Sarcopenia is a progressive and generalised disorder of skeletal muscle strength, function, and mass that is most commonly associated with the normal ageing process although is increasingly recognised in inflammatory bowel disease and liver disease. In this edition, Hollingworth and colleagues discuss the recent advances and practical management. Sarcopenia is common but poorly recognised by clinicians. Pathogenesis is multifactorial and sarcopenic obesity well described. The authors discuss sarcopenic obesity, cachexia, and frailty as clinically distinct but overlapping conditions. The SARC-F (see table 2 in the paper linked below) is a useful screen for symptomatic sarcopenia assessing strength, difficulties with mobility (rise from a chair, climbing stairs), and number of falls in the last year. Diagnosis is by grip strength, dual energy X-ray absorptiometry, gait speed, and CT measurement of muscle mass. Treatment is nutritional intervention (particularly protein intake), and by resistance exercise programmes. There are no proven pharmacological treatments although treatment of underlying conditions is important. There is much ongoing research in this area but in summary, better recognition and management is likely to improve outcomes for patients with underlying gut and liver disease.