Physical Activity and Mental Health in Children and Adolescents with Overweight and Obesity: Mechanisms and Effects on Depressive and Anxiety Symptoms -Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.54.70718Keywords
physical activity, obesity, overweight, children, adolescents, depression, anxiety, mental healthAbstract
Background: Childhood obesity is associated with an increased risk of anxiety and depressive symptoms, representing a growing global mental health concern.
Aim: The aim of this review was to examine the impact of physical activity on anxiety and depressive symptoms in children and adolescents with overweight or obesity, with particular emphasis on underlying neurobiological, psychosocial, and behavioral mechanisms.
Material and methods: This narrative review synthesizes current evidence on the effects of physical activity on mental health outcomes in children and adolescents with overweight or obesity. A literature search was conducted using PubMed, Scopus, and Web of Science, including studies published between January 2015 and January 2026. Both observational and interventional studies, including randomized controlled trials, systematic reviews, and meta-analyses, were considered. Findings were synthesized narratively.
Results: Available evidence indicates that physical activity is associated with small-to-moderate reductions in depressive and anxiety symptoms in youth, with more consistent effects observed for depression. These benefits are mediated through multiple neurobiological, psychosocial, and behavioral pathways. Intervention effectiveness appears to depend on factors such as duration, intensity, supervision, and the inclusion of psychosocial components. However, substantial heterogeneity across studies and limited long-term data remain important limitations.
Conclusions: Physical activity represents a promising, accessible, and cost-effective strategy for improving mental health outcomes in children and adolescents with overweight or obesity. To maximize benefits, interventions should be structured, inclusive, and supported by behavioral and motivational strategies. Further research is needed to optimize intervention design and clarify causal mechanisms.
References
1. World Health Organization. Obesity and overweight [Internet]. Geneva: WHO; 2025 [cited 2026 Apr 8]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. United Nations Children’s Fund (UNICEF). Feeding profit: how food environments are failing children. Child Nutrition Report 2025 [Internet]. New York: UNICEF; 2025 [cited 2026 Apr 8]. Available from: https://www.unicef.org/reports/feeding-profit
3. Lindberg L, Hagman E, Danielsson P, Marcus C, Persson M. Anxiety and depression in children with obesity: a nationwide study in Sweden. BMC Med. 2020;18:30. https://doi.org/10.1186/s12916-020-1498-z
4. Wang S, Sun Q, Zhai L, Bai Y, Wei W, Jia L. Prevalence of depression and anxiety in Chinese children: a systematic review and meta-analysis. Int J Environ Res Public Health. 2019;16(3):340. https://doi.org/10.3390/ijerph16030340
5. Zhyrov V, Gorman A, Walker RA, et al. The relationships between body weight, appetite, depression, and anxiety: Findings from the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Health Psychology Open. 2025;12 . https://doi.org/10.1177/20551029251359056
6. Miller AH. Beyond depression: the expanding role of inflammation in psychiatric disorders. World Psychiatry. 2020;19(1):108–109. https://doi.org/10.1002/wps.20723
7. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: Inflammation and the pathogenesis of depression. Trends Immunol. 2006;27(1):24–31. https://doi.org/10.1016/j.it.2005.11.006
8.Udina M, Moreno-España J, Capuron L, Navinés R, Farré M, Vieta E, Martín-Santos R. Cytokine-induced depression: current status and novel targets for depression therapy. CNS Neurol Disord Drug Targets. 2014;13(6):1066–1074. https://doi.org/10.2174/1871527313666140612121921
9. Warnick JL, Darling KE, West CE, Jones L, Jelalian E. Weight stigma and mental health in youth: a systematic review and meta-analysis. J Pediatr Psychol. 2022;47(3):237–255. doi:10.1093/jpepsy/jsab110. https://doi.org/10.1093/jpepsy/jsab110
10. Pont SJ, Puhl R, Cook SR, Slusser W; Section on Obesity, The Obesity Society. Stigma experienced by children and adolescents with obesity. Pediatrics. 2017;140(6):e20173034. doi:10.1542/peds.2017-3034. https://doi.org/10.1542/peds.2017-3034
Echeverri-Alvarado B, Pickett S, Gildner D. A model of post-traumatic stress symptoms on binge eating through emotion regulation difficulties and emotional eating. Appetite. 2020;150:104659. doi:10.1016/j.appet.2020.104659. https://doi.org/10.1016/j.appet.2020.104659
11. Albardan L and Platat C (2025) A holistic exploration of the psychosocial, environmental, neurobiological, and individual factors influencing children’s food choices: a narrative review. Front. Nutr. 12:1645293. doi: 10.3389/fnut.2025.1645293. https://doi.org/10.3389/fnut.2025.1645293
12.Lubans DR, Richards J, Hillman CH, Faulkner G, Beauchamp MR, Nilsson M, et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics. 2016;138(3):e20161642. https://doi.org/10.1542/peds.2016-1642
13. Meeusen R, De Meirleir K. Exercise and brain neurotransmission. Sports Med. 1995;20(3):160–188. https://doi.org/10.2165/00007256-199520030-00004
