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Journal Articles Clinical Nutrition Year : 2022

Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement

Lorenzo Donini
Luca Busetto
Stephan Bischoff
Tommy Cederholm
  • Function : Author
Maria Ballesteros-Pomar
  • Function : Author
John Batsis
Juergen Bauer
Yves Boirie
Alfonso Cruz-Jentoft
  • Function : Author
Dror Dicker
  • Function : Author
Stefano Frara
Gema Frühbeck
  • Function : Author
Laurence Genton
  • Function : Author
Yftach Gepner
  • Function : Author
Andrea Giustina
  • Function : Author
Maria Cristina Gonzalez
Ho-Seong Han
  • Function : Author
Steven Heymsfield
Takashi Higashiguchi
  • Function : Author
Alessandro Laviano
Andrea Lenzi
  • Function : Author
Ibolya Nyulasi
  • Function : Author
Edda Parrinello
Eleonora Poggiogalle
  • Function : Author
Carla Prado
  • Function : Author
Javier Salvador
Yves Rolland
  • Function : Author
Ferruccio Santini
Mireille Serlie
  • Function : Author
Hanping Shi
Cornel Sieber
  • Function : Author
Mario Siervo
  • Function : Author
Roberto Vettor
  • Function : Author
Dennis Villareal
Dorothee Volkert
  • Function : Author
Jianchun Yu
Mauro Zamboni
  • Function : Author
Rocco Barazzoni
  • Function : Author


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 an 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 datasets, to study the predictive value, treatment efficacy, and clinical impact of this SO definition.

Dates and versions

hal-03897729 , version 1 (14-12-2022)



Lorenzo Donini, Luca Busetto, Stephan Bischoff, Tommy Cederholm, Maria Ballesteros-Pomar, et al.. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clinical Nutrition, 2022, 41 (4), pp.990-1000. ⟨10.1016/j.clnu.2021.11.014⟩. ⟨hal-03897729⟩
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