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Background The purpose of this study was to examine the effectiveness of a six months' physical activity programme for overweight and obese adolescents, in order to improve the perception of their own body image and composition between two groups of adolescents, and to check possible gender differences. Aims The aim is to improve the body perception and composition in overweight adolescents with a physical activity programme. Methods It was a quasi-experimental design, with a control group and intervention group. Measures of pre-test and post-test were taken. A total of 38 adolescents that belong to the first cycle of Compulsory Secondary aged 12–15, with a body mass index (BMI) higher than the 85th percentile according to the WHO (World Health Organization), participated in the intervention. The anthropometric variables, height, weight, BMI, body fat percentage, and the circumference of the waist, hip, arm and medial calf, were measured pre- and post-treatment. The body image perception was measured using the Gardner test. The experimental group participated in the physical activity programme for a six months period. The physical activity intervention consisted of three sessions of 90 minutes each week in a sports centre. The structure of the sessions consisted of a warm-up (5–10 minutes), a main activity (60–70 minutes), combineding strength and cardiovascular training and a cool-down (7–10 minutes). Results After physical activity intervention the results showed significant improvements in the experimental group compared to the control group in the circumference of the waist, the hip, the arm, the medial calf (p