Background The rising prevalence of overweight and obesity among university students constitutes a pressing public health concern; however, the differential effectiveness of various exercise interventions on body composition remains insufficiently characterized. Methods This network meta-analysis aimed to evaluate the effects of four exercise modalities—high-intensity interval training (HIIT), resistance exercise (RE), aerobic exercise (AE), and combined aerobic-resistance exercise (AE+RE)—on adiposity-related outcomes in overweight and obese university students. The primary outcomes assessed included body mass index (BMI), body fat percentage (BFP), body weight (BW), hip circumference (HC), waist circumference (WC), and body fat mass (BFM). We systematically searched the Data Knowledge Service Platform to identify randomized controlled trials (RCTs) published up to July 1, 2025. Data on study characteristics, intervention details, and outcome measures were extracted, and statistical analyses were performed using RevMan 5.3 and Stata 16 software. A total of 39 RCTs involving 2,585 participants were included in the final analysis. Results Compared with the control group, AE+RE emerged as the most effective intervention for improving BMI, BW, and BFM (mean difference (MD) = 2.57 , 95% confidence interval (CI) 1.82–3.32, P < 0.001). Aerobic exercise was found to be most effective for reducing WC (MD = 8.44 , 95% CI 1.16–15.72, P < 0.001), while RE demonstrated superior efficacy in decreasing HC (MD = 4.78, 95% CI 1.97–7.59, P = 0.0009). HIIT yielded the greatest improvements in BFP (MD = 4.05, 95% CI 1.05–7.05, P = 0.008). Conclusions These findings address the existing gap in knowledge regarding exercise efficacy for overweight and obese university students and provide a scientific foundation for the development of personalized public health strategies.
Lv et al. (Mon,) studied this question.