Effects of Aerobic Exercise-Based Interventions on Physical and Mental Health in Overweight and Obese Children and Adolescents: A Three-Level Meta-Analysis.

In 30 seconds

This three-level meta-analysis synthesized 39 controlled trials involving 3,446 children and adolescents aged 6–18 years with overweight or obesity. The trials evaluated aerobic exercise-based programs, including a small number that also incorporated dietary modification. Overall, these programs were associated with improvements in weight, waist circumference, BMI-related measures, body fat percentage, and peak oxygen uptake. No significant effects were found for blood pressure or glycolipid markers. Mental health evidence was limited: depression showed a small, non-robust reduction, while findings for self-esteem were inconclusive.

Key findings

• Across 39 studies (n = 3,446), aerobic exercise-based programs were associated with improvements in weight, waist circumference, BMI-related indicators, and body fat%.
• Peak oxygen uptake (VO 2 peak) increased, indicating improved cardiorespiratory fitness.
• No significant effects were observed for blood pressure or glycolipid metabolic markers.
• Depression showed a small pooled reduction that was not robust; evidence on self-esteem was sparse and inconclusive.

Why it matters

The findings suggest that programs including aerobic exercise may improve body composition and cardiorespiratory fitness in young people with overweight or obesity. However, the pooled results do not isolate exercise from dietary modification in all trials, and evidence for metabolic and mental health outcomes is limited. Substantial heterogeneity and low overall certainty mean the results should inform, rather than settle, expectations about benefits.

What to keep in mind

Substantial heterogeneity and low certainty of evidence limit confidence. Some included programs combined exercise with dietary modification, so pooled effects cannot be attributed to aerobic exercise alone; mental health evidence was limited.