It is written for endocrinologists, physicians, geriatricians, physiotherapists and dietitians. For background on muscle loss in general, see sarcopenia in India<\/a>.<\/p>\n Before 2022, sarcopenic obesity meant different things in different papers. A systematic review run for ESPEN and EASO<\/a> found 75 eligible studies and marked heterogeneity in how obesity and sarcopenia were defined, how body composition and function were measured, and which cut-offs were used. Prevalence figures could not be compared, and neither could outcome studies.<\/p>\n The response was the ESPEN and EASO consensus statement<\/a> (Donini et al., published jointly in Clinical Nutrition and Obesity Facts, 2022). It defines sarcopenic obesity as the co-existence of excess adiposity and low muscle mass or function, and lays out a screening, diagnosis and staging algorithm.<\/p>\n Screening needs two things at the same time:<\/p>\n The panel also states that everyone over 70 with overweight or obesity should be considered at risk.<\/p>\n Diagnosis has two parts, and the order matters.<\/p>\n The consensus names handgrip strength, knee extensor strength, or a chair-stand test (five-times sit-to-stand or 30-second chair stand). It says muscle strength should be the functional parameter of choice. For handgrip cut-offs it points to Dodds et al. for Caucasian populations and to Chen et al., the AWGS authors, for Asian populations. In India that usually means the AWGS 2019 values of under 28 kg in men and under 18 kg in women. Our grip strength normal values guide<\/a> compares these with Indian-derived cut-offs and covers protocol.<\/p>\n If function is altered, body composition must show both<\/strong> excess fat and low muscle. The consensus prefers DXA, with bioimpedance (BIA) as second choice. The key points:<\/p>\n The weight adjustment is the important difference from ordinary sarcopenia criteria. A larger body carries more muscle in absolute terms, so a height-adjusted index can look normal in someone whose muscle is low for their size. A 2026 study of 205 patients awaiting knee replacement<\/a> found low muscle mass in 32.7% by an ASM\/BMI index against 8.8% by the height-adjusted index. The patients flagged only by ASM\/BMI had weaker grip and slower walking before surgery. That was a Japanese orthopaedic cohort, but the logic applies wherever obesity is common.<\/p>\nWhy a Consensus Was Needed<\/h2>\n
Step 1: Screening<\/h2>\n
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Step 2: Diagnosis<\/h2>\n
2a. Skeletal muscle function first<\/h3>\n
2b. Body composition second<\/h3>\n
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Step 3: Staging<\/h2>\n