BACKGROUND: Globally, the prevalence of overweight and obesity has dramatically increased in the recent years. In India, more than 10% of schoolchildren are overweight or obese. Schools play a major role in the modification of behavior. The aim of this study was to assess the effectiveness of after-school physical activity intervention on body mass index (BMI) and waist circumference/height ratio as primary outcomes. MATERIALS AND METHODS: A randomized controlled trial was adopted where the schools were randomized. Each group, ie, study and control groups, had 140 overweight adolescents. BMI and waist circumference/height ratio were measured. After-school physical activity intervention was carried out for a period of 9 months by the study group. The posttests were carried out at an interval of 3 months up till 9 months. RESULTS: There was a statistically significant difference in BMI between the study and control groups during the 6th and 9th months (t = 1.256, p < 0.001 and t = 0.920, p < 0.001), respectively. The repeated measures analysis of variance did not show a significant reduction in BMI and waist circumference/height ratio over a period of time. CONCLUSION: School-based physical activity interventions are effective in prevention of childhood overweight/obesity and are a very cost-effective measure that can be easily implemented in schools.

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