Optimal Dose and Modality of Exercise for Reducing Visceral Adipose Tissue in Individuals with Overweight or Obesity: A Systematic Review and Dose–Response Network Meta‐Analysis

BACKGROUND: The aim of this study is to evaluate the comparative efficacy of exercise modalities and doses for reducing visceral adipose tissue (VAT) in individuals with overweight or obesity. Six databases (PubMed, Embase, Web of Science, Scopus, Cochrane Library, and EBSCO) were searched through October 2025, with supplementary searching on August 18, 2026. Two reviewers independently assessed study quality. Randomized controlled trials were synthesized using random-effects pairwise, network, and dose-response meta-analyses. RESULTS: , respectively; 58.4% were female. Network meta-analysis showed the largest estimated effects versus controls for vigorous aerobic exercise (AE [V]; SMD -0.73, 95% CI -0.96 to -0.51) and high-intensity interval training (HIIT; SMD -0.73, 95% CI -0.94 to -0.53). These were followed by combined exercise (CBE; SMD -0.61, 95% CI -0.81 to -0.41), moderate to vigorous intensity aerobic exercise (AE [MV]; SMD -0.53, 95% CI -0.67 to -0.39), and resistance training (RT; SMD -0.50, 95% CI -0.72 to -0.28). Total exercise dose showed a U-shaped relationship with VAT improvement; the fitted 95% credible interval was below zero at approximately 99-1225 MET-min/week. The model-estimated dose threshold for achieving the Substantial Clinical Benefit Threshold (SCBT; -0.89) was approximately 440 MET-min/week. CONCLUSION: Exercise reduces VAT, with AE (V) and HIIT yielding the largest estimated effects versus controls. Approximately 750 MET-min/week appears to yield the greatest model-predicted reduction. Research should refine dose-specific effects on VAT and body composition to support personalized prescriptions.