Among adolescents with obesity and type 2 diabetes who exercise for at least 3 hours per week, more exercise appears to be associated with fewer symptoms of depression, according to research presented at the European Academy of Paediatrics (EAP) 2025.

Michael Yafi, MD, a pediatric endocrinologist with UTHealth Houston, Houston, collaborated with Mona A. Eissa, MD, MPH, PhD, director of Adolescent Medicine Division at McGovern Medical School at UTHealth Houston, and colleagues to retrospectively review the charts of approximately 200 patients with obesity who were seen at a pediatric weight management clinic between 2018 and 2021.

The patients were 12-18 years old and reported how much physical activity they got per week. To assess symptoms of depression, the researchers looked at scores on a depression screening tool, the Patient Health Questionnaire-9 (PHQ-9).

In a regression analysis that accounted for whether patients had types 2 diabetes or psychiatric diagnoses, every additional minute of exercise decreased total PHQ-9 score by 0.006 (P < .05).

In another analysis that focused on patients with type 2 diabetes who were physically active at least 3 hours per week, there appeared to be a moderate negative correlation between PHQ-9 scores and minutes of exercise per week (correlation coefficient = -0.54; P = .057). This relationship was not apparent in patients who did not have type 2 diabetes, however.

The relatively small sample size was a limitation of the study, Yafi acknowledged.

Future studies could examine the effects of different types of physical activity, he said.

“In our patient population, any kind of reported exercise is a positive thing.” 

Multiple Pathways

“The results are consistent with a growing body of evidence showing that regular physical activity is associated with reductions in depressive symptoms among adolescents, including those with type 2 diabetes and obesity,” said Ben Singh, PhD, with the University of South Australia, Adelaide, Australia, who has studied how exercise influences symptoms of depression and anxiety in children and adolescents.

Exercise can support mood regulation by improving insulin sensitivity, reducing inflammation, and enhancing neurochemical balance through the release of endorphins and endocannabinoids, Singh said.

“Even modest, regular activity can have meaningful psychological effects, especially when exercise is presented as enjoyable, social, and achievable rather than prescriptive,” he said.

“From a clinical perspective, these findings reinforce the importance of promoting physical activity as a key part of comprehensive care for young people with metabolic and mental health challenges,” commented Jean-Philippe Chaput, PhD, with the University of Ottawa, Ottawa, Ontario, Canada, and a senior scientist with the Healthy Active Living and Obesity Research Group.

Yafi, Singh, and Chaput had no relevant financial disclosures.