Osteo-sarcopenic obesity in midlife and older women: a current worldwide public health challenge

Sarcopenic obesity, defined as the coexistence of excess adiposity and sarcopenia, represents a high-risk clinical condition that amplifies the adverse effects of each disorder. When accompanied by bone loss, the entity progresses to osteo-sarcopenic obesity (OSO), which further compromises physical function, metabolic health and overall prognosis. Affected individuals face an increased risk of falls, fractures, functional disability, hospitalization, cardiometabolic complications and premature mortality. In women transitioning through menopause, declining estrogen levels accelerate fat accumulation and muscle loss, while also heightening susceptibility to osteoporosis, insulin resistance, hypertension, dyslipidemia, type 2 diabetes and certain cancers. These interrelated changes underscore the need for heightened awareness, early identification and multidisciplinary management of the OSO syndrome. Establishing clear and universally accepted diagnostic criteria, integrating patient education and implementing preventive strategies - including lifestyle, nutritional and medical interventions - are essential to address this complex and emerging clinical entity, ultimately improving health outcomes and quality of life for midlife and older women.