Body image is understudied in aging women. The present perspective article reviews body image, body composition, and aging in women. Sarcopenia, a condition of low muscle mass, is associated with aging, and sarcopenia in combination with excessive body fat causes sarcopenic obesity. Findings of improved health in people with a higher body mass index, known as the obesity paradox, are due to misclassifying healthy people as overweight according to height and body weight instead of according to fat mass and fat-free mass. Body fat infiltrates internal organs in aging adults as increasing levels of body fat are redistributed into the trunk, especially in the abdomen, while subcutaneous fat in the appendages decreases. Accuracy of body image perceptions can determine an individual’s control of body weight. Aging women can protect against sarcopenic obesity by increasing fat-free mass with resistance training and by lowering body fat levels with weight management knowledge and skills. Healthy dietary patterns are low in ultra-processed foods that stimulate excessive consumption of calories and increase body fat levels. In combination with the phosphate additives in ultra-processed food which increase sarcopenia and aging, the present article proposes an etiological pathway in which ultra-processed food consumption eventually leads to aging-related sarcopenic obesity.
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