Although the etiology of osteosarcopenic obesity can only be hypothesized at this time, Fig. 2 illustrates potential mechanisms leading to progressive losses of bone and muscle mass and an increase in adipose tissue. Regardless of the initiating metabolic abnormalities, an increase in total and/or abdominal adipose tissue causes an increase in pro-inflammatory cytokines, as well as some hormonal disturbances leading to losses of both muscle and bone tissues through a variety of mechanisms which ultimately affects clinical outcomes such as increase in risk for falls and fractures and potentially a variety of other problems (discussed below). The decreases in muscle and bone are associated with decreases in physical activity; once losses hit a threshold, physical activity becomes even more limited, leading to a vicious cycle of progressive loss of muscle and bone and gain in fat, of unveiled complexity (Fig. 2).