Background: Sarcopenic obesity, defined as the coexistence of excess adiposity and reduced muscle mass/function, is associated with impaired mobility, reduced quality of life, and increased metabolic risk. According to the updated EWGSOP2 guidelines, sarcopenia should be identified primarily through low muscle strength, confirmed by reduced muscle quantity or quality, and its coexistence with obesity further amplifies health risks. Objective: The aim of this study was to evaluate the impact of a multidisciplinary residential program (MRP) on risk factors of sarcopenic obesity in adults with obesity. Identifying strategies for this condition is therefore a growing clinical priority. Methods: A total of 61 obese patients (36 women, 25 men; mean age 60.0 ± 13.5 years; BMI ≥ 30 kg/m² with metabolic comorbidities) completed a two-month MRP consisting of personalized nutritional counseling, structured physical activity, and psychological support. Anthropometric variables, body composition, and biochemical markers were assessed before and after the intervention. Results: Participation in the MRP resulted in significant improvements in body composition and metabolic outcomes. Body weight (-6.4 kg), fat mass (-3.9 kg), visceral adipose tissue (-314 g), BMI (-2.45 kg/m²), and waist and hip circumferences were all significantly reduced (p < 0.001). Muscle function, assessed with the Short Physical Performance Battery (SPPB), significantly improved (+0.93 points, p < 0.001). Moreover, reductions were observed in fasting glycemia (-16.4 mg/dl), HbA1c (-0.81%), insulin (-2.77 mcU/ml), HOMA-IR, and lipid profile parameters: total cholesterol, LDL, and triglycerides. Although a modest decrease in lean mass was recorded (-0.8 kg), overall changes favored improved physical function. Patients lost weight and fat mass, with a slight loss of lean mass. They showed improved muscle function (SPPB) and metabolic profile (glucose, insulin, HbA1c, and lipids). Conclusions: These findings suggest that a structured, multidisciplinary residential approach can effectively improve body composition, metabolic health, and functional performance in obese patients at risk of sarcopenia, highlighting its value in clinical obesity management.