The impact of physical activity interventions on body composition and quality of life in adolescents with anorexia nervosa: a meta-analysis of randomized controlled trials.

Objective: This study systematically evaluated the effects of exercise interventions on adolescents diagnosed with anorexia nervosa (AN), focusing on key outcomes such as body composition, skeletal muscle metrics, and quality of life. Additionally, this study aimed to identify the most effective intervention protocol.

Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Embase, Scopus, the Cochrane Library, the China Biomedical Literature Database, CNKI, the Wanfang Database, and the VIP Database. Eligible studies included randomized controlled trials (RCTs) examining the impact of exercise interventions on adolescents with AN. Meta-analyses and systematic reviews were performed via RevMan 5.4 and Stata 15 software.

Results: A total of seven RCTs involving 211 adolescent patients were included. Compared with the control interventions, exercise interventions did not significantly affect body mass index (BMI), fat mass, or lean body mass compared to control groups (all P > 0.05). However, significant improvements were observed in weight, thigh muscle circumference, mid-thigh skinfold thickness, and overall quality of life (as measured by the SF-36 scale) (all P < 0.05). Subgroup analysis revealed that an 8-week exercise program, with three sessions per week lasting approximately 50 min each, significantly improved body weight (P < 0.05). Variations in frequency, duration, or intervention period did not significantly affect BMI (all P > 0.05). Notably, combining aerobic and anaerobic exercise had a significant effect on BMI (P < 0.05), although no significant improvements were found in the 10 subdimensions of the SF-36 quality of life scale (all P > 0.05).

Conclusion: Exercise interventions benefit adolescents with AN, particularly by supporting weight recovery, increasing thigh muscle circumference, improving skinfold thickness, and enhancing quality of life. An 8-week programme combining aerobic and anaerobic exercise (three sessions per week, 50 min per session) significantly promoted weight recovery and improved BMI. These findings underscore the importance of personalized exercise interventions to optimize body composition, skeletal muscle health, and quality of life in adolescents with AN.