Physical Activity and Mental Health in Children and Adolescents with Overweight and Obesity: Mechanisms and Effects on Depressive and Anxiety Symptoms -Narrative Review

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.