14. Banks WA. Leptin and the blood–brain barrier: curiosities and controversies. Compr Physiol. 2021;11(4):2351–2369. doi:10.1002/j.2040-4603.2021.tb00183.x. https://doi.org/10.1002/j.2040-4603.2021.tb00183.x
Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res. 2015;60:56–64. https://doi.org/10.1016/j.jpsychires.2014.10.003
15. Rimmele U, Seiler R, Marti B, Wirtz PH, Ehlert U, Heinrichs M. The level of physical activity affects adrenal and cardiovascular reactivity to psychosocial stress. Psychoneuroendocrinology. 2009;34(2):190–198. https://doi.org/10.1016/j.psyneuen.2008.08.023
16. Joisten N, Wenning M, Zimmer P, et al. Physical activity, inflammation, and mental health. Front Psychiatry. 2020;11:163. doi:10.3389/fpsyt.2020.00163. https://doi.org/10.3389/fpsyt.2020.00163
17. Biddle SJH, Ciaccioni S, Thomas G, Vergeer I. Physical activity and mental health in children and adolescents: an updated review. Ment Health Phys Act. 2019;16:100303. https://doi.org/10.1016/j.psychsport.2018.08.011
18. Eime, R.M., Young, J.A., Harvey, J.T. et al. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. Int J Behav Nutr Phys Act 10, 98 (2013). https://doi.org/10.1186/1479-5868-10-98
19. Homan KJ, Tylka TL. Exercise, body image, and self-esteem. Body Image. 2022;41:211–220. https://doi.org/10.1016/j.bodyim.2014.01.003
20. Crichton M, Vu J, Fenesi B. Physical activity participation among children and youth with mental health symptoms: clinician perspectives. Children (Basel). 2024;11(7):880. https://doi.org/10.3390/children11070880
21. Yan H, Xin G, Chen R. Effects of exercise interventions on sleep quality in adolescents: a systematic review and meta-analysis. Front Public Health. 2025;13:1623506. doi:10.3389/fpubh.2025.1623506. https://doi.org/10.3389/fpubh.2025.1623506
22. Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: evidence from a population-based study. Prev Med Rep. 2018;12:271–283. doi:10.1016/j.pmedr.2018.10.003. https://doi.org/10.1016/j.pmedr.2018.10.003
23. Stiglic N, Viner RM. Effects of screen time on health and well-being in children and adolescents: a systematic review. JAMA Pediatr. 2019;173(9):885–894. https://doi.org/10.1136/bmjopen-2018-023191
24. Jacobson NS, Martell CR, Dimidjian S. Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol Sci Pract. 2001;8(3):255–270. doi:10.1093/clipsy.8.3.255. https://doi.org/10.1093/clipsy.8.3.255
25. Singh B, et al. Effectiveness of physical activity interventions for improving depression and anxiety in children and adolescents: a systematic umbrella review. Br J Sports Med. 2023;57(18):1203–1212. https://doi.org/10.1136/bjsports-2022-106195
26. Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019;107:525–539. doi:10.1016/j.neubiorev.2019.09.040.. https://doi.org/10.1016/j.neubiorev.2019.09.040
28. Oberste M, Medele M, Javelle F, et al. Physical activity for the treatment of adolescent depression: a systematic review and meta-analysis. Front Physiol. 2023;14:1132514. https://doi.org/10.3389/fphys.2020.00185
29. Logan NE, Ward-Ritacco CL. The developing brain: considering the multifactorial effects of obesity, physical activity and mental wellbeing in childhood and adolescence. Children (Basel). 2022;9(12):1802. doi:10.3390/children9121802. https://doi.org/10.3390/children9121802
30. Pedersen, B.K. Physical activity and muscle–brain crosstalk. Nat Rev Endocrinol 15, 383–392 (2019). https://doi.org/10.1038/s41574-019-0174-x. https://doi.org/10.1038/s41574-019-0174-x
31. Andrade G, et al. Exercise and anxiety in adolescents: a cross-sectional analysis. Front Pediatr. 2025;13:1494998. https://doi.org/10.3389/fped.2025.1494998
32. Stonerock GL, Hoffman BM, Smith PJ, Blumenthal JA. Exercise as treatment for anxiety: systematic review and analysis. Ann Behav Med. 2015;49(4):542–556. doi:10.1007/s12160-014-9685-9. https://doi.org/10.1007/s12160-014-9685-9
33. Matei D, Trofin D, Iordan DA, Onu I, Condurache I, Ionite C, Buculei I. The endocannabinoid system and physical exercise. Int J Mol Sci. 2023;24(3):1989. doi:10.3390/ijms24031989. https://doi.org/10.3390/ijms24031989
Eime RM, et al. Health benefits of sport participation: an update. BMC Public Health. 2020;20:488. https://doi.org/10.1186/1479-5868-10-98
34. Men J, Zhang Y, Wu S, Wang P, Yu Z, Zhu G, Wang J, An W, Li Z, Liu P. Does physical activity really improve anxiety and depression in overweight or obese children and adolescents? A systematic review and meta-analysis. BMC Psychiatry. 2026;26. https://doi.org/10.1186/s12888-025-07761-9
35. Eime RM, et al. Health benefits of sport participation: an update. BMC Public Health. 2020;20:488. https://doi.org/10.1186/1479-5868-10-98
36. Men J, Zhang Y, Wu S, Wang P, Yu Z, Zhu G, Wang J, An W, Li Z, Liu P. Does physical activity really improve anxiety and depression in overweight or obese children and adolescents? A systematic review and meta-analysis. BMC Psychiatry. 2026;26. https://doi.org/10.1186/s12888-025-07761-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Agata Wyborska , Zuzanna Oćwieja, Karolina Fengler , Olga Jakubowska, Dominika Kominiak, Marcel Gascon Carreno, Mikołaj Mińkowski, Kamila Pietrzak, Agata Urbanik, Katarzyna Solecka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 5
Number of citations: 0
