ObjectiveTo systematically evaluate the effects of different exercise interventions on weight management, body composition, metabolic health, and physical function in overweight or obese adults under caloric restriction. MethodsA comprehensive search was conducted up to October 2024 in PubMed, Embase, Scopus, Web of Science, CNKI, and Cochrane Library databases. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was performed using RevMan 5.4 and Stata 14 software. ResultsA total of 60 randomized controlled trials (RCTs) involving 4 998 overweight/obese participants were included. The meta-analysis results indicated that, compared with the control group, aerobic exercise significantly reduced weight (MD=?3.94, 95%CI ?5.42 to ?2.46, P<0.05; BMI: MD=?1.32, 95%CI ?1.79 to ?0.84, P<0.05), and body fat percentage (MD =?1.41, 95%CI ?2.30 to ?0.52, P<0.05) in overweight/obese adults. For secondary outcomes, aerobic exercise significantly improved VO2max and decreased total cholesterol (CHO) and low-density lipoprotein (LDL), while the combination of aerobic and resistance exercise significantly reduced triglycerides (TG) and insulin resistance index. ConclusionExercise enhances weight loss, BMI reduction, body fat percentage reduction, and metabolic health improvement in conjunction with caloric restriction. Both aerobic and combined aerobic-resistance exercise interventions show beneficial multidimensional effects. However, some evidence remains uncertain, and future high-quality, long-term randomized controlled trials are needed to provide a solid foundation for personalized treatment plans.
