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Aerobic exercise programs improve anthropometric outcomes and cardiorespiratory fitness in children with obesityAerobic exercise improves body composition in children with obesity

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Key Takeaway
Consider aerobic exercise-based programs to improve anthropometric outcomes and cardiorespiratory fitness in children with obesity.

This meta-analysis evaluated the impact of aerobic exercise-based interventions, including exercise-only and multicomponent programs with dietary modifications, on children and adolescents with overweight or obesity. The analysis included a total sample size of 3446 participants. The primary outcomes of interest were anthropometric and body-composition measures, including weight, waist circumference, BMI-related indicators, and body fat percentage.

The authors synthesized findings showing improvements in anthropometric and body-composition outcomes and an increase in cardiorespiratory fitness (peak oxygen uptake). Regarding secondary outcomes, the study reported a small pooled reduction in depression, while effects on blood pressure and glycolipid metabolic markers were not significant. Data regarding self-esteem were described as sparse and inconclusive.

Several limitations were noted, including substantial heterogeneity and an overall low certainty of evidence. Specifically, the evidence for mental health outcomes was limited, and the finding for depression was not robust. Due to the low certainty of evidence and the heterogeneity of the included studies, these findings should be interpreted with caution in clinical practice.

How this fits prior evidence

This meta-analysis addresses a gap in pediatric weight management by evaluating aerobic exercise-based interventions for children and adolescents. While previous evidence noted that pediatric excess weight is associated with impaired cardiac autonomic modulation, this study provides evidence that aerobic exercise improves cardiorespiratory fitness and anthropometric outcomes in this population. The findings regarding depression are not robust and should be interpreted cautiously.

Finding ways to help children and adolescents manage weight is a major priority for families and doctors. New data from a large review of 3,446 children and teens shows that aerobic exercise programs—which can include just exercise or a mix of exercise and diet—lead to improvements in body composition. These improvements include changes in weight, waist circumference, and body fat percentage.

Beyond weight, the study found that these programs increased cardiorespiratory fitness, which is the body's ability to use oxygen during physical activity. While the data showed a small reduction in depression scores, the evidence for mental health was not very strong. Other markers, like blood pressure and certain blood fats, did not show significant changes.

It is important to note that the evidence for these findings is not very certain because the studies involved were quite different from one another. Additionally, the results for self-esteem were unclear. Because these findings come from a broad collection of studies, talk to a doctor to determine the best exercise plan for a child's specific needs.

What this means for you:
Aerobic exercise programs help children and teens with obesity improve body composition and fitness levels.

Common questions

What specific physical benefits did children see from aerobic exercise?

Children and adolescents in the study showed improvements in body composition, including weight, waist circumference, and body fat percentage. They also showed an increase in cardiorespiratory fitness, which is the body's ability to use oxygen during exercise. These results were seen in programs that used only aerobic exercise or a combination of exercise and diet.

Does aerobic exercise help with mental health in children with obesity?

The study found a small reduction in depression scores for the children involved. However, the evidence for this finding was not robust. Results regarding self-esteem were sparse and inconclusive, meaning the data was not strong enough to draw a firm conclusion about how exercise affects a child's self-esteem.

How certain are these results for children and teens?

The overall certainty of the evidence is low because the studies included were very different from one another. While the improvements in body composition and fitness were noted, the findings should be interpreted cautiously. You should speak with a healthcare provider to create a safe and effective plan for a child.

Study Details

Study typeMeta analysis
Sample sizen = 3,446
EvidenceLevel 1
Follow-up216.0 mo
PublishedNov 2026
View Original Abstract ↓
This review used a three-level meta-analysis to synthesize evidence from controlled trials on aerobic exercise-based interventions in overweight/obese children and adolescents (6-18 years). Databases were searched from inception to December 31, 2025, and 39 studies (n = 3,446) were included. The included interventions comprised exercise only programs and a small number of multicomponent programs combining aerobic exercise with dietary modification. Overall, aerobic exercise-based interventions were associated with improvements in anthropometric and body-composition outcomes, including reductions in weight, waist circumference, body mass index-related indicators, and body fat%, as well as increased cardiorespiratory fitness, as reflected by peak oxygen uptake (VOpeak). However, because diet-plus-exercise trials were included in the primary synthesis, these pooled estimates should be interpreted as effects of intervention programs including aerobic exercise rather than as effects of aerobic exercise alone. No significant effects were observed for blood pressure or glycolipid metabolic markers. Evidence for mental health outcomes was limited: depression showed a small pooled reduction, but this finding was not robust and should be interpreted cautiously, whereas evidence for self-esteem was sparse and inconclusive. Given substantial heterogeneity and overall low certainty of evidence, these findings should be interpreted cautiously and well-designed studies with standardized reporting and longer follow-up are needed.
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