Effects of Physical Activity-Based Digital Health Interventions on Psychological Outcomes in Overweight and Obese Adolescents: A Systematic Review and Meta-Analysis

Background The morbidity of adolescent overweight and obesity has escalated into a pressing global epidemic, adversely impacting physical health and contributing to a spectrum of psycho-logical issues. It is crucial to identify effective intervention strategies aimed at enhancing the mental health of these adolescents. As digital behavior technology develops, physical activity (PA)-based digital health (DH) has gained attention as a promising approach due to its convenience and accessibility.Purpose Existing data concerning the efficacy of this intervention in addressing mental health issues among overweight and obese adolescents present inconsistent findings. This study systematically evaluated the effects of PA-based DH interventions on the psychological status of over-weight and obese adolescents, aiming to provide health and physical educators with actionable insights to inform intervention design and program planning.Methods The review, registered on PROSPERO, included comprehensive searches for Embase, PubMed, Web of Science, and the Cochrane Library to locate eligible randomized controlled trials (RCTs) and quasi-experimental studies aimed at assessing how PA-based DH influence psychological outcomes among overweight and obese adolescents. The Cochrane ROB-2 tool was utilized for evaluating the risk of bias. Seventeen studies satisfying all inclusion criteria were identified. Data were construed through the random effects model (REM) via the Review Manager software.Results The meta-analysis includes 17 studies involving 970 participants. PA-based DH interventions targeting psychological well-being significantly improved self-efficacy (SMD = 0.44, 95% CI [0.11, 0.77], p = .009), depression (SMD = -0.47, 95% CI [−0.87, −0.06], p = .02), and psychosocial outcomes (SMD = 0.60, 95% CI [0.06, 1.14], p = .03). However, no significant effects were observed on self-esteem (SMD = 0.46, 95% CI [−0.02, 0.94], p = .06), quality of life (QOF, SMD = 0.34, 95% CI [−0.11, 0.79], p = .14), and stress (SMD = -0.16, 95% CI [−0.49, 0.18], p = .36).Discussion PA-based DH demonstrates effectiveness in enhancing self-efficacy, reducing depression, and improving psychosocial outcomes for overweight or obese adolescents. However, its effects on self-esteem, QOF, and stress levels are still inconclusive and need indepth investigation. Greater focus should be placed on the design of DH programs, including intervention cycles, frequencies, session duration, dose effects, and long-standing interventions, aimed at optimizing the design and effectiveness of future interventions.Translation to Health Education Practice Health education specialists should consider PA-based DH interventions as an effective strategy for improving psychological outcomes in overweight and obese adolescents. The findings support their role in assessment, program planning, and advocacy for scalable, technology-enhanced health promotion initiatives.