Influence of yoga on the epigenetics of obesity: a study on its short- and medium-term benefits in the treatment of patients with severe/morbid obesity eligible for bariatric surgery
In brief
Yoga was linked to lower noradrenaline before bariatric surgery
In this non-randomized study of 40 patients with severe obesity, those attending a 3-month yoga program had lower plasma noradrenaline than controls after adjustment for baseline levels. The study found no significant DNA methylation changes, and other apparent benefits did not hold up after adjustment; whether yoga caused the noradrenaline difference remains unknown.
- Journal
- Frontiers in public health (Q1)
- Published
- 9 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Carmela Asteria, Giorgia Scichilone, Rosanna Cardani, Dejan Lazarevic, Valentina Milani, Federico Ambrogi, et al.
- PMID
- 42920517
- DOI
- 10.3389/fpubh.2026.1858629
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (top studies of the week, 25 October 2026): Preoperative intervention studied in patients awaiting bariatric surgery
Abstract
BACKGROUND: Obesity is a growing global health problem characterised by chronic low-grade inflammation and epigenetic dysregulation. Epigenetic mechanisms-potentially reversible changes in gene expression occurring without alteration of the DNA sequence, most notably DNA methylation-are increasingly implicated in obesity-related inflammation. Yoga may act as complementary therapy. OBJECTIVE: To explore whether participation in a structured yoga program is associated with changes in DNA methylation of TNF-α, and with clinical, hormonal, metabolic and psychological parameters, in patients with severe obesity awaiting bariatric surgery. METHODS: In this prospective, non-randomised, controlled observational cohort study, 40 patients were analysed (20 yoga, 20 control). The intervention group underwent 36 PRANA_it yoga sessions over the 3 months preceding surgery (mean attendance 26/36, 72.5%). DNA methylation was profiled using a targeted three-gene inflammatory panel (TNF-α, IL-6, CRP). Between-group differences were estimated by baseline-adjusted ANCOVA. RESULTS: Plasma noradrenaline was significantly lower in the yoga group at T1 after adjustment for baseline [adjusted difference -206.92, 95% CI (-349.62, -64.21), p = 0.0057]. SF-36 physical functioning differed between groups in the unadjusted change-score comparison (p = 0.0206) but not after baseline adjustment [-8.69, 95% CI (-21.74, 4.36), p = 0.185]. Circulating TNF-α protein changed significantly more in the yoga group in the unadjusted analysis (p = 0.0452), a finding with high variance. Vitamin D3 showed no significant adjusted difference at T1 (p = 0.879); the T2 difference was borderline (p = 0.064). DNA methylation of TNF-α, IL-6 and CRP showed no significant changes after correction for multiple comparisons. Psychological outcomes, a secondary domain, did not differ significantly between groups. CONCLUSION: In patients with severe obesity preparing for bariatric surgery, a structured preoperative yoga program was associated with a significant baseline-adjusted reduction in plasma noradrenaline, consistent with reduced sympathetic activation during a demanding phase of care. No epigenetic changes were detected, suggesting that measurable methylation remodelling may require longer exposure, larger samples, or tissue-specific sampling. These exploratory findings support yoga as a feasible, low-risk adjunct within bariatric prehabilitation, while the non-randomised design precludes causal inference. Adequately powered randomised trials with extended follow-up are needed to confirm this neuroendocrine signal.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.