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Life sciences · Journal article
Frontiers in Public Health · October 9, 2026
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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.