Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement

Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Fruehbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber C, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R (2022)

Publication Type: Journal article

Publication year: 2022


DOI: 10.1159/000521241


Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. Aims and Methods: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. Conclusions: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition. (C)& nbsp; 2021 The Author(s)Published by S. Karger AG, Basel

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Involved external institutions

Geneva University Hospitals / Hôpitaux universitaires de Genève (HUG) CH Switzerland (CH) Tel Aviv University IL Israel (IL) University of Alberta CA Canada (CA) Università degli studi "La Sapienza" IT Italy (IT) University of Verona / Università degli Studi di Verona IT Italy (IT) Houston Texas Medical Center US United States (USA) (US) Uppsala University SE Sweden (SE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Catholic University of Pelotas / Universidade Católica de Pelotas (UCPel) BR Brazil (BR) University of Padua / Universita degli Studi di Padova IT Italy (IT) Complejo Asistencial Universitario de León ES Spain (ES) Clínica Universidad de Navarra ES Spain (ES) University of Clermont Auvergne FR France (FR) Capital University of Medical Sciences / 首都医科大学 CN China (CN) Hospital Universitario Ramón y Cajal ES Spain (ES) University of North Carolina at Chapel Hill US United States (USA) (US) Centre Hospitalier Universitaire (CHU) de Toulouse FR France (FR) Universität Hohenheim DE Germany (DE) Peking Union Medical College / 北京协和医学院 CN China (CN) Università Vita-Salute San Raffaele (UniSR) IT Italy (IT) Universidad de Navarra ES Spain (ES) University of Nottingham GB United Kingdom (GB) Università degli Studi di Trieste IT Italy (IT) Monash University AU Australia (AU) Pennington Biomedical Research Center US United States (USA) (US) University of Pisa / Università di Pisa (UniPi) IT Italy (IT) University of Amsterdam NL Netherlands (NL) Fujita Health University JP Japan (JP) Seoul National University Bundang Hospital (SNUBH) / 분당 서울대병원 KR Korea, Republic of (KR)

How to cite


Donini, L.M., Busetto, L., Bischoff, S.C., Cederholm, T., Ballesteros-Pomar, M.D., Batsis, J.A.,... Barazzoni, R. (2022). Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obesity facts.


Donini, Lorenzo M., et al. "Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement." Obesity facts (2022).

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