Objectives: To analyze the effects of physical exercise and nutritional guidance on body composition, physical fitness, lipid profile and insulin resistance among obese adolescents with and without metabolic syndrome. Methods: Sixty-four obese adolescents (26 boys), 10-16 years of age, were divided into two groups: with metabolic syndrome (n=29) and without metabolic syndrome (n=35). They were classified as having metabolic syndrome if they met three or more criteria for age and sex according to the Adult Treatment Panel III (ATP III). Blood pressure, waist circumference, maximum oxygen uptake (VO 2peak ), blood glucose, blood insulin, homeostatic model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and lipid profile were assessed at baseline and after 12 weeks of intervention. Both groups participated in 12 weeks of physical education and two nutritional guidance sessions. Each physical education session consisted of 50 min indoor cycling, 50 min of walking/running and 20 min of stretching, three times a week. Results:Fifty-five participants (with metabolic syndrome=25; without metabolic syndrome=30) completed the treatment. After 12 weeks, both groups showed reductions in body weight, BMI z-score, waist circumference, fat mass and triglycerides; and increases in height, HDL-C and VO 2peak (p<0.05). In addition, the group with metabolic syndrome presented reduced systolic blood pressure and increased insulin sensitivity (p<0.05). The risk factors for metabolic syndrome decreased by 72%. Conclusion: Following the multidisciplinary intervention, the risk factors decreased, with improvements in physical fitness and metabolic profile. The multidisciplinary intervention was effective in reducing metabolic syndrome.Key words: cardiovascular diseases; physical exercise; obesity. ResumoObjetivos: Analisar os efeitos de exercícios físicos (EF) e orientação nutricional (ON) sobre a composição corporal, aptidão física, perfil lipídico e resistência insulínica em adolescentes obesos com e sem síndrome metabólica (SM). Métodos: 64 obesos (26 meninos), com idade entre 10 a 16 anos, divididos em dois grupos: com SM (n=29) e sem SM (n=35). Utilizou-se como critério de classificação de SM a presença de três ou mais critérios para idade e sexo de acordo com Adult Treatment Panel III (ATP III). Mensuraram-se antes e após 12 semanas de intervenção: pressão arterial, circunferência abdominal, consumo máximo de oxigênio (VO2 pico ), glicemia, insulinemia, (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) e perfil lipídico. Os dois grupos participaram de 12 semanas de EF e duas sessões de ON. Cada sessão de EF consistiu em 50 minutos de ciclismo indoor, 50 minutos de caminhada e 20 minutos de alongamento, três vezes por semana. Resultados: 55 sujeitos (com SM=25; sem SM=30) completaram o tratamento. Após 12 semanas, houve diminuição na massa corporal, IMC escore-z, circunferência abdominal, massa gorda, TG e aumento na estatura, HDL-C e VO2 pico , em ambos os grupos. Além disso, hou...