BACKGROUND/OBJECTIVES: Sarcopenic obesity (SO) is a clinical condition in which there is an excess of fat mass and a loss of muscle mass, strength, and function. Its prevalence increases with age, particularly in adults over 65 years old. However, debate persists on the definition and assessment of SO. The purpose of this review is to examine the impact of resistance training on older adults with sarcopenic obesity. METHODS: This review included studies investigating the effects of resistance training interventions in older adults with SO. A comprehensive literature search was conducted across six databases (PubMed, SCOPUS, Cochrane Library, Embase, EBSCO, and Web of Science), yielding 1882 articles. The risk of bias in the included studies was assessed using the PEDro scale and the GRADE system. RESULTS: Eleven randomized clinical trials were analyzed qualitatively and nine were analyzed quantitatively. The meta-analysis demonstrated that exercise interventions revealed the positive effects of exercise mainly on physical performance (SMD 0.36, 95% CI 0.03 to 0.69, p = 0.003) and body composition (SMD 0.35, 95% CI 0.12 to 0.57, p = 0.003), with no significant differences in biomarkers (SMD 0.1, 95% CI -0.28 to 0.49, p = 0.52). CONCLUSIONS: Resistance training benefits older adults with SO, improving body composition and physical function, whereas there were no significant differences in blood biomarkers. The present review highlights the limitations of the existing evidence base. Many included studies exhibited methodological shortcomings, necessitating the cautious interpretation of findings. Future research should prioritize rigorous study designs, including larger sample sizes and extended follow-up periods, to enhance the precision and generalizability of results.

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