sarcopenic obesity are still being debated by researchers, there’s no doubt that the condition has serious health consequences.

Sarcopenia itself is associated with an increased risk of many adverse health outcomes, such as physical disability, poor quality of life, and death.[1]  When combined with obesity, it is also strongly associated with metabolic syndrome, a group of risk factors that includes high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat. Also called Syndrome X, it raises the risk for heart disease and other health problems, such as diabetes and stroke.[1] Age-associated changes in hormone levels, low vitamin D, inflammation, and insulin resistance (the precursor to type 2 diabetes) have all been implicated in contributing to sarcopenic obesity.[1] 

Normal weight obesity

Metabolic syndrome is also strongly associated with normal weight obesity, or metabolic obesity with normal weight. This condition is similar to sarcopenic obesity, except that it does not necessarily involve abnormally low muscle mass. It simply refers to people who have the same diseased metabolism of most obese individuals, but are at a normal weight for their height. Many people classified as normal weight obese may also have undiagnosed diminished muscle mass and strength.

There is nothing normal about normal weight obesity. Researchers from the Mayo Clinic have called for a new official definition of obesity that would include this population.[2] They cited the overwhelming evidence that normal weight obesity is a huge risk factor for developing metabolic syndrome, coronary artery disease, and early death. The Mayo researchers use the term “cardiometabolic dysregulation” to describe what happens in this population.

Nearly one-quarter of normal weight people may actually be suffering from cardiometabolic dysregulation, which includes such problems as high triglycerides, blood sugar and systemic inflammation, low HDL “good” cholesterol, insulin resistance, and high blood pressure.[3]

The cure for normal weight obesity

The only cure for sarcopenic or normal weight obesity is dietary changes and exercise, including resistance training. Here are specific tips:

  • Say goodbye to added sugars, white flour, and other empty carbohydrates.
  • Embrace a diet based on whole, unprocessed foods and homemade meals loaded with vegetables and healthy sources of protein for building muscle.
  • Take fish oil to decrease inflammation and protect your heart.
  • Take a high-quality multivitamin mineral supplement and extra vitamin D.
  • Exercise regularly and include resistance training.

There is solid evidence that following this basic yet powerful diet and lifestyle advice is the most effective way regain a healthy metabolism and body composition.


[1] Endocrinol Metab (Seoul). Jun 2013; 28(2): 86–89.
[2] Prog Cardiovasc Dis. 2014 Jan-Feb;56(4):426-33.
[3] Nutr Metab Cardiovasc Dis. 2012 Sep;22(9):741-7.

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