Introduction: The aim of this study was to compare the effectiveness of green tea supplementation, exercise training, and their combination on waist circumference and visceral fat in overweight and obese individuals using a network meta-analysis approach.

Methods: Randomized controlled trials investigating the effects of green tea supplementation, exercise training, or their combination on waist circumference and/or visceral fat in overweight or obese individuals were included. Methodological quality was assessed using the PEDro scale. A random-effects network meta-analysis was performed, and interventions were ranked using P-scores.

Results: A total of 38 studies involving 2,235 participants were included in the final analysis. The results demonstrated that all three interventions significantly reduced waist circumference compared with placebo. The greatest reduction in waist circumference was observed with the combined intervention of green tea supplementation and exercise training (p < 0.0001), whereas exercise training alone (p = 0.006) and green tea supplementation alone (p = 0.03) also produced significant improvements. Intervention ranking further confirmed the superiority of the combined intervention for reducing waist circumference. Regarding visceral fat, only green tea supplementation resulted in a significant reduction compared with placebo (p = 0.03) and achieved the highest efficacy ranking.

Conclusion: The findings of this network meta-analysis indicate that both green tea supplementation and exercise training are effective strategies for improving central obesity-related indices; however, their combination appears to be the most effective intervention for reducing waist circumference. Furthermore, green tea supplementation emerged as the most effective intervention for reducing visceral fat.