Obesity, Sarcopenic Obesity, and Osteoarthritis: The Triad Driving Disability

Obesity, sarcopenia, and osteoarthritis (OA) frequently co-occur in midlife and older adults and can interact to accelerate functional decline. Excess adiposity increases mechanical loading on joints and is associated with chronic low-grade inflammation and metabolic dysregulation that may contribute to cartilage degeneration and pain sensitization. In parallel, age- and disease-related loss of muscle mass and strength compromises joint stability, gait efficiency, and shock absorption, worsening symptoms and limiting physical activity. When obesity and sarcopenia coexist as sarcopenic obesity, individuals may experience a particularly harmful cycle of reduced mobility, worsening cardiometabolic risk, and escalating disability. Despite this clinical reality, research and care pathways are often siloed, leaving major gaps in how we define, measure, prevent, and treat this interlinked triad.This Research Topic aims to bring together multidisciplinary evidence on the mechanisms, clinical consequences, and intervention strategies related to the obesity–sarcopenic obesity–OA nexus. We welcome submissions spanning molecular and cellular pathways (e.g., adipokines, myokines, inflammasome signaling, mitochondrial dysfunction), biomechanics (joint loading, alignment, muscle quality, neuromuscular function), and imaging and digital phenotyping approaches that better capture body composition, muscle function, and OA progression. Particular interest lies in work that clarifies causal relationships and heterogeneity—such as sex differences, aging trajectories, comorbidity clusters, and the role of metabolic health—using robust epidemiology, longitudinal cohorts, and advanced analytics.A key goal is to advance integrated management strategies that target both symptoms and underlying drivers of disability. We invite clinical trials and pragmatic studies of combined interventions, including resistance and aerobic exercise, dietary approaches and protein optimization, pharmacologic and anti-obesity therapies, pain management strategies, and multimodal rehabilitation. Studies examining implementation in real-world settings, health equity considerations, and patient-centered outcomes (mobility, function, quality of life, participation, and work capacity) are strongly encouraged. We also welcome methodological contributions addressing definitions and diagnostic thresholds for sarcopenic obesity, standardized outcome sets for OA and function, and risk stratification tools to identify individuals most likely to benefit from specific interventions.By integrating perspectives from geriatrics, rheumatology, rehabilitation, endocrinology, nutrition, biomechanics, and public health, this collection aims to refine the conceptual model of this disabling triad and accelerate translation into effective prevention and treatment strategies that preserve mobility and independence across the lifespan. Topic editors: Shengfa Li, Wei Fan Source: https://www.frontiersin.org/research-topics/78251/obesity-sarcopenic-obesity-and-osteoarthritis-the-triad-driving-disability