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World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2019): ESCEO-WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing Symposium Abstracts (ESCEO-WHO CC) # International Osteoporosis Foundation and National Osteoporosis Foundation 2019 ESCEO-WHOCC1 OSTEOSARCOPENIC OBESITY: FACTS AND EVIDENCE SUPPORTING A DISTINCT ENTITY J. Bauer Center for Geriatric Medicine, University of Heidelberg, Heidelberg, Germany, Agaplesion Bethanien Krankenhaus Heidelberg, Heidelberg, Germany The co-existence of impaired bone health (osteopenia/ osteoporosis), reduced muscle mass and strength (sarcopenia), and increased adiposity (obesity) in middle-aged and older people has been identified in recent studies, leading to a proposal for the existence of “osteosarcopenic obesity” (OSO) as a distinct entity. At present OSO is described as the most advanced stage in a conceptual model of bone, muscle, and fat tissue change resulting from ageing and individual comorbidities. A prevalence of 12–19% of OSO has been reported in women aged over 50 years in several studies. In the majority of them it was associated with poor physical performance and frailty. Recent evidence suggests a potential interconnection between osteoporosis, sarcopenia, and obesity on the basis of a shared pathophysiology. An increase in total and/or abdominal adipose tissue causes an increase in pro-inflammatory cytokines, as well as hormonal disturbances leading to losses of both muscle and bone tissues through a variety of mechanisms which ultimately affect clinical outcomes, such as a higher risk for falls and fractures. Mechanisms responsible for the development of OSO components are complex and may include multiple factors: endocrine versus local regulation, threshold effects, hormonal implications of comorbidities, and cross-talk between endocrine-immune-neurologic factors. However, at the moment evidence for the clinical relevance of OSA coming from carefully designed prospective studies is still scarce. Additional studies are therefore eagerly warranted. ESCEO-WHOCC2 OSTEOSARCOPENIC OBESITY: ENOUGH EVIDENCE FOR A DISTINCT ENTITY? J. Bauer, A. J. Cruz-Jentoft, on behalf of the ESCEO Working Group on osteosarcopenic obesity Center for Geriatric Medicine, University of Heidelberg; AGAPLESION Bethanien Krankenhaus, Heidelberg, Germany, Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain The co-existence of impaired bone health (osteopenia/ osteoporosis),beyond the risks associated with the sum of the component parts remains to be proven and is a question of research interest. In this article we review evidence for the current operational definition of OSO, prevalence, pathophysiology, outcomes and exploratory approaches to the management of OSO components. To expand knowledge and understanding in this area, there is a need for consensus on a definition of OSO which will allow for identification, further epidemiological studies and comparisons between studies. Additionally, studies should assess whether the clinical outcomes associated with OSO are worse than the mere addition of those linked with its components. This will help to determine whether defining a person as having this condition will eventually result in a more effective treatment than addressing each of the three conditions separately. Authors: Jürgen M. Bauer MD, PhD, Alfonso J. Cruz-Jentoft MD, PhD, Roger A. Fielding PhD, John A. Kanis MD, JeanYves Reginster MD, PhD, Olivier Bruyère PhD, Matteo Cesari MD, PhD, Roland Chapurlat MD, PhD, Nasser AlDaghri PhD, Elaine Dennison MB BChir, PhD, Jean-Marc Kaufman MD, PhD, Francesco Landi MD, PhD, Andrea Laslop MD, Médéa Locquet MSc, MPH, Stefania Maggi MD, PhD, Eugene McCloskey MD, Simone Perna PhD, Osteoporosis International (2019) 30 (Suppl 2):S191–S192 https://doi.org/10.1007/s00198-019-04983-y