Physical activity in the treatment of childhood overweight and obesity: current evidence and research issues

Purpose: This paper reviews the utility of exercise as a treatment for overweight and obese children and adolescents. Methods: Computer database searches identified 13 studies that met the following criteria for inclusion: 1) obese children or adolescents were provided either different types of exercise programs or an exercise progam compared with a no-exercise control: 2) subjects were randomly assigned to groups or assigned by matching on demographic and anthropometric variables, and 3) the exercise program was at least 2 months in duration. Results: The only area in which there were a sufficient number of studies to make a quantitative analysis was the comparison of diet versus diet plus exercise programs, which suggested that exercise adds to the effect of diet in the short-term treatment of pediatric obesity. There was not enough research to evaluate the effects of exercise alone. The majority of findings indicate fitness changes are greater for subjects provided exercise alone or exercise combined with diet in comparison with subjects provided no exercise (control) or diet alone. Conclusions: Research on effects of exercise or physical activity in pediatric obesity treatments are encouraging and may be important for improving treatment outcome for obesity and comorbid conditions. Recommendations for future research are presented.