Sarcopenic Obesity in Adults: Endocrine-Metabolic Mechanisms, Body Composition, and Nutritional Strategies in the Latin American Context

Sarcopenic obesity is a complex clinical condition characterized by the coexistence of excessive adiposity and reduced skeletal muscle mass, strength, or function, generating a phenotype associated with metabolic dysfunction, physical limitation, and increased clinical vulnerability. This study aimed to analyze the endocrine-metabolic mechanisms, body-composition alterations, diagnostic approaches, and nutritional and exercise strategies related to sarcopenic obesity in adults, with particular emphasis on the Latin American context. An integrative literature review structured according to the Scientific

Method: was conducted using evidence from systematic reviews, meta-analyses, clinical trials, observational studies, and international consensus statements. The analyzed evidence showed a high burden of abdominal obesity in Latin America, considerable variability in sarcopenic obesity prevalence according to diagnostic criteria, and a relevant coexistence of obesity with impaired muscle function in adult and older populations. Insulin resistance, chronic low-grade inflammation, ectopic fat accumulation, hormonal alterations, mitochondrial dysfunction, and impaired anabolic signaling were identified as major mechanisms linking adipose tissue dysfunction with skeletal muscle deterioration. Body mass index alone was insufficient to characterize the phenotype, supporting the integration of waist circumference, body-composition assessment, handgrip strength, gait speed, and functional tests. Nutritional interventions were associated with modest reductions in fat mass, while resistance training showed more consistent improvements in body fat, muscle mass, strength, and physical performance. The

Findings: support a multidimensional approach in which therapeutic success is defined not only by weight reduction but also by preservation or improvement of skeletal muscle and metabolic health. In Latin America, standardized diagnostic criteria, culturally adapted interventions, and greater access to body-composition and functional assessment are needed to improve early detection and management.