Overweight and obesity are prevalent health concerns among postmenopausal women. However, the effects of aerobic exercise training on multidimensional body composition outcomes in postmenopausal women with overweight or obesity, as well as the potential dose–response relationship, remain unclear. This systematic review and meta-analysis followed PRISMA guidelines. PubMed, Cochrane Library, Web of Science, EBSCO, and ProQuest were searched from inception to March 8, 2026. Randomized controlled trials comparing aerobic exercise training with non-exercise control in postmenopausal women with overweight or obesity were included. Three-level meta-analyses were performed to account for dependent effect sizes. Restricted cubic spline models, subgroup analyses, and meta-regression were used to explore dose–response patterns and potential moderators. Sixteen RCTs involving 1,571 participants were included. Compared with non-exercise control, aerobic exercise training reduced body weight (MD = -2.17 kg, P < 0.01; low certainty), body mass index (MD = -0.73 kg/m 2 , P < 0.01; low certainty), body fat percentage (MD = -1.40%, P < 0.01; moderate certainty), fat mass (MD = -1.83 kg, P < 0.01; moderate certainty), waist circumference (MD = -2.02 cm, P < 0.01; moderate certainty), and hip circumference (MD = -1.39 cm, P = 0.04; low certainty). The pooled estimate for lean body mass was positive but imprecise (MD = 0.72 kg, P = 0.14; low certainty). Baseline age was inversely associated with changes in body weight and BMI. No clear non-linear dose–response association was observed between total aerobic exercise volume and pooled body composition effects, although some fitted curves suggested possible plateau-like patterns. Aerobic exercise training may improve several adiposity-related body composition outcomes in postmenopausal women with overweight or obesity, although the evidence for hip circumference and lean body mass remains less certain. Future trials should improve reporting of exercise dose, adherence, dietary control, and follow-up outcomes.
Liu et al. (Sat,) studied this question.