This article aims to systematically review the available evidence concerning the relationship between basal metabolism (BM), body composition (BC), and physical activity (PA) with central obesity. The search strategy was carried out using Web of Science, PubMed, Google Scholar, and SciELO following the PRISMA guidelines. The STROBE checklist and the Jadad scale for quality assessment were also used. A total of 1382 studies were initially identified being 25 publications eligible for systematic data extraction. Individual studies showed that adults with waist circumference (WC) above 88 cm in women and above 102 in men had a higher risk of metabolic alterations related to high absolute energy expenditure and less maximum oxygen consumption (VO2 max). Participants with central obesity presented a high percentage of body fat (BF%) between 30.6% and 41.6%. Most of the PA intervention studies reported reductions in WC between 1.3 and 5.8 cm. In conclusion, there is a direct relationship between the components of BM with central obesity and a direct association between central obesity and BF%. PA is a protective factor that needs to be promoted to reduce WC and control central obesity as a public health problem. PROSPERO ID registration: CRD42021232917.