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Understanding Sarcopenic Obesity and Why It’s Costing Us More Than We Think
When we think of obesity in Trinidad & Tobago, we often picture someone visibly overweight. But what if we told you that some of the most at-risk people in our communities don’t appear obese at all? That’s the hidden danger of sarcopenic obesity—a condition where individuals carry excess fat and too little muscle.
What is Sarcopenic Obesity?
Sarcopenic obesity is the coexistence of high fat mass and low muscle mass. Unlike traditional obesity, which is usually defined by Body Mass Index (BMI), sarcopenic obesity often hides in plain sight. A person may look “average” in size or weight but have dangerously high levels of visceral fat (fat around the organs) and insufficient muscle mass to support good metabolic and physical health.
Why It Matters in Trinidad & Tobago
Trinidad & Tobago, like much of the Caribbean, is seeing rising rates of non-communicable diseases (NCDs)—including type 2 diabetes, hypertension, and cardiovascular disease. According to the Pan American Health Organization (PAHO) and CARPHA, obesity rates are among the highest in the region, and physical inactivity is a growing concern.
But the real danger is in what we’re not measuring.
The Problem with BMI
BMI is still used widely in clinics across T&T, but it doesn’t tell us what the body is made of. Two people with the same BMI can have completely different health risks. One might have strong muscle tone, while another could have dangerously low muscle mass and excess hidden fat. The second person would be considered “normal” by BMI—but they may be at greater risk for:
Insulin resistance and type 2 diabetes
Fatty liver disease
Heart disease
Functional decline and frailty in older age
Who’s Most at Risk?
Middle-aged adults who are inactive or have lost muscle over time
Older adults, particularly women, who may lose muscle mass due to aging or hormonal changes
Individuals with diets high in processed food and low in protein
People recovering from long illnesses or living sedentary lifestyles
What Can Be Done?
Use Better Tools: Clinics and community health centers can adopt Bioelectrical Impedance Analysis (BIA) to measure visceral fat, muscle mass, and hydration levels—far more useful than BMI alone.
Promote Strength-Based Activity: Encourage activities like resistance training, yoga, or even bodyweight exercises to help preserve muscle and burn fat more effectively than cardio alone.
Improve Nutrition Education: Focus not just on cutting calories, but on increasing high-quality protein, fiber, and micronutrients to support muscle repair and metabolic health.
Create Multidisciplinary Programs: Support from dietitians, fitness coaches, mental health professionals, and doctors is essential to help patients sustainably rebuild muscle and reduce fat.
Track Progress, Not Just Weight: Regular health tracking using BIA scales and wellness apps can help patients see real improvements in muscle mass and fat composition—even when the scale doesn’t budge.
Why It Matters for Healthcare Costs
Early detection and management of sarcopenic obesity could save Trinidad & Tobago millions in avoidable healthcare costs. It reduces the risk of:
Hospital admissions for falls, fractures, and cardiovascular events
Long-term use of medication for diabetes and hypertension
Surgical interventions due to joint deterioration or severe obesity
Final Thoughts
Sarcopenic obesity may be silent—but it’s anything but harmless. As we continue to face a growing NCD crisis, it’s time we start looking beyond BMI and investing in smarter, more holistic tools to keep our population healthier and stronger.
Sources:
Kim TN, Yang SJ et al. (2021). J Obesity & Metab Syndr
Liu P et al. (2022). Journal of Diabetes Research
PAHO / CARPHA Country Health Profiles
Healthy Caribbean Coalition (HCC) Reports
World Health Organization (WHO) – NCD Fact Sheets
Skinny fat is real bruh
Yes this is a big problem- had old uncle fall and break hip.