The efficacy of physical exercise on body mass index in schizophrenia patients: A systematic review and meta-analysis on exercise prescription, intensity, and delivery.

In 30 seconds

This systematic review and random-effects meta-analysis assessed randomised controlled trials of physical exercise and BMI in people with schizophrenia, including whether exercise type, delivery, intensity, and duration influenced outcomes. Nine trials involving 356 participants were included. Exercise was associated with a statistically significant, small-to-moderate reduction in BMI. Subgroup analyses found significant effects for aerobic exercise, moderate-to-vigorous intensity, interventions lasting ≥20 weeks, and individual delivery; anaerobic and concurrent training showed no clear effect. Group-based programmes had descriptively lower dropout rates, although their BMI effects were less pronounced.

Key findings

• Across nine trials with 356 participants, physical exercise produced a statistically significant, small-to-moderate reduction in BMI.
• Aerobic exercise showed a significant BMI effect; anaerobic and concurrent training did not show a clear effect.
• Moderate-to-vigorous intensity and interventions lasting ≥20 weeks appeared to significantly influence BMI.
• Individual delivery showed statistical efficacy, while group formats had descriptively lower dropout rates.

Why it matters

People with schizophrenia have elevated rates of overweight and obesity, which contribute to cardiometabolic disease and premature death. This synthesis suggests that exercise can reduce BMI in this population and identifies programme features associated with stronger effects. The findings also highlight a potential trade-off between individual delivery and the apparently better feasibility of group formats.

What to keep in mind

The evidence comes from nine trials with 356 participants, and subgroup findings may be based on limited data. The abstract provides no pooled effect estimate or details on follow-up.