Review Quality Rating: 9 (strong) - View Quality Assessment Citation: Kelley GA, & Kelley KS. (2013). Effects of exercise in the treatment of overweight and obese children and adolescents: A systematic review of meta-analyses. Journal of Obesity, 2013, 783103. Abstract PURPOSE: Conduct a systematic review of previous meta-analyses addressing the effects of exercise in the treatment of overweight and obese children and adolescents. METHODS: Previous meta-analyses of randomized controlled exercise trials that assessed adiposity in overweight and obese children and adolescents were included by searching nine electronic databases and cross-referencing from retrieved studies. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. The alpha level for statistical significance was set at P < 0.05. RESULTS: Of the 308 studies reviewed, two aggregate data meta-analyses representing 14 and 17 studies and 481 and 701 boys and girls met all eligibility criteria. Methodological quality was 64% and 73%. For both studies, statistically significant reductions in percent body fat were observed (P = 0.006 and P < 0.00001). The number-needed-to treat (NNT) was 4 and 3 with an estimated 24.5 and 31.5 million overweight and obese children in the world potentially benefitting, 2.8 and 3.6 million in the US. No other measures of adiposity (BMI-related measures, body weight, and central obesity) were statistically significant. CONCLUSIONS: Exercise is efficacious for reducing percent body fat in overweight and obese children and adolescents. Insufficient evidence exists to suggest that exercise reduces other measures of adiposity. Keywords: Adolescents, Body Composition, Community, Education, Awareness & Skill Development or Training, Grade School Aged, Health Care Setting, Home, Meta-analysis, Physical Activity, School, Youth Health